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Click here or scroll down to respond to this candidateCandidate's Name
Street Address Cell: PHONE NUMBER AVAILABLE Email: EMAIL AVAILABLEADMINISTRATIVE PROFESSIONALHEALTH CARE CLAIMS INSURANCE CUSTOMER SERVICE DATA SUPPORT NONPROFITPROFESSIONAL PROFILEHighly capable administrative professional offering eighteen years of broad-based experience in customer service, administrative processes, data entry, small-Group sales support, claims, and account administration gained from nonprofit and health care industries. Excellent communication and people skills. Demonstrated ability to work well under stressful conditions; able to manage multiple assignments and meet deadlines effectively. Collaborator able to build strong rapport with diverse range of customers, co-workers, and management; strong customer service orientation. Welcome new challenges, accept responsibility, with a commitment to excellence. Adapt quickly to changing environments, solid time management skills.Technical Skills: MS Office MS Outlook Salesforce Internet Savvy.Core Competencies: Data Entry/Data Analysis Customer Support Claims Administration/Medicaid Benefit Enrollments Sales/Client Services Customer Service/Call Center Sales/Marketing Support Administrative Support Policies and ProceduresSUMMARY OF SKILLSCustomer Service / Account ManagementIdentified customer service opportunities and recommended appropriate service and products to customers. Consistently demonstrated responsiveness, strong customer focus, and ability to build/maintain good customer relationships. Consistently updated and maintained customer database, provided management and staff with accurate and compatible information at all times on accounts.AdministrationProvided administrative support to include reviewing correspondence, filing, reporting, scheduling, data entry, monitoring payment receipts, and kept abreast of industry standards. Functioned as customer service lead for mentoring and training new employees on department procedures; ensured daily organization of files maintained. Provide support for specific customers in a professional manner to improve the customer experience. Disseminated information for management on assigned accounts through daily reports. Organized account information; performed data entry on accounts; analyzed information and corrected errors on customer files.PROFESSIONAL EXPERIENCEAmeriCorps Racine, WI 2023 presentLiteracy TutorAmeriCorps Atlanta, GATutor working with K-3 grades, to help kids ages 5-8 with letter sounds, word blending, phonics, and fluency to develop early reading skills and build the skills and confidence they need to succeed. Track student progress and meet with the schools on-site coach monthly. Conduct skill assessments and enter student scores into data software weekly. Represent Early Learning Corps at school events and share your experience with the community to raise awareness.ILIFE FINANCIAL MILWAUKEE, WI 2020 - 2024SUPPORTIVE HOME CARE /PERSONAL CARE WORKERprovide and assist disable clients with personal care needs, such as bathing, grooming, cleaning, laundry, and light meal prep in a home setting.participate in the assessment of client needs, program planning and implementation and program documentation and evaluation with assigned Nurse Coordinator monthly.Schedule and track client appointments and accompany them to those meetings by providing personal and/or private transportation.Manage and administer daily medications to clients as well as monitoring vitals and changing gauze when needed.Jewish Federation of Greater Atlanta, GA 2018 2019Administrative AssociateCoordinate office activities and operations to secure efficiency and compliance with company policies.Managed and answering switchboard phone lines and dispatching all calls to appropriate office contact.Provide administrative and customer service support to thirty project executives to include handling general administrative needs such as filing, faxing, scanning, scheduling meetings, mailings, and preparing letters and other business correspondence.Process program contributions, including logging payments, applying credit to Donors account for incoming check donation that finance department for deposit within 24-48 hours, and sending acknowledgements to the donors.Help VP of Donor Services with responding to and resolving donor issues pertaining to donations via phone and/or email.Enter data and maintain a database for donations, follow with donors to obtain corrections, obtain final approvals.Function as a liaison for community wide security team in the event of an emergency; account for all employees using the SCN Alert System; attend quarterly safety meetings; responsible for entering all new hires into the SCN Alert System.Candidate's Name Page 2Aetna/ Coventry Health Care of Georgia, Inc., Atlanta, GA 2002 2017Customer Service Specialist, Aetna, Atlanta, GA, 2014 2017Coordinated with proposal units on RFP responses to brokers and groups and maintained various system updates for proposal pipeline and sales activity.Collaborated closely with underwriting team and sales and marketing team to prepare a release the proposed business.Answered incoming phone calls from customers and identified the type of assistance the customer needed.Asked appropriate questions and listened actively to identify specific questions or issues while documenting required information in computer systems.Entered data using Salesforce pertaining to existing account renewal process and new proposal logs.Screened health applications for small group underwriting teams and nurses by evaluating and determining the medical debits to incorporate to the base premium to lock in Groups monthly premium.Utilized internal and external quoting system to support small group sales.Sales & Marketing Assistant New Business, Coventry Health Care, Atlanta, GA, 2011 2014Sales & Marketing Assistant Renewal Business, Coventry Health Care, Atlanta, GA, 2009 2011Administrative Assistant, Coventry Health Care, Savannah, GA, 2008 2009Functioned as team lead for all new employees for the sales & marketing team and provided new hire orientation and training.Provided online quotes for account executives and brokers using the internal/external quoting tool; explained outcome of claims issues and explanations of benefits to members and providers for resolution.Assisted in case installation and enrollment of small group sold cases.Scheduled meetings with brokers to discuss and confirm sold group benefits and documents were accurate.Organize and package benefit summaries and brochures for brokers and account executives meetings with clients and groups.Provided guidance and coaching to clients and brokers through online training on how to navigate to the corporate website to locate appropriate resources.Participated in staff meetings, case consultation and training opportunities; successfully collaborated with peers and managers.Conducted online research and successfully managed multiple tasks and projects.Rating Coordinator, Coventry Health Care, Atlanta, GA, 2005 2008Collaborated with underwriting team and used internal and external quoting tool to determine additional debits for base premiums.Identified unusual medical health conditions and provided debits based on quoting tool.Maintained adequate knowledge of rating procedures, coverage, and the industry to effectively manage, maintain and develop client relationships.Previous experience as a Sales and Marketing Assistant, Coventry Health Care, Atlanta, GA, 2002 2005.United Health Care, Atlanta, GA 1998 2002Rating Proposal Coordinator, 2000 2002Duties entailed creating and generating health care quotes for comparison pricing utilizing online quoting tools.Provided administrative support to account executives to assist in the sale by acting as a liaison to brokers in their absence.Claims Processor, 1998 2000Resolved pending healthcare claims, prior approval requests and responded to providers.Analyzed claims to determine whether billing department would approve or deny payment based on CPT code provided and authorizations.Applied knowledge of medical coding and various medical claims forms to the claims process.EDUCATIONPursuing Associate Degree in Health Information Technology Atlanta Technical College, Atlanta, GA, 2017 (on hold) |
