Destiny Edwards
Norfolk
Summary
Detail-oriented healthcare administrative professional with a strong background in insurance verification, prior authorizations, and high-volume inbound call center support. Experienced in navigating complex healthcare systems, resolving claims and coverage issues, and delivering clear, compassionate service to patients and providers while meeting performance metrics in fast-paced environments
Overview
7
7
years of professional experience
2
2
years of post-secondary education
Work History
Insurance Verification Authorization Representative
Chesapeake Regional Healthcare
Chesapeake
11.2024 - Current
- Obtained pre-authorizations or referrals from insurance companies to ensure timely and appropriate care.
- Evaluated denied claims and initiated appeals or reconsiderations in accordance with company guidelines.
- Assessed patient eligibility for medical services by verifying insurance coverage and benefits.
- Responded promptly to inquiries from healthcare providers, patients, or insurance carriers regarding authorizations status or issues.
- Educated patients on their insurance coverage, out-of-pocket expenses, and available financial assistance programs.
- Reviewed medical records and identified appropriate diagnostic codes.
Customer Service Representative
Sentara Healthcare
Virginia Beach
07.2022 - 09.2024
- Managed high-volume inbound calls from patients, providers, and members regarding insurance coverage, eligibility, and claims.
- Provided clear explanations of health insurance policies, benefits, premiums, and prescription coverage.
- Utilized EHR and insurance systems to document interactions, authorizations, and claim updates accurately.
- Resolved issues related to prescription benefits, eligibility verification, and claim payment inquiries.
- Maintained quality assurance standards, call metrics, and compliance requirements while delivering excellent customer service.
Customer Service Representative
Conduent
Chesapeake
07.2018 - 05.2022
- Handled high-volume inbound calls assisting members with prescription claims, coverage verification, and billing questions.
- Processed pharmacy claims and verified insurance coverage for medications.
- Updated patient profiles with accurate demographic, insurance, and medication history information.
- Educated members on payment options, reimbursement processes, and pharmacy benefit changes.
- Maintained compliance with healthcare regulations while providing empathetic and solution-focused support.
Education
Bachelor of Science (B.S.) - Healthcare Administration
Liberty University
Virginia 10.2025 - 12.2025
Associate in Science (A.S.) - Health Service Administration
Bryant & Stratton
Virginia 09.2022 - 08.2024
Skills
- Microsoft Office applications
- Excel
- Healthcare plans
- Provider issues
- Electronic Health Record (EHR)
- Oral communication
- Written communication
- CPT codes
- Insurance plans
- Customer service
- Active listening
- Patience
- Adaptability
- Teamwork
- Digital literacy
- Attention to detail
- Time management
- Strong work ethic
Timeline
Bachelor of Science (B.S.) - Healthcare Administration
Liberty University
10.2025 - 12.2025
Insurance Verification Authorization Representative
Chesapeake Regional Healthcare
11.2024 - Current
Associate in Science (A.S.) - Health Service Administration
Bryant & Stratton
09.2022 - 08.2024
Customer Service Representative
Sentara Healthcare
07.2022 - 09.2024
Customer Service Representative
Conduent
07.2018 - 05.2022