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Click here or scroll down to respond to this candidateCandidate's Name
Street Address Plaudit WayLouisville, Kentucky Street Address
EMAIL AVAILABLEPHONE NUMBER AVAILABLECareer Related SkillsCustomer Service in Healthcare (Medical, Dental, Vision and Life)Subject Matter Expert (SME)Communication SkillsVarious Microsoft programs (Excel, OneNote, Outlook, Adobe)Customer Interface (CI) (Medical, Dental, Vision and Life)Claims Administration System (CAS)Metavante (MTV) (Medical, Dental, Vision and Life)Microsoft Word and ExcelPremium Billing System (PBS)Request for Proposal (RFP)Professional ExperienceNew Sales- Offer/Quote/Negotiate/Close. Understands the work needed to install, support, Installation administration Professional, Enrollment. ARC, Specialty Rate Systems, First Rate (Work Bench), MTV, OneNote, and Account Manager.Confirm the Brokers/GA for new requests for quote (RFQ).Manage the New Sales quote process by validating information included in the RFQ for completeness and accuracy.Review the enrollment file when necessary. Implementation-New Sale, confirm successful quote of new sale with Broker/GA/Salesperson. Send final quote to Sales/retention team member as appropriate.Scrubs submission documentation for accuracy and completeness, obtains any missing documents and corrects any inaccuracies.Attend all installation meetings and calls.Loads product line information and required documents into ARS CRM and routes for rating and quote from Underwriting.Sends final quote to Sales as appropriate.Sales and Underwriting Support Large GroupJune 2018 to May 2023 (Remote Work from Home)Performs varied activities and moderately complex administrative/operational/customer support assignments.Drafts sales documentation, proposals, reports, and correspondence such as sales contracts and maintenance agreements (Microsoft spreadsheets and Word Documents).Performs background research on customer accounts, prospects, competitors, and industry trends to support the sales teams activities.Answers internal and customer inquiries.Communicates with staff from other areas in the organization to confirm the status of orders and resolve customer complaints.Maintains up-to-date customer records.HumanaOne Integrated SpecialistMay 2015 to June 2018Prepared paperwork and analyze the structure for Exchange and Medicare BenefitsAttend meetings and develop appropriate strategies to process efficient renewals, changes and new build.Assist Analyst, Billing and Enrollment department, Membership Support and Project Managers in efforts to enhance the system for our customers.Install benefits while adhering to established product and exceeding quality expectations.Resolve errors on assigned accounts to reduce customer inconveniences.Act as a subject matter expert and provide direction to fellow associates and other partners.Employer Group SetupContract SpecialistSeptember 2007 to May 2015Perform quality checks for Account Installation Manager (AIM) and Underwriting (UW) by completing a comparison of paperwork to platforms, Claims Administration System (CAS) Customer Interface (CI) and MetaVance (MTV), New Case Document (NCD)Assist Account installation Managers, Area Service Directors, Customer Service Executives, Underwriting, Sales and Billing in confirming successful customer implementation.Assist and approve Paperwork for strategies for mass move for membership.Provide instruction to peers and on how to process membership changes and other group level requests effectively.Maintain information in an Access database to record group information and track installation progress.Act as a Subject Matter Expert (SME) and provide guidance for accurate procedure (The first to acquire SME for both Platforms CAS & MTV)Manual processing as required due to business needs.Billing and Enrollment Customer Service-ATC SpecialistFebruary 1999 to September 2007Assist customer service representatives with various call and system issues (CAS & MTV)Enroll commercial members with Access to Care for medical services (CAS & MTV)Arrange and provide enrollment verification for members.Collaborate efforts with pharmacy resources to ensure members attain prescriptions.Assist with complex issues related to billing and enrollment-Premium Billing System (PBS)Proactively identify call patterns and root causes for increased call volumeNotify Leadership of call and find ways to eliminate/reduce common customer concerns.Related System Knowledge/SkillsArc, Request for Proposal (RFP), CRM, Specialist Rating System (SRS), SharePoint, Medical & Ancillary, Resolving Customer Complaints, Subject Matter Expert, Customer Support Specialist, OneNote, Customer Interface, Premium Billing System (Pbs), Excel & Microsoft Word, Outlook, Received 5 Star Awards for Achievements being the first Subject Matter Expert in both systems for Customer Interface and MetaVance, and as well for Excellent Customer Service & Enrollment Representative**References available upon request. |
