| | | 20,000+ Fresh Resumes Monthly | |
|
|
| | Related Resumes Administrative Assistant Customer Service Burleson, TX Administrative Assistant Customer Service Arlington, TX Administrative Assistant Customer Service Grand Prairie, TX Administrative Assistant, Receptionist, Customer Service, Postal Fort Worth, TX Administrative Assistant Customer Service Arlington, TX Customer Service Administrative Assistant Dallas, TX Administrative Assistant Customer Service Weatherford, TX |
|
Click here or scroll down to respond to this candidateCandidate's Name
EMAIL AVAILABLEPHONE NUMBER AVAILABLEGrand Prairie, TX Street Address
SummaryProven ability with 5+ years in the customer service to listen attentively, solve problems quickly and efficiently, and create high-quality professional relationships with callers. Fully committed to following company procedures and winning loyal customers. Maintaining composure even in the most difficult situation and approaches situations with care, integrity respect and empathy.WORK EXPERIENCESparks group Administrative Assistant06/2018 to 12/2020, MarylandAnswer and direct phone callsOrganize and schedule appointmentsPlan meetings and take detailed minutesWrite and distribute email, correspondence memos, letters, faxes and formsAssist in the preparation of regularly scheduled reportsDevelop and maintain systemUpdate and maintain policies and proceduresOrder supplies and research new deals and suppliersMaintain contact listsBook travel arrangementsSubmit and reconcile expense reportsProvide general support to visitorsAct as a point of contact for internal and external clients with executive and senior administrative assistants to handle requests and queries from senior managersResponsible for the setup, to include any troubleshooting, and breakdown of events requiring technical support.Supported over 100 events annually, which ranged form less than a dozen participants to thousands of participants with prestigious guests.Responsible for the setup, to include any troubleshooting, and breakdown of events requiring technical support.Supported over 100 events annually, which ranged form less than a dozen participants to thousands of participants with prestigious guests.Translated and assembled business requirements into detailed, production-level technical specifications, detailing new features and enhancements to existing business functionality.Interacted with business users to analyze the process and gather the requirements, making necessary changes to schema objects to fill their reporting and business needs.Assisted in the creation of a classroom environment conducive to learning and appropriate to the physical, social and emotional development of students.Cigna Customer service representative02/2021 to 11/2022, MinnesotaAnswer inbound calls from patients and providers about claims, account issues, and scheduling medication shipments.An average of 30-50 calls are expected daily.Provide exceptional customer service while taking calls frequently with little down time.Document data and navigate through multiple systems while on calls.Resolve customer complaints through independent problem-solving skills and one-call resolution.Provide knowledgeable responses to telephone inquiries in a courteous and professional manner, utilizing pre- scripted responses which they must read verbatim to provide basic general and claims specific information.Follow established and documented policies and standard operating procedures such as filling out timesheets, adhering to privacy rules and responding to numerous phone inquiries.Assist caller with filling out online application and submitting it electronically to plan provider for processing. .Refer calls as required to Customer Service Representative II.Report problems that occur via the online system so they can be addressed by the appropriate parties.Following established procedures to resolve patient account balances: Identifying consumer payment plansSetting up consumer payments over the phoneDocumenting all conversations electronically on company and/or client systemsAssisting patients in determining eligibility for financial assistance programs and/or bank loans when applicable Providing information to Client Services as neededUnderstanding and fully complying with all federal and state laws and regulations (HIPPA, Medicare Fraud, Waste and Abuse, etc.) regarding collections policies and proceduresUnited Healthcare Senior customer service representative 11/2022 to Present, MinnesotaProvide members with deductibles, copay, co-insurance and responsibility informationProactively identify solutions to non-standard requests.Solves moderately complex problems on own. Works with team to solve complex problems.Plans, prioritizes, organizes, and completes work to meet established objectivesServe as direct contact to members and give them response to their Prior authorization decisionsContact doctors/Provider office to walk them through on how to submit Member Prior authorization, providing them with templates, time phrase on decisions.Serve as primary point of contact for providers or members regarding medical/behavioral/clinical services or benefits.Extract and review fax requests for medical or clinical services.Receive calls requesting medical/behavioral/clinical services or benefits information (e.g., from providers or members)Receive electronic referral form requests formedical/behavioral/clinical servicesUpdate COB (coordination of benefits)Provided dependent verification informationAdhere to Hippa protocol and guidelinesWalk member through portal finding information and giving them detail explanation helping them submit appeals onlineUtilize phone system to respond to and transfer calls to appropriate individualsAnswer calls from other insurance to verify members benefits and eligibilityAlso scheduled member for sick visits as well as scheduling them for annual examinations and flu shotsProvide member with list of in network providers and facilities which accepts UHC insuranceProvided member with details about what their benefits covers and also use the assigned softwares to to know and determine their out of pocket costAccess and give out information about financial accounts such as HAS, HRA, FSAProcess and walk member through their portal on ways to submit claims for HSA, FSA and HRAUpdate member demography such as phone number, Address, And dependentOrder insurance card and also FSA, HRA and HSA cardsProcessed Medication request and schedule home deliver RXGive out pharmacy benefit and provided member with in network pharmacyUsed tools to get drug pricing help member with details on how medication claims are processedCheck on CPT codes to determine coverage using Job aid toolsAsk callers standard questions to understand requests, gather necessary information, and assess urgency Access electronic member les using policy or id number -Determine member eligibility Follow protocols to task requests appropriatelyDetermine whether authorizations are required for requested medical servicesReference automated job aid tools via computer to research relevant rules, regulations, or proceduresLearn computer system and process changes and updates and incorporate into daily workContact internal resources if necessary to clarify information Identify appropriate resource Provide/explain authorization information to members/providersCommunicate with clinical team to ensure provider receives a response when necessaryDocument call history information into relevant computer system Enter medical request data into relevant computer system Follow standard procedures to complete requestsGive out referrals to member such as 247 nurse line, 247 EAP line and Also the 247 behavioral lineRequest medical review via relevant computer system as needed Review and advise member/provider of status of a request (e.g.,, authorization)Schedule appointments for members based on request Provide information regarding appointments and medical services to facilities staff to assist members.EDUCATIONPan African Institution for development west Africa Migration and refugee studies10/2015 to 12/2018SKILLSMicrosoft OutlookMicrosoft TeamsDocumentationTypingComputerCustomer serviceLANGUAGESENGLISH FRENCH |
