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Click here or scroll down to respond to this candidateCandidate's Name
Cape Girardeau, MO Street Address
EMAIL AVAILABLEPHONE NUMBER AVAILABLEMy goal is to become an employee of a cutting-edge company where I can utilize my service orientation acumen to contribute to the long term goals of the company. I am a highly driven and self-motivated employee, and proficient in problem resolution.Authorized to work in the US for any employerWork ExperienceCustomer Service SpecialistProvider Plus-Cape Girardeau, MOFebruary 2023 to Present Develop and maintain working knowledge of current products and services offered by the company Answer all calls and emails in a timely manner, in adherence to their goals Facilitate resolution on customer complaints and problem solving Process orders, and follow up with customers when necessary Complete insurance verification to determine patient eligibility, coverage, co-insurance and deductibles. Obtain pre-authorization if required by insurance carrier and process physician orders to insurance carrier for approval and authorization when needed. Client Benefit Manager / Commercial Account Manager Express Scripts-St. Louis, MOJuly 2014 to March 2020 Responsible for overall satisfaction and retention of assigned book of business. Manages day to day client relationships through comprehensive knowledge of client's benefit its plan and Express Scripts product offerings. Responsible for timely and accurate management and execution of all client benefit it requests, including benefits changes, product upsells, new groups, terminations and escalated issues. Accountable for new group and specific product implementations; including establishing and leading internal meetings to ensure collaboration and attention to detail throughout the process in order to meet expected timelines and quality standards. Lead client CDH meetings to review ESI's operational performance against client's expectations and needPersonal Injury AdjusterFireman's Fund Insurance-St. Louis, MOOctober 2006 to July 2014* Manage a high volume workload with a client portfolio averages 50-75 clients; caseload of 150-350 claims* Responsible for clear and concise documentation of relevant information* Analyze portfolio and responsible for settling liens and arbitration* Responsible for conducting investigations and creating detailed action plans* Held several Property & Casualty Licenses in multiple states Customer Relations SpecialistUnited Health Group-St. Louis, MOJanuary 2004 to December 2006* Handled customer inquiries, complaints, billing questions for members' health claim issues* Built rapport with members, listened carefully and managed conversational flow* Resolved an average of 500 inquiries per week and met performance benchmark consistently* Earned 100% marks in areas such as, communication skills, listening skills, problem resolution and soft skills* Handled emotional customers with delicacy, listening empathetically while maintaining company policy Customer Service AgentGMAC Insurance-St. Louis, MOApril 2002 to September 2004* Provided professional insurance counsel to GMAC insured's regarding their policy needs* Managed the resolution process for policy holders* Enforced company guidelines and exercised full underwriting authority* Manage upset customers, conflicts, and challenging situations* Worked in a team, but in a self-directed environment EducationAssociates Degree in Office Technolgy/Applied Science Northwestern Business College - Chicago, ILMay 1993 to May 1995Skills Benefits Administration Workers' Compensation PeopleSoft Microsoft Excel ICD coding Microsoft Word Microsoft Office Insurance verification Business requirements ICD-10 Medical Billing Medical coding Medical office experience CPT coding Medical billing Medical Scheduling |
