Amanda DeGoede
SAN DIEGO, CA,CA
Summary
Knowledgeable professional with proven background in healthcare, commissions and employer health insurance. Expertise in providing comprehensive insurance solutions and fostering strong client relationships. Demonstrated proficiency in navigating complex insurance policies and regulatory requirements.
Overview
15
15
years of professional experience
Work History
Employer and Broker Services
United Healthcare
01.2023 - Current
- Deliver excellent customer and provider service by building strong positive relationships and assisting with the resolutions of disputes
- Responsible for accurately processing claims and performing investigations to ensure resolution of denials to achieve daily goals and providing recommendations on new processes to improve productivity
- Responded via telephone and email to questions regarding licensing, commissions, website logins and website navigation.
- Adhered to health and prescription insurance products, delivery systems, and claims systems.
- Answered incoming phone calls to articulate product value to prospective customers and support current policyholders.
- Enhanced customer satisfaction by addressing and resolving insurance-related inquiries and concerns.
- Processed insurance policy cancellations and renewals quickly to meet call time targets.
- Fostered strong relationships with clients, providing personalized service and assistance on various insurance products.
- Reviewed and adjusted customer coverage levels to address, identify, and resolve customer conflicts.
- Provided exceptional support during annual open enrollment periods, guiding customers through plan selection processes effectively.
- Facilitated smooth transitions between departments during claim handoff processes to ensure seamless coordination among internal teams for prompt resolution times.
- Provided exceptional customer service to internal clients during inquiries or disputes regarding commissions calculations or adjustments.
Practice Manager
Elevation Therapy Center
01.2021 - 01.2023
- Communicating with insurance companies to ensure that claims are processed correctly
- Wrote and enforced policies governing successful care delivery and staff performance.
- Managed daily practice operations to optimize appointment scheduling, patient records management and billing functions.
- Coordinated with insurance providers to streamline the billing process and minimize any delays in reimbursement.
- Established effective communication channels between management, therapists, support staff, patients, and their families.
- Developed strong relationships with referral sources to increase new patient acquisition and grow the business.
Detox Nurse / Psychiatric Technician
Laguna Treatment Hospital
01.2010 - 01.2021
- Streamlined admission processes by efficiently assessing incoming patients, gathering relevant medical history information, and initiating appropriate treatment protocols.
- Provided crisis intervention services during high-stress situations to maintain patient safety and stability during the detox process.
- Provided guidance and support to newly-hired nursing staff, sharing knowledge and expertise in the field of detox nursing.
- Administered medications as prescribed, ensuring proper dosages and timely administration for optimal treatment outcomes.
- Managed withdrawal symptoms effectively by applying evidence-based nursing practices tailored to individual needs.
- Consistently maintained a high level of professional conduct and confidentiality while working with sensitive patient information.
- Maintained accurate documentation of patient progress, evaluations, treatments, and medication administration in compliance with regulatory requirements.
- Enhanced patient safety with diligent monitoring of vital signs and appropriate interventions when necessary.
Education
Life, Health And Accident Insurance Certification -
Xcel Insuring Training
Remote03-2025
Associate of Science - Psychiatric Nursing
West Hills College
Coalinga, CA12-2009
Skills
- Effective Caseload Coordination
- Regulatory Compliance
- Claims Review
- Experienced in Medical Billing Processes
- Data Retention Management
- Claims processing
- Payment and investigation escalations
- Account management
- Microsoft Excel expertise
- Salesforce proficiency
- Audit support
Timeline
Employer and Broker Services
United Healthcare
01.2023 - Current
Practice Manager
Elevation Therapy Center
01.2021 - 01.2023
Detox Nurse / Psychiatric Technician
Laguna Treatment Hospital
01.2010 - 01.2021
Life, Health And Accident Insurance Certification -
Xcel Insuring Training
Associate of Science - Psychiatric Nursing
West Hills College
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