Angela M. Sidney, LIA

Created and maintained database systems to track and analyze operational data. project plans. timelines, budgets & financials.
Devised and implemented processes and procedures to streamline operations.
Delivered high-quality presentations to stakeholders, effectively communicating project objectives, results and effectively troubleshooting client issues against evaluated needs & expectations.

• .Scheduled appointments and actively listened to customer needs and desires to identify and recommend optimal benefit products while building customer loyalty and retention.
• Followed federal guidelines when interviewing applicants & collected data to determine eligibility for economic assistance and clarified questions pertaining to the scope of explanation of benefits.
• Educated clients on current promotional offerings and products using persuasive selling tactics.
• Generated new referrals and sales leads to achieve and exceed monthly sales goals

• Increased client sales by transferring to PHA sales via e-commerce feature when applicable
• Liaised with management & virtual teams when applicable to resolve customer & system technicalities for solutions.
• Initiated success of organization by meeting & exceeding metric goals of monthly & annual performance
• Provided outstanding service to clients to maintain and extend relationship for future business opportunities.

• Support clinical staff via data entry phone support, initial triage and administrative intake of members within call center setting.
• Vital point of contact for research and reconciliation regarding patient care claims, corrections, and provider payments (EOBs), RX processing.
• Educate patients and providers on programs, benefits, and eligibility and bridge with in-network managed care liason.
• Evaluated medical records as part of claim assessments, ensuring an accurate understanding of treatment costs and recovery timelines.
• Reduced claim processing time by implementing efficient workflow procedures and organization systems.
• Identified fraudulent activity through meticulous analysis of claim data, protecting company resources from potential losses.

• Preserved revenue streams by utilizing strong communication and negotiation skills, offering refunds as last resort to maintain customer satisfaction & resolved complaints with forward-thinking strategies .
• Provided information to customers regarding charge accounts and loyalty program and helped to open and activate new accounts.
• Answered customer calls promptly to avoid on-hold wait times. Managed stock. Communicated with vendors regarding back order availability, future inventory and special orders

• Verified eligibility and compliance against authorization request from service providers.
• Communicated with executives about consistent customer issues.
• Obtained and logged accurate patient insurance and demographic information for use by insurance providers and medical personnel.
• Completed form letters in response to requests or problems identified by correspondence.

• Managed team performance by training, mentoring, disciplining and motivating over 7 employees. Created & maintained weekly employee timesheets & workflow schedules. Formulated plans for improving procedures, training and processes.
• Tracked, analyzed, & resolved weekly inventory data reports for orders. Assessed & resolved excess claims reports for payments.
• Consulted with insurance company representatives to complete claims processing, resolve concerns and reconcile payments.
• Calibrated, maintained and operated Pixus equipment evaluations for maximum performance.