Charlethea Keller
Covington,GA
Summary
Experienced healthcare professional with over 24 years of expertise in customer service, data entry, and claims processing. Proficient in Medicaid, Medicare, and Commercial claims, with a deep understanding of insurance verification, billing procedures, and HIPAA compliance. Adept at working in production environments, handling multiple assignments accurately and efficiently. Skilled in Epic Software, claims adjudication, and utilizing tools like Edifecs for seamless claim tracking. Seeking to leverage strong analytical skills and experience to contribute to a dynamic healthcare team.
Overview
12
12
years of professional experience
Work History
Senior Claims Benefit Specialist
CVS/Aetna
Remote
07.2025 - Current
- Review and process claims.
- Document claims accurately in the system.
- Address claim issues and discrepancy.
- Analyzed complex benefit claims to ensure compliance with regulations and company policies.
- Resubmitted claims after editing or denial to achieve financial targets and reduce outstanding debt.
- Evaluated and settled complex insurance claims in strict timeframes.
Contact Representative
Internal Revenue Service
Remote
01.2024 - 09.2025
- Addressed tax-related inquiries from clients, ensuring that all responses were accurate and in line with government regulations.
- Streamlined communication between departments, ensuring timely information exchange and efficient problem resolution.
- Analyzed client data to identify patterns and improve service strategies, ensuring enhanced customer satisfaction and tax compliance.
- Managed a high volume of inquiries, maintaining accuracy and ensuring that responses were both compliant and timely.
- Utilized MS Office Suite for documentation and tracking, improving the efficiency of client case management.
- Responded to taxpayer inquiries, providing accurate information on tax regulations and procedures.
- Educated taxpayers on filing requirements, improving understanding of complex tax issues.
Public Asistance Crew Lead
Department of Homeland Security
Washington, DC
09.2017 - 03.2025
- Facilitated FEMA application processes, ensuring that all referrals were precise and efficiently processed within the guidelines.
- Managed client communications to ensure prompt and clear updates, improving the client experience throughout the disaster recovery process.
- Coordinated with aid agencies, providing customer service and ensuring all applications were processed and updated accurately.
- Streamlined documentation processes, ensuring accurate recording of client data and enhancing the speed of application processing.
- Managed multiple cases simultaneously in a fast-paced environment, achieving timely resolution of over 90% of applications.
- Coordinated applicant intake processes to streamline service delivery and enhance user experience.
- Developed training materials for staff to improve knowledge of FEMA programs and services.
- Trained new hires on policies and procedures, fostering a knowledgeable team environment.
- Led initiatives to enhance customer service protocols, resulting in increased applicant satisfaction ratings.
- Evaluated applicant eligibility by analyzing documentation and conducting interviews efficiently.
- Enhanced communication channels between departments, fostering collaboration and improving service delivery to applicants.
Personal Care Assistant
Right at Home Healthcare
Johns Creek, GA
01.2014 - 01.2017
- Assisted patients with daily living tasks, improving comfort and satisfaction.
- Managed 50 patient records, ensuring all information complied with HIPAA standards and regulations.
- Recorded and monitored vital signs, ensuring that any changes were promptly communicated to healthcare teams.
- Assisted in the creation and implementation of personalized care plans, leading to improved patient outcomes.
- Worked alongside healthcare professionals to ensure accurate documentation and efficient care delivery.
- Collaborated with healthcare professionals to coordinate comprehensive care strategies.
- Administered medications according to prescribed schedules, ensuring adherence to care plans.
Education
Bachelor of Arts - Healthcare Administration
Ashford University
Clinton, IA08.2016
Skills
- Medical Claims Processing
- QNXT Claims Processing Software
- Edifecs
- Epic Software
- Insurance Verification
- Billing and Coding
- Data Entry and Documentation
- HIPAA Compliance
- MS Office Suite
- Problem-Solving and Analytical Skills
- Claims management expertise
- Project management experience
Timeline
Senior Claims Benefit Specialist
CVS/Aetna
07.2025 - Current
Contact Representative
Internal Revenue Service
01.2024 - 09.2025
Public Asistance Crew Lead
Department of Homeland Security
09.2017 - 03.2025
Personal Care Assistant
Right at Home Healthcare
01.2014 - 01.2017
Bachelor of Arts - Healthcare Administration
Ashford University