Amor Daniell
Danbury,CT
Summary
Competent Professional, experienced managing high volume personnel. Highly proficient managing multiline phone system while providing the highest level of costumer service . Bilingual with fluency in Spanish. Eager to contribute to team success through hard work and attention to detail. Health Advisor experienced handling high volume of calls in fast-paced call center environments. Well-versed in answering questions, researching problems and resolving discrepancies. Detail-oriented and personable with exceptional work ethic and passion for service.
Overview
2
2
years of professional experience
Work History
Consumer Resolutions Advocate-
United Healthcare
02.2023 - Current
- Researched claims and benefit information for more than 20 issues daily to ensure that the claims and policies were properly applied
- Reviewed and corresponded with adjustments department regarding denied claims to ensure proper benefits and rates are being captured to ensure proper pricing and payment
- Reviewed documentation during calls to asses whether documentation was properly submitted for review team to review and instruct claim handling information
- Used strong analytical and problem-solving skills to develop effective solutions for challenging situations
- Communicated with member and providers through phones and electronically to ensure proper claim information is received.
- Educated providers on policy information to ensure proper guidelines were being used when claim is being submitted.
Health Advisor-Remote
United Health Care
02.2022 - 02.2023
- Respond to and resolve on first call, customer service inquires and issues by identifying topic and type of assistance caller needs such as benefits, eligibility and claims, financial spending accounts and correspondence
- Research and resolve claims on first contact basis using multiple software's
- Handled more than 40 daily inbound calls from health plan customers.
- Continually improved knowledge, skills and performance based on feedback and self-identified professional developmental needs.
- Resolved problems related to benefits, eligibility and claims
Education
Certificate-02001210 - Certified Professional Coder
Aapc
Salt Lake City, UT04.2023
BBA - Health Services Administration
Berkeley College
New York, NY04.2022
Skills
- Versatile problem solver
- Verbal and written communication
- Problem-solving
- Computer skills
- Time management
- Decision making
- Organization
References
Furnished upon request.
Timeline
Consumer Resolutions Advocate-
United Healthcare
02.2023 - Current
Health Advisor-Remote
United Health Care
02.2022 - 02.2023
Certificate-02001210 - Certified Professional Coder
Aapc
BBA - Health Services Administration
Berkeley College