Summary
Overview
Work History
Education
Skills
Timeline
AssistantManager
Alex Gerhart

Alex Gerhart

Butte,MT

Summary

Efficient claims processor and refund specialist with a combined 6 years of experience in medical, dental, and vision insurance. Productive and diligent with enthusiasm for resolving discrepancies through attention to detail and creative problem-solving. Passionate about perpetuating company values through impeccable work ethic and drive.

Overview

12
12
years of professional experience

Work History

Refund Specialist

Avesis
02.2022 - 09.2023
  • Enhanced team productivity by providing training on new processes, leading to more efficient refund processing.
  • Contributed to the development of departmental goals and strategies for improving overall refund operations efficiency.
  • Assisted management in developing a comprehensive policy manual outlining clear guidelines for handling refunds.
  • Maintained accurate records of all refunds processed, ensuring proper documentation for auditing purposes.
  • Developed strong working relationships with colleagues across various departments, facilitating smooth resolution of cross-functional issues involving refunds.
  • Participated in regular meetings with management to discuss progress toward department targets, suggesting improvements where necessary.
  • Collaborated with other teams to resolve complex refund cases, resulting in improved client relationships.
  • Team specific responsibilities included; Pulling, reviewing, distributing, and working the weekly SharePoint Triggers Report. Reviewing and posting provider checks and returned checks. Reviewing and completely the NPID TIN Term Requests sent to the refund team mailbox. Creating refund letters to be sent to providers and other corresponding letters needed. Creating step by step notes for refund processes to train current and new members of the refunds team.
  • Exposure to: Cadence, BRAIN, SharePoint, MCARE, BAS, Microsoft Office: Excel, Word, Access, PowerPoint, Outlook, and teams
  • Consistently met production and quality with few to no errors sent over from audit reviews.

Claims Analyst

Centene Corporation
04.2017 - 01.2023
  • Reduced claims processing time by implementing efficient analytical techniques and strategies.
  • Enhanced customer satisfaction by resolving complex claims issues in a timely manner.
  • Streamlined workflow processes for improved efficiency and reduced claim resolution times.
  • Collaborated with cross-functional teams to develop best practices for claim handling procedures.
  • Identified trends in claim patterns, providing actionable insights for process improvements and risk mitigation strategies.
  • Demonstrated a high level of accuracy and attention to detail in reviewing claim documentation for approval or denial decisions.
  • Increased customer satisfaction by efficiently processing refund requests and resolving disputes.
  • Reduced processing time for refunds by streamlining procedures and enhancing communication with other departments.
  • Processes basic pends quickly with focus on quality
  • Takes on additional tasks
  • Ability to adapt to changing programs/processes.
  • Provider outreach when needing information for a refund check
  • Tracking of checks in Refund Database
  • Utilize Golden reports to obtain claim numbers
  • Trained and works in OMNI.
  • Exposure to: CRM, AWD, KMAP & other various OIC web portals, Microsoft Office: Excel, Word, Access, PowerPoint, Outlook, and teams
  • Trained in Centene's Basic and advanced analytical training, pricing, COB, Appeals, Returned Letters, Mac Updates, and Refund processing.

Cleaning Technician

Superior Cleaning
01.2021 - 05.2021
  • Enhanced customer satisfaction by maintaining a clean and hygienic environment in commercial spaces.
  • Reduced allergens and improved air quality through thorough dusting, vacuuming, and mopping.
  • Performed deep-cleaning tasks for optimal sanitation levels in high-traffic areas.
  • Contributed to a healthy workplace by consistently sanitizing office equipment and surfaces.
  • Increased efficiency with proper usage of industrial cleaning equipment and chemicals.
  • Regular responsibilities include; Wash walls, clean bathroom fixtures, collect bio- hazardous trash, and perform high dusting, using various cleaning chemicals-and disinfectants as required, clean and maintain equipment, vacuuming, mopping, other sanitation duties

Cleaning Technician

Biz Clean, LLC
05.2018 - 10.2018
    • Enhanced customer satisfaction by maintaining a clean and hygienic environment in commercial spaces.
    • Reduced allergens and improved air quality through thorough dusting, vacuuming, and mopping.
    • Performed deep-cleaning tasks for optimal sanitation levels in high-traffic areas.
    • Contributed to a healthy workplace by consistently sanitizing office equipment and surfaces.
    • Increased efficiency with proper usage of industrial cleaning equipment and chemicals.
    • Regular responsibilities include; Wash walls, clean bathroom fixtures, collect bio- hazardous trash, and perform high dusting, using various cleaning chemicals-and disinfectants as required, clean and maintain equipment, vacuuming, mopping, other sanitation duties
    • Safeguarded property integrity by careful handling of client belongings during the cleaning process.
    • Adhered to safety guidelines when using hazardous materials, ensuring a secure work environment for all staff members.

Bartender

Coyote Club And Event Center
10.2011 - 10.2017
    • Increased customer satisfaction by providing excellent service and crafting high-quality cocktails.
    • Reduced wait times for drinks by efficiently managing the bar area and prioritizing orders.
    • Maintained a clean and organized workspace, ensuring compliance with health and safety regulations.
    • Contributed to a positive work environment through effective teamwork and communication with colleagues.
    • Prepare food patrons
    • Plan and present menu
    • Check identification and follow legal drinking laws
    • Comply with all food and beverage regulations
    • Check in all deliveries
    • Monitor and order supplies and merchandise
    • Check and balance till
    • Make nightly money deposits
    • Opening and closing responsibilities

Night Auditor and Front Desk Clerk

Best Western Inn And Suites
12.2014 - 12.2016
  • Enhanced guest satisfaction by efficiently managing night audit tasks and resolving issues promptly.
  • Streamlined the check-in and check-out process for guests, ensuring a smooth experience during overnight hours.
  • Maintained accurate financial records by diligently balancing daily revenue reports and identifying discrepancies.
  • Assisted management in forecasting room occupancy rates, optimizing room allocation and maximizing revenue.
  • Complete knowledge of emergency procedures
  • Phone communications
  • Understands principles of auditing, balancing, and closing out accounts

Dental Assistant

Marias Healthcare Services, INC
08.2013 - 01.2016
    • Enhanced patient comfort by providing gentle and thorough dental cleanings.
    • Streamlined appointment scheduling for increased efficiency and reduced wait times.
    • Assisted dentists with complex procedures, ensuring optimal patient care and treatment outcomes.
    • Maintained a clean and sterile work environment to prevent cross-contamination and infection.
    • Educated patients on proper oral hygiene techniques, promoting long-term dental health.
    • Managed inventory of dental supplies, reducing waste and optimizing resource allocation.
    • Provided chairside assistance during examinations, improving dentist efficiency and patient satisfaction.
    • Conducted preliminary assessments of new patients, gathering crucial information for accurate diagnoses.
    • Prepared instruments and equipment for use in dental procedures, ensuring their availability when needed.
    • Contributed to office organization by maintaining accurate patient records and updating files regularly.
    • Handled administrative tasks such as billing, insurance claims processing, and appointment confirmation calls to support office operations efficiently.
    • Performed x-rays safely while adhering to radiation safety guidelines, ensuring high-quality diagnostic images for dentists'' evaluations.
    • Reduced appointment cancellations by implementing reminder calls and text messaging services, resulting in improved scheduling efficiency.
    • Supported dentists during oral surgeries by preparing surgical rooms with necessary tools and sterilized instruments.
    • Cleaned and sanitized dental tools and equipment, straightened treatment rooms, and restocked supplies to prep for next patient and maintain health and safety practices.
    • Sanitized trays, instruments, and surfaces for clean dental office setting and patient safety.
    • Successfully assisted dentist by performing four-handed dentistry and other chair-side duties.
    • Performed general chair-side duties for general dentistry, endo procedures, and oral surgery.
    • Assisted dentists, hygienists, and other personnel by handing appropriate tools and supplies needed for procedures.

Education

High School Diploma -

Conrad High School
Conrad
05.2013

Skills

  • Conflict Management
  • Adaptability and Time Management
  • Problem Solving and Critical Thinking
  • Professionalism
  • Attention to Detail and Analytical Thinking
  • Computer Literacy
  • Organizational Skills
  • Software Proficiency
  • Data Entry Accuracy

Timeline

Refund Specialist

Avesis
02.2022 - 09.2023

Cleaning Technician

Superior Cleaning
01.2021 - 05.2021

Cleaning Technician

Biz Clean, LLC
05.2018 - 10.2018

Claims Analyst

Centene Corporation
04.2017 - 01.2023

Night Auditor and Front Desk Clerk

Best Western Inn And Suites
12.2014 - 12.2016

Dental Assistant

Marias Healthcare Services, INC
08.2013 - 01.2016

Bartender

Coyote Club And Event Center
10.2011 - 10.2017

High School Diploma -

Conrad High School

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Alex Gerhart