Rodjeyann Pinnock
@rodjeyannpinnock
Claims call center representative focused on accurate, compliant medical billing and customer service.
United StatesWhat I'm looking for
I’m a Claims Call Center Representative with hands-on experience reviewing, processing, and adjudicating high-volume medical and pharmacy claims for accuracy, compliance, and coverage. I communicate with providers and patients to resolve claim disputes, denials, and appeals, while navigating insurance systems to verify patient eligibility and track claim status.
Before my current role, I processed and monitored electronic and paper Medicare, Medicaid, and commercial payer claims, researched denials, posted adjustments, and supported timely collections and billing compliance with accurate documentation for audit and reconciliation. I also bring a patient-centered approach from healthcare work as a Medical Screener and Personal Care Assistant, ensuring safety, HIPAA compliance, and clear reporting—always grounded in problem-solving and dependable teamwork.
Experience
Work history, roles, and key accomplishments
Claims Call Center Representative
CVS Health / Aetna
Apr 2024 - Present (2 years 2 months)
Review, process, and adjudicate medical and pharmacy claims for accuracy, compliance, and coverage while resolving denials, disputes, and appeals with providers and patients. Track claim status, verify eligibility, review medical codes, and support audit/compliance efforts to reduce fraud and overpayment.
Assisted patients with daily living activities including mobility, hygiene, feeding, and medication reminders while monitoring and documenting health status. Supported therapy exercises and maintained a clean, safe environment in compliance with health and safety standards.
Performed donor health screenings and assessed suitability for plasma donation, ensuring safe, accurate data entry and HIPAA/FDA compliance. Answered donor medical questions and referred donors to medical professionals when appropriate.
Education
Degrees, certifications, and relevant coursework
Colorado Technical University
Bachelor's degree in Criminal Justice, Criminal Justice
2024 -
Bachelor's degree program in criminal justice expected to graduate in 2029.
Southwest High School
High School Diploma, High School
Completed a high school diploma in June 2020.
Availability
Location
United StatesAuthorized to work in
Job categories
Skills
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