Andrea Capps
Brandon,WI
Summary
Motivated Patient Account Representative offering 15 years customer service experience. Highly effective time management, communication and interpersonal skills. Result oriented, dependable and professional. Comfortable and effective with personalities of all levels whether in a team or individual situation. Self-motivated, and comfortable with following direction or working independently. Very adept at peacefully resolving conflicts while remaining calm.
Served on the Executive Board of Directors for Fond du Lac Soccer Association as Treasurer and Recreational League Coordinator for 3 years.
Overview
19
19
years of professional experience
1
1
Certification
Work History
Patient Account Representative II - Float
SSM Health/Agnesian Healthcare
06.2019 - Current
- Gathers information from patient and enters into appropriate database
- Seeks appropriate resources to resolve issues about the type, date or location of prescribed procedures
- Schedules patient procedures in a manner that most efficiently utilizes the patient's time and clinical resources
- Coordinates and communicates schedules
- Assists with coordination of activities related to insurance pre- certification/authorization
- Provides counseling to patient, participant or their representative regarding pre-service requirements and instructions
- Performs clerical and reception duties associated with patient registration
- Identifies process improvement opportunities and participates in improvement plans
- Works on special projects as needed.
- Worked with outside entities to resolve issues with billing, claims and payments.
Agent Producer
Encompass Insurance Solutions
08.2018 - 06.2019
- Evaluating business or individual customers' needs and financial status and proposing protection plans that meet their criteria
- Maintain bookkeeping systems, database and records
- Create productive relationships to create a pool of prospective clients from various sources by networking, cold calling, using referrals etc
- Explain the features of various policies
- Handle policy renewals.
- Provides service to clients’ changing insurance needs by selling Home, Auto, Life and Health insurance.
- Establishes productive working relationships with clients.
- Communicates with adjusters.
- Obtains underwriting approval by completing application for coverage.
- Completes coverage by delivering policy, planning future follow-up visits, and evaluations of needs.
- Updates job knowledge by participating in educational opportunities, maintaining personal networks, and participating in professional organizations.
- Enhances insurance agency reputation by accepting ownership for accomplishing new and different requests and exploring opportunities to add value to job accomplishments.
Agent Producer/Office Manager
Farmers Insurance
12.2017 - 08.2018
- Approaches potential clients by utilizing mailings and phone solicitation; making presentations to groups at company-sponsored gatherings; speaking publicly to community groups on the subject of personal insurance coverage
- Determines clients' particular needs by scheduling fact-finding appointments and determining extent of present coverage
- Developing a coordinated coverage plan by calculating and quoting rates for immediate coverage action
- Obtaining underwriting approval by completing application for coverage and successfully resolving any issues
- Completing coverage by delivering policy and planning future follow-up visits for evaluation of change of needs.
Lead Deli
Piggly Wiggly
09.2016 - 09.2017
- Assisting manager with day to day operations such as preparing special orders, product inventory, assisting customers and product ordering from several different vendors
- Employee scheduling and new hire training
Driver/Helper Seasonal
UPS
11.2016 - 01.2017
- Assisting driver with package deliveries and pick-ups to/from both commercial and residential addresses
- Obtaining proper authorization for delivery when required
- Correctly organizing packages based upon their code number/zip code in vehicle for easier delivery
- Providing excellent customer service.
- Exhibited good attendance, work habits and willingness to learn job functions.
Account Coordinator
AIA Corporation
11.2014 - 08.2016
- Liaison between customers (Franchise Owners, Sales Affiliates, suppliers, etc.) and AIA Corporation
- Assist owners with maintaining their compliancy and provided ongoing training and guidance
- Research and provide answers to all customer inquiries
- Communicate with owners on all matters affecting their business
- Ensure that owners are in compliance with AIA standards
- Maintain/retain communication documentation pertinent to transactional activity
- Work with staff in various departments within AIA to resolve customer issues
- Follow up with team members on progress, and ultimately ensure that customer concerns are satisfactorily handled
- Ensure that Cost Carry Forward and other related issues are communicated to the collections area
Economic Support Worker
Fond du Lac County Dept of Social Services
08.2013 - 10.2014
- Timely evaluated eligibility of clients requesting county/state funded benefits such as FoodShare (Foodstamps), Badgercare and Medicaid
- Successfully maneuvered between up to 12 different programs during interview (on phone or in person) to verify clients' information such as earned and unearned income, criminal record and legal status in the US
- Correctly calculated any over/under payments of benefits to be adjusted
- With empathy yet successfully resolved questions and/or issues surrounding the clients' case.
Claims Representative II
Anthem Blue Cross & Blue Shield
06.2009 - 08.2013
- Worked productively in fast-moving work environment to process large volumes of claims.
- Followed up with patients and providers on unresolved issues.
- Modeled exceptional customer service skills and appropriate diagnostic sales techniques to team members.
- Verified client information by analyzing existing evidence on file.
- Processed all types of medical claims based on Medicare's guidelines and Fee Schedule
- In charge of queue that consists of requests from customer service to assist with an aged or escalated claim
Customer Service Associate II
Anthem/Wellpoint
09.2003 - 06.2009
- Assist senior members and providers with questions pertaining to the member's policy I.E: billing, claims and resolve any issues at hand
- Given difficult situations and other heightened issues to resolve and follow up on
- Assisted Provider Maintenance department with completing Financial Check Requests for overpayments/refunds
- Helped large volume of customers every day with positive attitude and focus on customer satisfaction.
Education
Associates Degree - Elementary Education
Miami University
Ohio Diploma -
Edgewood High School
Skills
- Courteous with Strong Service Mindset
- Understanding Customer Needs
- Efficient and Detail-Oriented
- Issue and Complaint Resolution
- Upbeat and Positive Personality
- Responding to Difficult Customers
- Telephone Management
- Service Quality Improvement
Certification
Licenses
Wisconsin Property Individual Resident License
Wisconsin Casualty Individual Resident License
Wisconsin Life Individual Resident License
Wisconsin Health Individual Resident License
Timeline
Patient Account Representative II - Float
SSM Health/Agnesian Healthcare
06.2019 - Current
Agent Producer
Encompass Insurance Solutions
08.2018 - 06.2019
Agent Producer/Office Manager
Farmers Insurance
12.2017 - 08.2018
Driver/Helper Seasonal
UPS
11.2016 - 01.2017
Lead Deli
Piggly Wiggly
09.2016 - 09.2017
Account Coordinator
AIA Corporation
11.2014 - 08.2016
Economic Support Worker
Fond du Lac County Dept of Social Services
08.2013 - 10.2014
Claims Representative II
Anthem Blue Cross & Blue Shield
06.2009 - 08.2013
Customer Service Associate II
Anthem/Wellpoint
09.2003 - 06.2009
Associates Degree - Elementary Education
Miami University
Diploma -
Edgewood High School