ANDREA PORTER
Philadelphia,Pennsylvania
Summary
Experienced in customer service, data entry, and conflict resolution with a keen eye for detail and thorough documentation. Proficient in multitasking and navigating multiple screen applications. Demonstrates a passion for helping others and delivering tailored solutions and troubleshooting to meet customer needs. Prioritizes building strong relationships with customers and consistently provides high-quality service. Possesses excellent communication and customer service skills, combined with a flexible and adaptable nature, enabling effective handling of any situation. Eager to learn and take on additional responsibilities to contribute to the achievement of team goals.
Overview
8
8
years of professional experience
Work History
Care Case Manager
Centene
11.2023 - Current
Medical Insurance Specialist
AbbVie Endocrinology
05.2023 - 07.2024
- Insurance Specialists help patients navigate their insurance benefits to see what coverage for a specific medication looks like
- In order to do this, we complete a benefit investigation on behalf of the patient
- This includes coverage status, cost of medication, Authorization requirements, Pharmacy information, and financial support they may be eligible for
Provider Service Representative
AmeriHealth Caritas, PA
09.2021 - 05.2023
- Correspondence with health care providers for medicaid regarding benefit, eligibility, and other provider issues
- Identified and corrected data entry errors to prevent duplication across systems
- Completed accurate and efficient data entry and database updates to support business operations
- Reconciles audit discrepancies, corrects in system and mak appropriate changes to avoid recurrence
- Navigated multiple computer systems and applications a utilized search tools to find information
- Reviews and adjudicates claims based on provider and health plan contractual agreements and claims processing guideline
Patient Advocate
Medrisk
09.2017 - 01.2020
- Responsible for lending support, guidance and positivity to patients with workers comp claims
- Patient advocates help injured workers find the best provider for physical rehabilitation in a location convenient to home or work
- Duties include making outbound scheduling calls, securing missing information from the insurance company, employer or physician and providing patients with educational materials as needed in advance of their first appointment
Call Center Representative
Lucky Vitamin
08.2016 - 09.2017
- Managing large amounts of inbound and outbound calls in a timely manner
- Identifying customers' needs, clarify information, research every issue and providing solutions
- Build sustainable relationships and engage customers by taking the extra mile
Education
California University of Pennsylvania
California, PASkills
- Customer service
- Microsoft excel/office
- Salesforce
- Attention to detail
- Conflict Resolution
- Leadership
- Patience
- Tenacity
- Active listening
- Adaptability
Training
Human Resources Specialist, Army National Guard
Timeline
Care Case Manager
Centene
11.2023 - Current
Medical Insurance Specialist
AbbVie Endocrinology
05.2023 - 07.2024
Provider Service Representative
AmeriHealth Caritas, PA
09.2021 - 05.2023
Patient Advocate
Medrisk
09.2017 - 01.2020
Call Center Representative
Lucky Vitamin
08.2016 - 09.2017
California University of Pennsylvania