KheVian Thorn

C

Benefits Enrollment Specialist

CVS

Dec 2022 - Current (3 years 6 months)

Respond to inbound calls and emails from members regarding benefits enrollment. Guide members through the benefits selection and enrollment process.Explain health plan options, coverage details, eligibility criteria, and deadlines. Accurately enter and update member information in enrollment systems.Process new enrollments, terminations, changes in coverage, and qualifying life events. Educate members on available health plans (e.g., HMO, PPO, Medicare/Medicaid options).Resolve enrollment-related issues, discrepancies, or complaints promptly and professionally. Collaborate with internal teams such as billing, claims, and provider services to support member needs.

Banking Customer Service Representative

Bank of America

Mar 2020 - Dec 2022 (2 years 10 months)

Delivered exceptional service in a fast-paced, high-volume inbound call center environment, assisting clients with banking inquiries, account information, and financial transactions.Handled 80-100+ calls per day, resolving customer concerns related to billing discrepancies, online banking issues, payment processing, and fraud prevention.Maintained detailed account notes and ensured all customer interactions complied with federal regulations, internal policies, and confidentiality standards.Demonstrated empathy, professionalism, and active listening skills while managing escalated situations and providing solutions to meet individual needs.

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Medical Claims Specialist

Access2Care

Jan 2018 - Mar 2020 (2 years 3 months)

Handled high-volume inbound and outbound calls related to medical claims processing, billing inquiries, denials, and appeals.Reviewed, researched, and resolved complex medical claims issues, ensuring timely and accurate claim adjudication and reimbursement.Verified insurance coverage, benefits eligibility, and prior authorizations for various healthcare services across commercial, Medicare, and Medicaid plans.Interpreted Explanation of Benefits (EOBs), coordinated with payers, and followed up on unpaid or denied claims to ensure prompt resolution.

Healthcare Customer Service Representative/Member Service Representative

GetixHealth

Jun 2015 - Jan 2018 (2 years 8 months)

Handled a high volume of inbound calls with professionalism and empathy, providing accurate information and resolving concerns efficiently.Educated members on plan benefits, co-pays, deductibles, prior authorizations, and referrals, ensuring clarity and member satisfaction.Delivered exceptional customer service to health plan members by addressing inquiries related to benefits, coverage, eligibility, claims status, provider networks, and medical services.Investigated and resolved claims issues, billing discrepancies, and service denials by coordinating with internal departments and external vendors.

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