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Sabrina Winton

@sabrinawinton

Customer service representative at Chenega Inc. reviewing medical claims and processing prior authorizations for providers and beneficiaries.

United States

Message

What I'm looking for

I’m open to remote roles.

At Chenega Inc., I review medical claims for providers and beneficiaries, verifying eligibility, authorizations, and referrals. I also process prior authorization requests and explain claims outcomes while maintaining HIPAA compliance.

At Blue Shield of California, I managed member grievances and appeals through the full case lifecycle, meeting regulatory turnaround requirements. I drafted compliant acknowledgement and resolution letters and helped members initiate coverage determinations and appeals.

At Ursus Inc. and Ensemble, I supported customers with technical inquiries and billing issues, updated patient files, and handled payment-processing questions. I’m proficient in Microsoft Office, including Excel case tracking.

Experience

Work history, roles, and key accomplishments

Current

Universal Customer Service Representative

Current

Chenega Inc.

Oct 2024 - Present (2 years)

Review 8–9 medical claims daily for providers and beneficiaries, verifying eligibility, authorizations, and referrals. Process prior authorization and pre-certification requests, explain claims outcomes, and maintain HIPAA compliance.

Claims Review Eligibility Verification Prior Authorizations Pre Certification HIPAA compliance Microsoft Office Excel Multitasking Documentation

Customer Service Representative

Ursus Inc.

Sep 2023 - Oct 2024 (1 year 1 month)

Provided technical support and resolved customer inquiries in a timely, professional manner. Maintained confidential patient information in accordance with HIPAA regulations.

Technical Support Customer Service HIPAA compliance Confidentiality File Management

Revenue Cycle Specialist

Ensemble

Jan 2023 - Oct 2023 (9 months)

Identified and resolved billing issues efficiently across phone and email channels. Assisted customers with payment processing inquiries while safeguarding confidential data.

Billing Payment Processing Customer Service Confidentiality Problem Solving

Appeals and Grievances Coordinator

Blue Shield of California

Sep 2018 - Sep 2022 (4 years)

Managed a caseload of member grievances and appeals through the full case lifecycle, meeting 30-day regulatory turnaround requirements. Drafted compliant letters and conducted research to resolve complex disputes.

Appeals Management Grievance Handling Regulatory Compliance Documentation Research Case Management Communication Skills