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Click here or scroll down to respond to this candidateCandidate's Name
CONTACTPHONE NUMBER AVAILABLEEMAIL AVAILABLECorapeake, USSKILLSCustomer ServiceMicrosoft ExcelMicrosoft OfficeActive ListeningMicrosoft OutlookCritical ThinkingClient SatisfactionInsurance KnowledgeDocumentation SkillsInsurance PracticesBenefits VerificationsInsurance Coverage VerificationInsurance Claims ManagementMicrosoft WindowsInsurance EligibilityBilling ProceduresClaims ProceduresUpdate RecordsCall Center Customer ServiceLinkedInFacebookExcellent CommunicationAttention to DetailMedical TerminologyPatient ConfidentialityEmpathy and CompassionInterpersonal SkillsComputer ProficiencyPatient SatisfactionHealthcare KnowledgeMultitasking AbilitiesInsurance VerificationDecision MakingProblem SolvingEthical ConductAppointment SchedulingPROFESSIONAL SUMMARYHighly motivated professional with experience providing exceptional customer service in a healthcare setting. Proven history of successfully managing patient accounts, resolving issues, and promoting patient satisfaction. Expert in utilizing interpersonal skills to build relationships and foster trust with patients. Exceptional ability to manage multiple tasks and adapt quickly to changing situations.EXPERIENCENovember 2023 - PresentPATIENT CARE COORDINATORConifer Health, USAnswered telephones and directed calls and voicemails to appropriate staffExplained medical procedures, treatments, and tests to patients and their familiesFacilitated reminder calls to patients for appointment confirmation and order pickup notificationCall patients to set up appointments for proceduresMade outbound calls to patients to set up appointments for proceduresProcess appointments for patients.May 2023 - November 2023INSURANCE SPECIALISTAston Carter, NorfolkTracked pending authorizations to resolve discrepancies and avoid revenue lossFollowed up on denials, late payments, extensions, and other special circumstancesMaintained confidentiality of patient finances, records, and health statusesMaintained high standards of customer service by building relationships with clientsResolved discrepancies in insurance payments by collaborating with carriersProcessed eligibility and benefits verification and authorization requestsReviewed claims documents for accuracy prior to submission for payment processingInvestigated claims to determine validity and coverage applicability.This was a position thru a temp agencyNovember 2020 - October 2022UTILIZATION MANAGEMENT REPRESENTATIVE I (REMOTE)Anthem, Inc., NorfolkAssist providers and facilities with starting authorizations for members who needed services such as inpatient detox, inpatient psych, residential substance abuse, Intensive Outpatient Services, Partial Hospitalization services, ABA services for children, psychological and neurological testing for children and adults and residential psych who has medicaid as their primary insuranceAlso help providers with verifying medicaid benefits for members as well as covered servicesProcess authorizations for medicare members for same services as mentioned earlierProcessed between 50-80 incoming faxes per day from providers and facilities for services mentioned above as well as take calls from members looking for providers and facilities within network and or covered servicesChecked cpt codes for providers/facilities to see if prior authorization is required for certain services.May 2018 - December 2018PRODUCT SUPPORT SPECIALIST (REMOTE)Concentrix, Farmington HillsAssisted customers with the upgrade of their phones, help with payment options for the purchase, process payments, general questions and concerns, and some general tech issuesAssisted customers with the purchase of TurboTax online, TurboTax download, or TurboTax Desktop versions of their softwareAlso assisted customers with tech issues concerning the software or efiling their returnsAssisted customers with any refunds that they had or purchases and answered any questions that they had about their accountAssisted the customers on their returns and smart look or live look with customers which gave me the option to look at their returns in real time and walked them thru the steps of filing or fixing any issues that may have occurred if the returns were rejected by the IRS.August 2013 - March 2016BENEFITS SPECIALISTLockehead Martin, ChesapeakeHelped employees add or delete dependants off their health insuranceAlso helped with questions concerning their deductibles, sending out information on their benefits, when their insurance ends, information about what is covered and what wasn't, dental and vision information, doctor and hospital info, replacement cards, 401k and medicare questions and concerns.August 2012 - September 2013ASSISTANT STORE MANAGERCiti Trends, Inc, DurhamAssisted Store Manager with daily operations and supervision of employeesMaintaining proper inventory controls, facilitate inventory transactions and maintain compliance standards for shrink controlMonitor sales activities to ensure that customers receive satisfactory serviceDirect and supervise employees engaged in sales, inventory-taking, reconciling cash receipts, or in performing services for customersEnsuring adherence of staff members to all Citi Trends, Inc Policies and procedures.June 2010 - July 2011CUSTOMER SERVICE SPECIALIST (REMOTE)Alpine Access, Inc, DenverAnswered phones for Citibank as a financial representative and as a customer service rep for AARPAll calls were answered from my home phone and services were done on a computer thru the internetI took between 60-100 calls per day.March 2009 - October 2009ELECTRONICS TECHNICIANACS, Inc, RaleighAnswered phones and worked on customer's cell phonesThe company is Sprint and I do anywhere from basic troubleshooting a customer's device to sending out replacement phones for the customersI answer questions and concerns about their plans and devices and also take payments when neededI took between 30-70 calls per day and also upsold to customers when their cellular plan was not fitting to their needs each month.July 2007 - August 2008DATA ENTRY CLERKTranscore, Inc, Prince WilliamProcessed ezpass accts for customers, updated their info when needed, and closed accts when they no longer needed their acctsProcessed violations that they may have received when using their tags.February 2007 - June 2007ASSISTANT MANAGERThe Wet Seal Inc, PortsmouthSupervised and motivated all sale associates when working on my shiftObtained fbc cards for the store from new customers, made sale quota for myself as well as push associates to make their goals daily to make store salesDid markdowns, damage out clothing, update customer information on computer, and put out and check in stock when neededCleaned store daily on my shift as well as do bank deposits in the morning, open and closed store when needed, and check store portal for up to date info about store sales, where we stand as a store in the district, get floor sets for the week, and check voicemail from our district manager for the day sales, events, and monetary goal.January 2005 - December 2005ASSISTANT MANAGERThe Dress Barn Inc, Virginia BeachSupervised, motivated, trained, and developed all sale associatesEnsured proper customer service throughout the dayCreated and maintained merchandise displays in the missy, career, and dressy deptsDid price changes, transfers, RTV's, layaways, bank deposits, pos, and check in merchandise as it came in dailyAlso helped with the recruitment, hiring, and training of new associates and motivated all sale associates to sell our charge card to new customers as well as process payroll for that week.EDUCATIONASSOCIATE OF ARTSRoanoke Chowan Community CollegeHIGH SCHOOL DIPLOMAGates County Senior High SchoolCITYCorapeake. |
