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Click here or scroll down to respond to this candidateCandidate's Name
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PHONE NUMBER AVAILABLE Cell PHONE NUMBER AVAILABLEEMAIL AVAILABLEQualifications16 years of Sales /call center experience with 10 years of supervisor and team lead experience which included managing employees daily attendance and leave of absents. Life and Health agent with numerous awards for salesmanship and accomplishments. Provided training on Medicare and Medicaid products. Ability to work alone or in team format. Proficient on word, excel and other Microsoft products.ProfessionalExperienceSupervisor2016-7/2024HumanaSupervised a team of 20 Medicaid representatives.Team provided authorizations for members medical needs.Provided authorizations for both medical and behavioral providers.Covered both fax and phone coverage from providers.Customer Service Lead2015-6/2016UnitedHealth GroupProvided leadership and development for customer service reps.Updated members accounts, providing urgent activationContacted members as needed for updates on RX and Medical.Recon/Membership Representative 112012-10/2015Anthem Blue Cross Blue Shield, Louisville KYWorked primarily on rejected claims and LEPResponsible for evaluating rejected claims and providing the solution for enrollment.Sent rejected claims to CMS for posting.Reviewed members LEP, and reported and sent uploads to CMSExperienced on Facets, Cosmo, MACESS and Medisys and other systems used to collect member data.COB experience, including gathering member data from providers for ECRSAchievements. Saved the company thousands on rejected claims expertise.. Perfect audit score awards.. Maintaining high quality in customer service.New Member AdvisorAnthem Blue Cross Blue Shield, Louisville KY 2010-2012Helped members to customize newly acquired plans to suit their needsCalculated premiums and established payment methods.Generated sales through referrals from new members.Explained features and benefits of various policies making sure members are satisfied with plan choice.AchievementsSaved customers thousands of dollars on insurance costs.Received award for Accuracy and efficiency for year 2011Consistently met goals and standards.Walgreens Inc., Louisville/KY2006-2010Case Manager,/CollectionsResponsible for verifying insurance coverage for patients to ensure timely reimbursement, and calling and collecting AR.Completed authorizations for commercial insurance, Medicare and Medicaid plans.Including map 9 for Medicaid patients and Diff for Medicare patients.DME product specialist.AchievementsIntroduced new ways of offering higher quality in customer service to our customersProficient on quality and production.Ability to maintain a high work performance on dual projects.LIFE HEALTH AGENTAmerican Life Assurance Company, Louisville KY2004-2006Sold commercial insurance products to employees of local business.Provided presentations for local businesses of 20 or more employees.EducationUniversity Of Louisville, Louisville,KY1980CommunicationsProfessionalCompleted courses/seminars in employee involvement, and leadership.TechnicalLife /Health License |
