Kenya Abron Email & Phone Number

Results-driven and strategic business professional with over 15 years of experience in customer service, corporate strategy, operations, and claims within the healthcare industry. Strong analytical and problem-solving skills, combined with excellent organizational, communication and leadership abilities.

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  Sr Provider Service Specialist

  Blue Cross Nc

  May 2018 - Present

  • Process claims and adjustments identified in service requests from customer service.• Review and research incoming healthcare claims from providers and verify the data/information necessary for processing the claims.• Identify, analyze, and resolve common, complex, and escalated operational issues impacting professional and hospital systems.• Identify and document global and/or systemic problems, gaps, or inconsistencies in workflows, and/or processes based on collected information.• Provide coaching and feedback to customer service and claims department regarding claims and claims errors.• Educate and encourage providers on the use of alternative delivery channels including Blue E, web, or provider services.• Provide cross functional support between the provider and various areas within the Plan including local, state and federal government entities across all lines of business.• Effectively manage inventory to meet departmental goals.• Handled special projects or requests from Provider Service Consultants and Coordinators as necessary.• Manage team mailbox and escalation phone line to address issues received from the Provider Service Consultants and Coordinators, Network Management, and the Leadership Team.