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Click here or scroll down to respond to this candidateCandidate's Name
Street Address EMAIL: EMAIL AVAILABLE PHONE: PHONE NUMBER AVAILABLEPROFESSIONAL SUMMARYMore than 20 years of business experience with extensive background in the customer services field to included healthcare. Utilize time management techniques effectively/efficiently in order to complete multiple assignments within a scheduled time period. Strong blend of technical, interpersonal and management skills, coupled by the ability to work well with individuals of diverse populations. Keys skill sets include:Service DeliveryProperty Damage ClaimsEHR Super UserElectronic Medical RecordsDisability ClaimsMedical ClaimsMicrosoft Office SuitesHIPAA ComplianceSalesTwo Factor AuthenticationExcellent Customer SkillsProblem-SolvingPROFESSIONAL BACKGROUNDAmeriHealth Caritas December 2022 October 2023Customer Service RepresentativeResponded to diverse membership and their providers as well as other customers in a timely, professional and courteous manner.Made outreach welcome calls to new members and conducted Health assessment survey as needed.Provided member education and assisted member with primary care physician (PCP) selection and assignments.Assisted with access to care and wellness program.American Automobile Association (AAA) South Jersey, Cherry Hill May 2015 December 2020Member Experience SpecialistActs as a Sales representative and Customer Service Agents to AAA current and new members by delivering excellent customer service to the organizations members.Promoting the sales of associate and primary memberships; assisting members with membership issues; and carrying out necessary changes on existing memberships.Provide assistant to members on all travel needs, including points of interest and accommodations.Assist members in obtaining inter-American/International Driving Permits; helping members to obtain car rentals; and taking passport photos.Advised members on the importance of getting total travel protection, including AAA Premier, Associate Membership, AAA Plus, and other products whenever necessary.Xerox Company, Cherry Hill, NJ August 2010 April 2015Customer Care SpecialistExceptional understanding of health and welfare benefits plans options and coverage.Dealt directly with customers to resolve questions and problems concerning billing and other issues.Provide policy benefits to our Insureds/Beneficiaries in compliance with policy language.Communicated appropriate options for a timely resolution.Informed customers about services available and assessed customer based on needs.Southern Jersey Family Medical Center, Hammonton, NJ March 2013 November 2013Health Information Medical Records SpecialistManaged and maintained patient medical records in electronic formatPrepared medical records for electronic processingProtected patient information accurately; and handle the release of the patients health information in compliance with organizational policies and HIPAA compliance.Understand EHR applications and the organization's work-flows.EHR super userInvolved with the testing and implementation of the new EHR and scanning software.Function in coordination with the Quality Assurance Compliance Officer to assure records are implemented and maintainedMetLife Insurance Company, Bloomfield, CT (Telecommuted) March 2007-August 2008Long Term Disability Account RepresentativeManaged assigned caseload of long-term disability (LTD) and short-term disability (STD) claims.Analyzed claims to determine eligible benefits through validation of policy status and policy languageManaged claims with longer duration and evolving medical conditionsPaid all covered claims accurately and timelyManaged both new claims and open claims equally and maintains decision timesStayed abreast of ongoing trainings associated with role and business unit objectivesCandidate's Name Page 2Reliance Standard Life Insurance Company, Philadelphia, PA September 1997-March 2007Long Term Disability Claims ExaminerPrompt and thorough investigation of claims within departmental and regulatory guidelines.Make accurate and compliant decisions related to LTD claims adjudication.Thorough knowledge of insurance coverage claims handling guidelines, legal and medical terminologyNetwork with both customers and physicians to medically manage claims from initial medical requests to reviewing and evaluating ongoing medical informationWork directly with clients and Vocational Rehabilitation Counselors to facilitate return to work either on a full-time or modified duty basisTECHNICAL QUALIFICATIONSOperating Systems: Windows 7, Windows 10Software: MS Office Suite, Office Outlook 365CERTIFICATIONMedicare and Medicaid Electronic Health Record (EHR) Incentive Program, Health IT Certification April 2013Certificate in Meaningful UseDepartment of Health and Human Services (HHS), Office of the National Coordinator (ONC) June 2012American Health Information Management Association (AHIMA), Certified Healthcare Technology SpecialistCertified in Electronic Health Record (EHR) Implementation Support SpecialistEDUCATION AND TRAININGGloucester County College, Sewell, NJ August 2013Practice Management and Electronic Health Record (EHR)Camden County College, Blackwood, NJ February 2012EHR, provisions of the American Recovery and Reinvestment Act and Physician Quality Reporting SystemHealth IT Certification on Meaningful Use Incentive Program March 2011Meaningful Use of an Electronic Health RecordsLincoln University, Lincoln University, PA May 1985Bachelor of Science in Business Administration |
