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Click here or scroll down to respond to this candidateCandidate's Name
Street Address EMAIL AVAILABLE PHONE NUMBER AVAILABLEObjectiveI am interested in obtaining a full-time development position, in a challenging environment that will allow me to fully utilize my communication, organization, data-entry and problem-solving skills.EXPERIENCEFEB 2012- AUG 2013CUSTOMER SERVICE REPRESENTATIVE PDS Placed outbound calls to clients explaining plan benefits Provided Customer service to elders and disabled people Documenting complaints about policy, copays, cover gaps on members profile Processing payments on accountsSEP 2013-SEP 2014CUSTOMER SERVICE REPRESENTATIVE -CONNEXTIONS Handled inbound/outbound calls for policy holders, resolving problems and correcting policy errors. Provided insurance inquirers, complaints, billing questions and payment request Data entry, noting every call Filing members prescription for mail order pharmacy Adheres to HIPAA regulations by verifying pertinent information to determine caller authorization level receiving information on account Promptly and courteously answer incoming telephone callsNOV 2014-2016PHARMACY REPRESENTATIVE -XEROXHandled high call volume from MDO and members, regarding prescription needs Process Prior Authorization, formulary exceptions, Quantity Limit and tiering request via phone/fax/email Calm Angry callers, repair trust, provided customer service on inbound/outbound calls May assists team with reports and projects to maintain team and individual productivity standards and goals.AUG 2017-PRESENTBENEFITS AND PRE-CERT SPECIALIST -FLORIDA HOSPITAL Maintains performance standards appropriate to area by obtaining account benefits or verifying authorizations are in place for all scheduled and/or unscheduled patient accounts under responsibility, meeting time line standards established by Leadership for all patient services. Meets or exceeds audit accuracy standard goal determined by Pre-Access Leadership. In working patient accounts for pre-certification; contacts physician, Patient Access staff, and clinical service area where appropriate, notifying authorization is not obtained by department deadline, advising of visit cancellation, reschedule, or to obtain life or limb order from physician allowing patient to proceed. Adheres to HIPAA regulations by verifying pertinent information to determine caller authorization level receiving information on accountEDUCATIONJUN 2010HSD, Penn Foster,AUG 2013AS HUMAN SERVICES, Columbia CollegeMEDICAL ADMINISTRATION ASSISTANT (NHA)2010SKILLSCustomer Service Expert Currently used/15 yearsData Entry/ records management Expert Currently used 7yearsCall center operations- Immediate Currently used 7 yearsComplaint handling/ Dispute Management- Immediate Currently used 3 yearsInsurance Verification /Benefits Expert Currently used 7yearsCustomer Service Expert Currently used/15 years |
