Hi, I’m
Albertha White Taylor
Columbia,SC
Summary
Highly experienced and knowledgeable candidate seeking a rewarding career and concurrently be a contributing asset to the organization. Qualifications include proven leadership ability to work independently as well as a team. Possess very strong work ethic and dependability. Effective communication skills and computer skills.
Overview
12
years of professional experience
Work History
HEALTH PLAN ONE
MEDICARE INSURANCE AGENT
09.2022 - 05.2023
Job overview
- Inbound MAPD, PDP, Med Supp, and ancillary sales for Medicare qualified clients
- Interview prospective clients to obtain data about their healthcare needs via needs analysis
- Customize insurance programs to suit individual clients in order to influence, negotiate and drive sales
- Outbound telephonic marketing presentations as necessary to target markets
- Achieve enrollments through extensive product knowledge, compliant procedures and skillful sales strategy
- Excellent communication skills, both verbal and written.
- Proved successful working within tight deadlines and fast-paced environment.
- Skilled at working independently and collaboratively in team environment.
- Assisted clients with completion of applications and paperwork.
- Interviewed applicants and explained scope of different available benefits
TAYLOR INVESTMENTS AND INSURANCE, LLC
INDEPENDENT INSURANCE AGENT
11.2021 - 01.2023
Job overview
- Schedule and attend appointments with prospects and clients to deliver sales and client service
- Interview prospective clients to obtain data about their healthcare and life insurance needs
- Customize insurance programs to suit individual clients in order to influence, negotiate and drive sales
- Deliver marketing presentations to target markets
- Provide excellent customer service
- Built relationships with clients using active listening and issue resolution to provide excellent service.
- Monitored changes in insurance industry to stay compliant with relevant laws and regulations.
- Determined client needs and financial situations by listening and scheduling fact-finding appointments.
- Cross-sold insurance products to existing clients to reach sales targets.
- Educated clients on insurance policies and procedures.
KELLY SERVICES/ PALMETTO INFUSION
INSURANCE CASE MANAGER
06.2022 - 09.2022
Job overview
- Obtains patient data from referring physician office for support of medical necessity; ensures data integrity
- Reviews payor medical policy to determine medical necessity based on payor guidelines and/or FDA indications
- Utilizes Medicare coverage principles and requirements to determine coverage for Medicare patients
- Re-verifies insurance prior to each visit for existing patients
- Obtains initial authorization and reauthorization as applicable
- Performed insurance verification in EMR software and ensures documentation obtained from payer's website is scanned into patient medical record
- Contacts case management/third party administrator/payor representative during verification process to determine eligibility and coverage
- Uses knowledge of reimbursement principles and pricing parameters in ensuring appropriate coverage for services
- Identifies and coordinates materials to be sent to payor for coverage determinations.
- Self-motivated, with a strong sense of personal responsibility
KELLY SERVICES/ STARSTONE INSURANCE
UNDERWRITING TECHNICIAN
02.2022 - 04.2022
Job overview
- Provide strong administrative and clerical support for Property and Casualty insurance/ D&O Management Professional Dept
- Processing and filing endorsements, binders and policy issuances
- Responsible for filing correspondence electronically
- Process and file Quotes, Acceptance, Declinations, Invoices and Submissions for New Business and Renewals
- Managed time efficiently in order to complete all tasks within deadlines.
BLUECROSS BLUESHIELD OF SC
ASSISTANT MANAGER
06.2018 - 11.2021
Job overview
- Supervised day-to-day operations to meet performance, quality and service expectations.
- Monitored cash intake and deposit records, increasing accuracy, and reducing discrepancies.
- Completed regular inventory counts to verify stock levels, address discrepancies, and forecast future needs.
- Offered hands-on assistance to customers, assessing needs, and maintaining current knowledge of consumer preferences.
- Mentored team members to enhance professional development and accountability in workplace.
- Generated repeat business through exceptional customer service and responded to customer concerns with friendly and knowledgeable service.
- Helped with planning schedules and delegating assignments to meet coverage and service demands.
- Developed loyal and highly satisfied customer base through proactive management of team customer service strategies.
- Created employee schedules to align coverage with forecasted demands.
- Developed strategy to increase sales and drive profits.
- Made hiring recommendations to increase company's productivity and profitability with quality workers.
- Opened and closed location and monitored shift changes to uphold successful operations strategies and maximize business success.
- Maintained positive customer relations by addressing problems head-on and implementing successful corrective actions.
- Evaluated employee performance and conveyed constructive feedback to improve skills.
- Used industry expertise, customer service skills and analytical nature to resolve customer concerns and promote loyalty.
- Recruited, interviewed and hired employees and implemented mentoring program to promote positive feedback and engagement.
- Increased Team Sales consistently every year by 10% margins.
BLUECROSS BLUESHIELD OF SC
RETAIL SALES REPRESENTATIVE
02.2015 - 06.2018
Job overview
- Schedule and attend appointments with prospects and clients to deliver sales and client service
- Interview prospective clients to obtain data about their healthcare needs
- Customize insurance programs to suit individual clients in order to influence, negotiate and drive sales
- Deliver marketing presentations to target markets
- Provide excellent customer service
- Suggest additions and or changes to policies and procedures
- Handle opening and closing of store
- Train new staff on store procedures
- Attend sales trainings to help increase profit marketability and company sales goals
- Demonstrate leadership by taking initiative to help fill in areas needed for smooth retail center experience including bank deposits, deposit storage and proper handling of PHI
- Used consultative sales techniques to understand customer needs and recommend relevant products and services.
- Logged reports, expenses, receipts, and sales in company database.
- Increased sales and customer satisfaction through personalized servicing.
- Increased sales by offering advice on purchases and promoting additional products.
KELLY SERVICES/ BLUECROSS BLUESHIELD OF SC
TECHNICAL INFORMATION/ ENROLLMENT/ APPEALS SPECIAL
02.2012 - 02.2015
Job overview
- Provided technical support with review of medical claims and utilization practices
- Performed research as needed to resolve inquires
- Troubleshot claims prior to nurse review
- Assisted in training staff members
- Determined whether to return, deny, or pay claims following organizational policies and procedures
- Documented decisions using indicated protocol sets or clinical guidelines
- Enrolled and re-enrolled new and current members into Medicare Advantage plan
- Verified and keyed applications into Membership and Billing desktop
- Support J11 Medicare Review Part A and Part B activities such as moving claims, Prescreening Phase I and II, CMS
- Aging report, TIP letter, MAC adjudication, Importing Erovers, sorting and organizing TIP letters, and processing records
- Successful in navigating through multiple system platforms
SERVICE ASSOCIATE| COLONIAL LIFE
POLICYHOLDER
01.2011 - 02.2012
Job overview
- Meet daily performance goals that contribute to overall goals of department.
- Demonstrated understanding of Company Accidental, Disability, Cancer, Critical Illness, and Life Products
- Research and respond to external customers inquiries with timely and accurate information
- Accurately navigate through multiple and specific system platforms and proficient use of basic office equipment; fax, computer, and copier
- Satisfactory completion of Basic training materials, tests, role play, call simulations, and on-the-job training.
- Paid attention to detail while completing assignments.
- Identified issues, analyzed information and provided solutions to problems.
Education
Brewer Insurance SchoolColumbia, SC
Property, Casualty, Surety And Marine Producer Pre-Licensing Course
2023
AHIP Education CertificationOnline
AHIP, Health Insurance Advanced Studies(PHIAS) Designation
2020
AHIP Education CertificationColumbia, SC
Professional Academy for Health Care Management (PAHM) Designation
2017
HarvardX Online Learning Initiative CertificationOnline
Exercising Leadership: Foundational Principles
2017
Exam FX Self StudyColumbia. SC
Exam FX Self-StudySouth Carolina Life, Accident and Health License
2015
Pace UniversityNew York, NY
Associate of Arts from Arts
06.1995
Skills
- Skills and Abilities
- Management Sales Communication Leadership
- LAH Licensed in 50 States
- Property & Casualty Licensed in SC
- Consultative Client Needs Analysis
- Enrollment Processing
- Claims Information Gathering
Timeline
MEDICARE INSURANCE AGENT
HEALTH PLAN ONE
09.2022 - 05.2023
INSURANCE CASE MANAGER
KELLY SERVICES/ PALMETTO INFUSION
06.2022 - 09.2022
UNDERWRITING TECHNICIAN
KELLY SERVICES/ STARSTONE INSURANCE
02.2022 - 04.2022
INDEPENDENT INSURANCE AGENT
TAYLOR INVESTMENTS AND INSURANCE, LLC
11.2021 - 01.2023
ASSISTANT MANAGER
BLUECROSS BLUESHIELD OF SC
06.2018 - 11.2021
RETAIL SALES REPRESENTATIVE
BLUECROSS BLUESHIELD OF SC
02.2015 - 06.2018
TECHNICAL INFORMATION/ ENROLLMENT/ APPEALS SPECIAL
KELLY SERVICES/ BLUECROSS BLUESHIELD OF SC
02.2012 - 02.2015
POLICYHOLDER
SERVICE ASSOCIATE| COLONIAL LIFE
01.2011 - 02.2012
Brewer Insurance School
Property, Casualty, Surety And Marine Producer Pre-Licensing Course
AHIP Education Certification
AHIP, Health Insurance Advanced Studies(PHIAS) Designation
AHIP Education Certification
Professional Academy for Health Care Management (PAHM) Designation
HarvardX Online Learning Initiative Certification
Exercising Leadership: Foundational Principles
Exam FX Self Study
Exam FX Self-StudySouth Carolina Life, Accident and Health License
Pace University
Associate of Arts from Arts
Similar Profiles
Yaireth GarciaYaireth Garcia
Quality Assurance Specialist at Health Plan OneQuality Assurance Specialist at Health Plan One
BRIAN CLARKBRIAN CLARK
DESKTOP SUPPORT SPEACIALIST at Health Plan OneDESKTOP SUPPORT SPEACIALIST at Health Plan One
Tyran ChenaultTyran Chenault
Licensed Health Insurance Agent at Health Plan OneLicensed Health Insurance Agent at Health Plan One