heather rice
@heatherrice
I implement and maintain commercial group health enrollment ensuring accuracy, compliance, and billing operations, with attention to detail.
United StatesWhat I'm looking for
At Blue Cross of Idaho, I managed commercial group implementation and resolved enrollment, eligibility, and billing discrepancies while maintaining HIPAA and operational accuracy.
I've reduced member abrasion by 25%, increased database accuracy by 15%, and helped automate complex enrollment changes to reduce workload by 20% using Salesforce, Facets, and MSSQL.
Previously, I strengthened broker and administrator data integrity at Dexian | DISYS and created AI-powered benefit-administration access and support that increased user engagement by 30%.
My customer experience work at Alorica included resolving billing disputes at a 90% initial resolution rate and validating sensitive member records with consistent 100% QA compliance scores.
Experience
Work history, roles, and key accomplishments
Enrollment & Billing Representative I
Blue Cross of Idaho
May 2023 - Feb 2026 (2 years 9 months)
Spearheaded implementation for multiple commercial group accounts, maintaining HIPAA and operational accuracy. Audited enrollment, eligibility, and billing discrepancies, reducing member abrasion by 25% and increasing database accuracy by 15%.
Operations Clerk - Contractor for BCI
Dexian | DISYS
Oct 2022 - May 2023 (7 months)
Developed data integrity by organizing and consolidating Broker and Administrator information in business CRM systems. Created digital AI-powered platform access for benefit administration, enhancing user engagement by 30% and preventing coverage gaps.
Customer Experience Specialist
Alorica Inc
Sep 2021 - Aug 2022 (11 months)
Evaluated billing disputes through strategic inquiry, achieving a 90% initial resolution rate. Leveraged LexisNexis AI to validate sensitive member records, maintaining privacy compliance and consistent 100% QA scores.
Education
Degrees, certifications, and relevant coursework
Westlake High School
High School Diploma, General Studies
Earned a high school diploma from Westlake High School in Saratoga Springs, Utah.
Salt Lake Community College
Certificate, Medical Device Manufacturing
Completed a certificate in Medical Device Manufacturing from Salt Lake Community College.
Tech stack
Software and tools used professionally
Availability
Location
United StatesAuthorized to work in
Salary expectations
Social media
Job categories
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