Holly McMasters
Georgetown
Summary
Customer-focused Customer Service Representative with 30 years of experience in medical insurance call centers. Expertise in delivering clear and accurate assistance on benefits, claims, and billing inquiries with a focus on one-call resolution. Committed to enhancing customer satisfaction through effective communication and reliable support, ensuring members feel informed and valued.
Overview
33
33
years of professional experience
Work History
Business Associate
North Vermilion Family Dental
Danville
04.2026 - Current
- Managed patient scheduling and appointment confirmations for efficient office operations.
- Assisted dental staff with patient intake forms and insurance verification processes.
- Coordinated patient communications regarding treatment plans and follow-up care instructions.
Customer Service Representative
Health Alliance Medical Plans
Champaign
09.2009 - 04.2026
- Handle high-volume inbound calls in a medical insurance call center, delivering professional, compassionate, and solution-focused support to members.
- Provide clear, accurate benefit details to policyholders, helping them understand coverage, eligibility, deductibles, and out-of-pocket costs.
- Process premium payments with accuracy and assist members with billing questions, ensuring clarity and resolving issues efficiently.
- Provide clear, easy-to-understand explanations of benefits, eligibility, and medical claim details to help members navigate their coverage while documenting interactions.
- Guide members through Health Insurance Marketplace (ACA) enrollment and renewal, explaining eligibility, required documents, plan options, subsidies, and key deadlines to ensure proper coverage.
- Assist customers with ACA Marketplace plans by providing clear explanations of premiums, tax credits, cost-sharing requirements, and how these impact monthly costs.
- Provide claims and benefit support for Health Insurance Marketplace members, ensuring accurate understanding of deductibles, copays, and out-of-pocket maximums.
- Consistently achieve excellent quality and production results by maintaining accuracy, meeting performance expectations, and delivering reliable, high-quality customer service.
- Go above and beyond for members by proactively researching solutions, following up on unresolved issues, and ensuring each customer feels supported and fully informed.
Receptionist
Provena United Samaritans Medical Group
Danville
12.2007 - 09.2009
- Managed the full patient check-in and check-out workflow for a high-volume OB/GYN practice, ensuring accuracy, confidentiality, and a smooth patient experience.
- Scheduled patient appointments, diagnostic procedures, and follow-up visits using electronic scheduling systems while coordinating provider availability and reducing wait times.
- Collected copays, processed patient payments, and posted transactions to accounts with precision and adherence to office billing policies.
- Entered charges, updated patient charts, and maintained accurate and organized medical records to support clinical staff and streamline office operations.
- Prepared professional correspondence, forms, and documentation for physicians, nurses, and patients.
- Managed a multi-line phone system, responding to inquiries with empathy and professionalism while maintaining strict patient privacy standards.
- Provided compassionate, confidential support to patients navigating sensitive OB/GYN appointments and procedures.
Customer Service Representative
Blue Cross Blue Shield
Danville
08.1993 - 08.2007
- Handled a large volume of inbound calls, delivering professional and empathetic customer service while navigating complex insurance policies and procedures.
- Assisted members with detailed inquiries regarding coordination of benefits (COB), explaining primary versus secondary coverage, resolving discrepancies, and ensuring claims were processed correctly.
- Provided clear and thorough explanations of benefits, eligibility, coverage levels, and claim outcomes to support both members and healthcare providers.
- Demonstrated strong communication and problem-solving skills by helping members understand their health plan options, claim statuses, and next steps.
- Collaborated with internal departments-including claims, billing, and provider services-to resolve member issues efficiently and ensure a positive customer experience.
- Processed medical claims with a high level of accuracy, reviewing documentation, applying policy guidelines, and ensuring proper adjudication and timely resolution.
- Documented all interactions accurately in internal systems to maintain compliance, support follow-up action, and improve service continuity.
Education
High School -
Georgetown-Ridge Farm High School
Georgetown, ILSkills
- Claims Management
- Benefit Analysis
- Eligibility Verification
- Billing Coordination
- Healthcare Customer Support
- Benefit resolution
- Appointment Management
- Data Entry & Documentation
- HIPAA Compliance
- Multitasking & Time Management
- Problem resolution
- Team Collaboration
- Strong Interpersonal Communication
- Client Interaction
- Communication skills
Timeline
Business Associate
North Vermilion Family Dental
04.2026 - Current
Customer Service Representative
Health Alliance Medical Plans
09.2009 - 04.2026
Receptionist
Provena United Samaritans Medical Group
12.2007 - 09.2009
Customer Service Representative
Blue Cross Blue Shield
08.1993 - 08.2007
High School -
Georgetown-Ridge Farm High School