Amelia Monique Robinson

• Exhibits a concierge attitude while assisting members, helping to maximize their benefits, navigate the healthcare system, and answer general policy and complex claim questions.
• Additional duties include educating members on high-quality, low-cost healthcare, assisting with the setup of preauthorizations, advising on physician redirection opportunities, scheduling appointments, completing cost estimations, assisting with behavioral health inquiries, and providing members with general health information on their condition or diagnosis to help them reach their optimal health.
• Works collaboratively with internal and external stakeholders to achieve and/or maintain knowledge of customer accounts, and actively seeks improvement, efficiency opportunities.
• Successfully have probing discussions with callers for the purpose of helping them make better choices (cost estimates, claims training, and warm transfers to clinical resources, etc.).
• Providing job and unit-specific coaching for Customer Service Advocates, Processors, and/or Examiners.
• Analyzed trends in employee utilization of benefits to identify areas for improvement or cost savings opportunities.
• Managed communications between insurance companies, employers and employees regarding plan details.

Refund Adjudication Examiner

• Research cash receipts files, and adjudicate claims accordingly through the Blue Chip System, FSS Assist, and FSS Web.
• Process claims requiring adjustment of refunded or recouped dollars.
• Review and edit claims data for accuracy.
• Make phone calls to providers and groups as needed.
• PC proficiency to include Microsoft Word, Excel, and Outlook.
• Knowledge of medical terminology and anatomy.
• Experience with Blue Chip, Financial Suspense System, or Blue Card SIRFing process.
• Maintain records on the claims system, and support systems.

• Attention to Detail.
• High concentration.
• Commitment
• Interact with a wide range of customers and technical issues.
• Active Listening
• Customer Service
• Troubleshooting hardware and printer issues.
• Installing software and hardware peripherals
• Performing daily backups
• Working with third-party vendors to resolve issues
• Rolling out new software, upgrades, and hardware
• Supporting IT infrastructure for operating issues
• Troubleshooting and resolving issues with hardware, software, telecommunications, business applications, and customer connectivity
• Adapting to support incoming calls, emails, and chats
• Quickly learning key terms and phrases to apply troubleshooting techniques

• Commercial driver's license
• All different types of products, that is ordered by customers
• Transport
• Loaded and unloaded freight
• Maintained vehicle
• Completed DVIR reports daily
• Delivery driver

• Assist clients in their daily personal tasks, such as bathing or dressing
• Perform housekeeping tasks, such as laundry, washing dishes, and vacuuming
• Help to organize a client’s schedule and plan appointments
• Arrange transportation to doctors’ offices or other outings
• Shop for groceries and prepare meals to meet a client’s dietary specifications
• Keep clients engaged in their social networks and communities

• Supervise, train and assist employees like Sales Representatives and Retail Store Clerks in customer service, store maintenance and product promotions
• Develop and maintain a schedule for employees and promotions centered on holiday sales and other cycles
• Seek ways to better promote the store, the product line and service within the store
• Maintain proper inventory levels, ensure stocking, implement purchasing plans and maintain contact with suppliers to ensure maximum efficiency in meeting sales goals
• Implement cross-training of employees and Assistant Managers to maintain productivity at all times
• Manage all controllable costs with a view to maintaining profitability
• Ensure the store remains clean and presentable at all times
• Hire and train as needed to ensure adequate personnel is on hand to provide outstanding customer service

• Maintains office operations by receiving and distributing communications; maintaining supplies and equipment; picking-up and delivering items; serving customers
• Office Experience - General, Scheduling, Telephone Skills, Typing, Documentation Skills, Meeting Planning, Verbal Communication, Written Communication, Dependability, Attention to Detail, Administrative Writing Skills
• Also anything else the Owner wanted done