Alex Alsup
Dayton,TX
Summary
Organized and dependable candidate successful at managing multiple priorities with a positive attitude. Willingness to take on added responsibilities to meet team goals. Detail-oriented team player with strong organizational skills. Ability to handle multiple projects simultaneously with a high degree of accuracy. To seek and maintain full-time position that offers professional challenges utilizing interpersonal skills, excellent time management and problem-solving skills.
Overview
12
12
years of professional experience
Work History
COORDINATION OF BENEFITS PROFESSIONAL 1
Humana Inc.
03.2020 - Current
- Participated in case reviews, consulted with team caring for client, to evaluate client's needs and plan for continuing services.
- Managed over 25 customer calls per day.
- Skilled at working independently and collaboratively in a team environment.
- Self-motivated, with a strong sense of personal responsibility.
- Designed training and system documentation to facilitate training sessions.
- Identified and analyzed core business processes and workflows.
- Guided business in improving processes by analyzing results.
- Proposed system features and requirements that satisfied business objectives and initiatives.
- Identified support issues and initiated actions for resolution.
- Defined problems, collected data, established facts and validated conclusions.
- Responsible for investigating and validating potential Third Party Liability.
- Validates primary insurance coverage for claims received by Humana Inc.
- Maintain accurate member COB information with COB applications.
- Examined letters from policyholders and agents, original insurance applications and other company documents to determine if changes were needed and affects of changes.
- Reviewed insurance policy to determine coverage.
- Processed, prepared and submitted business and government forms, such as submitting applications for coverage to insurance carriers.
CLAIMS RESEARCH AND RESOLUTION REPRESENTATIVE II
Humana Inc.
03.2019 - 03.2020
- Responsible for investigating and validating potential Third Party Liability
- Validates primary insurance coverage for claims received by Humana Inc
- Maintain accurate member COB information with COB applications
- Examined letters from policyholders and agents, original insurance applications and other company documents to determine if changes were needed and effects of changes
- Reviewed insurance policy to determine coverage
- Processed, prepared and submitted business and government forms, such as submitting applications for coverage to insurance carriers.
BILLING AND ENROLLMENT SPECIALIST
Humana Government Business
07.2017 - 03.2019
- Performed administrative tasks, such as maintaining records and handling policy renewals
- Obtained and provided information when claims were made on policy
- Calculated premiums and established payment method
- Explained features, advantages and disadvantages of various policies to promote sale of insurance plans
- Called on policyholders to deliver and explain policy, to analyze insurance program and suggest additions and changes and to change beneficiaries
- Provided product information and resolved concerns to assist customers.
PEMS SPECIALIST
Humana Inc.
09.2016 - 02.2017
- PEMS specialist understands and applies department and CMS policies, procedures, and processes, which are critical to high-performing business environment
- PEMS specialist researches documents, evaluates member's information, responds to inquiries and requests in timely manner, maintains accurate records, and resolves problems in order to provide exceptional service for members.
- Analyzed marketing data and trends to identify opportunities for improvement
- Collected, arranged, and input information into database system
Sales Manager
Oxmoor Ford Lincoln Mercury
08.2011 - 12.2015
- Recommend and help customers select merchandise based on their needs
- Handled customer relations issues, enabling quick resolution, and client satisfaction.
- Resolved customer issues quickly to close deals and boost client satisfaction.
- Maintained relationships with customers and found new ones by identifying needs and offering appropriate services.
- Coached employees in successful selling methods and encouraged cross-selling to drive revenue.
- Served as liaison between customers, store personnel and various store departments
- Confirm that appropriate changes were made to resolve customers' problems
- Provide information to consumers pertaining to current sales and promotions.
- Track sources of special products and services to meet customers' special needs
- Provide Customer Service Policies/Service Level Standards Training to new employees
- Set sales targets and budgets for team leads and employees.
- Approved advertising campaigns and developed promotional material for retail use.
Education
No Degree - Barbering
The Barber Academy
422 Spring Street, Jeffersonville, IN 4713001.2017
Computer Informational Science -
MID STATE COLLEGE
Peoria, IL05.2006
Skills
- Process Improvement
- Data Integrity Assurance
- Data Research and Validation
- Trend Analysis
- MS Excel
- Complex Problem-Solving
- Organizational Skills
- Good Telephone Etiquette
- Quality Assurance
- Problem Resolution
- Research
- Critical Thinking
- Professional relationship building
Timeline
COORDINATION OF BENEFITS PROFESSIONAL 1
Humana Inc.
03.2020 - Current
CLAIMS RESEARCH AND RESOLUTION REPRESENTATIVE II
Humana Inc.
03.2019 - 03.2020
BILLING AND ENROLLMENT SPECIALIST
Humana Government Business
07.2017 - 03.2019
PEMS SPECIALIST
Humana Inc.
09.2016 - 02.2017
Sales Manager
Oxmoor Ford Lincoln Mercury
08.2011 - 12.2015
No Degree - Barbering
The Barber Academy
Computer Informational Science -
MID STATE COLLEGE