Hi, I’m
Akeem Hertenstein
Branson,MO
Summary
Knowledgeable and dedicated customer service professional with extensive experience in the Insurance industry. Solid team player with outgoing, positive demeanor and proven skills in establishing rapport with clients. Motivated to maintain customer satisfaction and contribute to company success. Specialize in quality, speed and process optimization. Adept at handling multiple tasks efficiently and accurately, exhibiting professionalism and maintaining confidentiality at all times. Articulate, energetic and results-oriented with exemplary passion for developing relationships, cultivating partnerships and growing businesses.
Overview
8
years of professional experience
Work History
Centene / Healthnet
Escalations Specialist
03.2017 - 09.2022
Job overview
- Delivered exceptional customer service to every member by leveraging extensive knowledge of products and services and creating welcoming, positive experiences.
- Quickly and accurately determine the issue and provide a solution to internal Agents, while maintaining a high standard of documentation and reporting,
- Provide outreach to Members, Vendors, Doctor and other offices as needed in a professional and detailed capacity to provide resolutions of complex issues.
- Using professional communication skills to lead effective training classes and nesting integration
- Creating and Processing reports that would be seen on a Director level, and distributed to over 5 sites, containing advance use of pivot tables and macros.
- Appeals and Grievance processing with case closures
- Quality review and Coaching as needed for Internal employees
- Collaborated with staff members to enhance customer service experience and exceed team goals through effective client satisfaction rates.
- Quickly and accurately answered customer questions, suggested effective solutions and resolved issues to increase customer satisfaction
McKesson
Case Manager
06.2015 - 01.2017
Job overview
- Helped patients receive appropriate, high-quality care with reasonable results.
- Partnered with physicians, social workers, activity therapists, nutritionists and case managers to develop and implement individualized care plans and documented patient interactions and interventions for Oncology Medications.
- Identified care needs of individual patients and coordinated responses based on physician advice, insurance limitations and procedural costs.
- Maintained extensive Medical Policies and Medical Records to establish a 100% increase in approval rates for the team and doctors office.
- Facilitated patient placement with vendors, while working with patients in a friendly and professional capacity to provide educations and referrals to eligible providers.
Republic Plastics
Thermoforming Lead Engineer
03.2014 - 03.2015
Job overview
- Controlled engineering activities to maintain work standards, adhere to timelines and meet quality assurance targets.
- Coordinated with Material loaders and other teams to meet vendors needs and production goals
- Repair and maintain Large Commercial scale machines
- Experience in Management of Teams, both Retail and Production
- Responsible for New-Agent development and advancement.
Education
Ozarks Technical Community CollegeSpringfield, MO
Associate of Science from Computer And Information Sciences
01.2025
Skills
- Customer Issue De-Escalation
- Escalation Management
- Complaint Investigations
- Project Management
- Product Development
- Technical Support
- Service Scheduling
- Hardware and Software Installation
- Microsoft Tools
- Staff Training
- Insurance Background, Private and Government sectors
Accomplishments
Spent 5+ years building desktop computers.
Able to build, diagnose and repair common computer hardware.
- Have spent 12+ years accumulatively, working with Medical and Pharmacy insurance.
Knowledge in many felids of insurance,
- Benefit administration
- Medicare
- Marketplace
- Claims
- Pharmacy Support
- Sales as Licensed Agent
- Internal Support Teams
- Appeals and Grievances
- Web and Chat Support
- Escalations
- Training Instructor
- Information Technology
- Medical Insurance and Billing
Timeline
Escalations Specialist
Centene / Healthnet
03.2017 - 09.2022
Case Manager
McKesson
06.2015 - 01.2017
Thermoforming Lead Engineer
Republic Plastics
03.2014 - 03.2015
Ozarks Technical Community College
Associate of Science from Computer And Information Sciences
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