princetta terry
@princettaterry
Healthcare claims and benefits specialist with 6+ years in payer and telehealth operations.
United StatesWhat I'm looking for
I am a healthcare professional with over six years of hands-on experience in claims analysis, benefits administration, eligibility verification, prior authorization support, and member advocacy across payer and telehealth environments. I consistently maintain HIPAA and regulatory compliance while managing high-volume inbound calls, resolving complex claims, and achieving 95%+ quality assurance standards.
I have supported prior authorization workflows, coordinated patient assistance programs, authenticated provider claims, and reconciled billing and benefits issues. I bring strong communication skills, attention to documentation accuracy, and practical experience with Microsoft Excel, CRM systems, and web-based insurance verification platforms to improve operational efficiency and patient-centered service.
Experience
Work history, roles, and key accomplishments
Health Advocate
Blue Cross Blue Shield
Aug 2022 - Jan 2026 (3 years 5 months)
Handled 60+ inbound member calls daily to resolve complex claims and policy inquiries, maintained 95%+ QA standards, supported prior authorizations, and ensured HIPAA-compliant claims authentication.
Managed inbound claimant inquiries for short- and long-term disability benefits, ensured compliance with FMLA/COBRA/ERISA/HIPAA, processed benefit enrollments and invoices, and coordinated payroll deductions.
Member Service Representative
Teladoc
Oct 2016 - Jun 2019 (2 years 8 months)
Provided registration, scheduling, payments support and technical assistance on a high-volume doctor-on-call platform, reconciled billing tickets, and performed insurance eligibility verifications including Medicare and Aetna.
Education
Degrees, certifications, and relevant coursework
Cedar Valley College
Completed coursework, Business Management / Human Resources
Activities and societies: Payroll for Accounting at Dan Jefferson Co.; Volunteer nursing assistant at South Dallas nursing home
Completed coursework towards Business Management with focus on Human Resources Management and related payroll training.
New Beginnings Christian Academy
High School Diploma, General Secondary Education
Activities and societies: AP English
High School Diploma with coursework in advanced computer skills and participation in AP English.
Tech stack
Software and tools used professionally
Availability
Location
United StatesAuthorized to work in
Job categories
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