Kristin Solomon

Healthcare operations and claims professional with 10+ years of experience researching complex cases, interpreting healthcare policies and benefits, documenting findings, resolving discrepancies, and supporting quality assurance. Familiar with HIPAA standards and the importance of protecting sensitive healthcare information. Experienced in reviewing information across multiple systems, maintaining accurate case records, identifying root causes, escalating complex issues, and communicating clearly with members, providers, brokers, and colleagues.

Brings a detail-oriented, service-focused approach to privacy program support, compliance monitoring, and patient trust.

Customer Care Associate - CareFirst BlueCross BlueShield - Owings Mills, MD

(2022-09)

• Research and resolve complex health insurance cases involving claims, benefits, eligibility, enrollment, billing, and account discrepancies across multiple internal systems.
• Review claim and benefit details to confirm accuracy, coverage, processing status, and member responsibility; follow issues through to resolution.
• Handle sensitive healthcare and account information in accordance with company guidelines and HIPAA standards.
• Document case activity, research findings, actions taken, and resolutions accurately across CRM, claims, and workflow management platforms.
• Identify root causes of complex accounting and billing issues, coordinate follow-through, and provide clear updates to relevant parties.
• Perform live call listening and quality assurance support to help assess service accuracy, reinforce standards, and identify coaching opportunities.
• Serve as a resource for colleagues on complex claims research, benefits interpretation, enrollment questions, and billing discrepancies.
• Support new-hire training by sharing system knowledge, research practices, and guidance for handling complex customer situations.
• Participate in AI development and digital-tool pilot projects, providing feedback to improve internal workflows, chat tools, and system functionality.
• De-escalate difficult interactions through careful listening, accurate policy interpretation, and solution-focused communication.

Client Specialist - ClearOne Advantage - Baltimore, MD

(2020-01 - 2022-04)

• Researched account activity, payment schedules, and financial documentation to resolve client questions and discrepancies.
• Maintained accurate client files and account notes while supporting billing, payment plans, account updates, and portal access.
• Monitored accounts for legal activity, documentation needs, and program requirements; followed up on outstanding items.
• Explained account status and next steps clearly while handling client information with professionalism and discretion.

Total Loss Advisor - BEPC Inc. - Owings Mills, MD

(2019-05 - 2019-07)

• Researched account information and claim status across multiple systems to provide accurate updates on open and closed claims.
• Verified account details and communicated claim requirements, documentation needs, and next steps.
• Maintained accurate records while supporting time-sensitive insurance and claims processes.

Customer Service Representative / Account Manager, Team Lead - Frontline Pest Professionals - Baltimore, MD

(2014-04 - 2018-10)

• Resolved escalated service and billing concerns by reviewing account history, identifying root causes, and documenting solutions.
• Managed account records, contract reviews, payment processing, scheduling, and customer information updates.
• Coached and supported a team of 10 employees through call reviews, quality monitoring, and workflow guidance.
• Used Microsoft Office, Excel, internal databases, and account-management tools to support accurate daily operations.

Business Administration Diploma - Milford Mill Academy (2006-06)