Angela Shenk

• Assisted Global clients with navigating the US

Healthcare System.

• Liaison with internal and external departments to resolve all member and US provider inquiries.
• Provided knowledgeable service and support for all Clients, Member's and providers.
• Assisted large volume of Clients daily with a cheerful outlook and focus on customer satisfaction.
• Communicated with clients regarding account services, statements and balances related to member account inquires.
• Maintained customer satisfaction with forward-thinking strategies focused on addressing customer needs and resolving concerns.
• Identified trends and supported the management of issues caused by deviation from a standard process.
• Facilitated the resolution of escalations related to member care pending.
• Developed, implemented and maintained all Standard Operating Procedures related to Pharmacy Benefit Management processes and procedures for UnitedHealth Care's Global clients.
• Provided education and training to UnitedHealthcare's Global Client Service Specialist team on all pharmacy vendors system applications to resolve any pharmacy related inquiries and or request received from internal and external parties.
• Reduced process inconsistencies and effectively trained team members on best practices and protocols.
• Trained and supervised junior customer service specialist on best practices to meet organizational goals.
• Developed and maintained departmental SharePoint's to analyze trending opportunities upon request from Sales Account Executives and departmental Directors.
• Verified client's structures and benefits.
• Resolved upfront and balance billing escalations.
• Responded to providers and third-party complaints and documented actions taken in appropriate systems.
• Researched overpayments and respond to inquiries regarding status of returned funds.
• Worked with eligibility analyst to identify areas of improvements and share findings with the client manager for implementation of a long-term solution.

• Received a high volume of inbound calls from providers, members and client's regarding medical claims, member enrollment and general customer concerns.
• Demonstrated outstanding Customer Service to identify the source of the caller's concerns and worked to resolve their inquires in a timely and professional manner.
• Ability to meet both Quality and Production standards on a monthly basics.
• Developed, created and maintained issue logs for the Adopt-A-Provider program.
• Single Point of Contact for the Adopt-A-Provider program while holding bi-weekly conference calls to provide updates on High Dollar Medical Claims sent to UnitedHealth Group for processing.
• Subject Matter Expert for Richardson and Manilla sites via TEAMS regarding any questions or concerns.
• Assisted management on enhancing performance goals.
• Assisted management with Daily Inventory, Supervisor Call Backs, created Standard Operating Procedures to assist Customer Service Representative and escalated assigned projects.
• Prepared Ice Breaker's for team meetings, coordinated monthly team activities and Volunteer Opportunities.
• Aided Account Management regarding complex provider claim inquires, provider call back request and projects when assistance was needed.

• Maintained a safe and clean environment for patients, reducing risks and ensuring optimal health outcomes.
• Assisted clients with activities of daily living, promoting independence and quality of life.
• Performed light housekeeping duties to maintain cleanliness standards while respecting the patient's personal space.
• Built strong relationships with clients to deliver emotional support and companionship.
• Turned and positioned bedbound patients to prevent bedsores and maintain comfort levels.
• Coordinated closely with family members regarding updates on patient conditions or concerns that arose during the course of caregiving duties.
• Managed patient appointments and transportation needs, ensuring punctual arrival at medical visits and other engagements.
• Transported individuals to events and activities, medical appointments, and shopping trips.

• Managed the resolution and status of routine to complex client requests through effective and timely communication
  to ensure client's expectations are met and understood.
• Increased client satisfaction by building strong relationships and addressing their needs promptly.
• Performed Quality Assurance functions such as moving all plan design implementations and/or changes into a Production status upon completion of a review within tight timeline.
• Achieved recognition for outstanding client service, contributing to team's reputation for excellence.
• Identified at-risk accounts through diligent monitoring and analysis, implementing retention strategies to prevent churn.
• Performed effectively in self-directed work environment, managing day-to-day operations and decisions.
• Gained Client's trust and confidence by demonstrating compelling, persuasive and composed professional demeanor.
• Met with Client's quarterly to discuss and ascertain needs, tailor solutions and close deals.
• Managed Client's related projects with internal partners to resolve identified issues.
• Maintained Client's groups and member eligibility files daily.
• Manually added Client's groups, member enrollments and medication prior authorizations in the system upon request.
• Presented Client's benefit summaries at Benefit Fairs with members prior to Open Enrollment.
• Performed Quality Assurance functions such as moving all plan design implementations and/or changes into a production status upon completion of review within tight timeline.
• Developed, implemented,maintained and trained Client specific training documents for Customer Care and the Claims Department to provide Client with exceptional service.
• Created,developed and executed RxNavigator reports to analyze drug utilization and member's mediation history.
• Built and executed systematic macros to add new groups, membership and prior authorizations in the system per the Client's request.
• Participated in client calibration sessions ensuring calls are being handled as specified by the client's intent.
• Lead quality assurance by conducting audits of calls of Customer Service Representatives.
• Provided coaching/feedback to advocate in call evaluations.
• Analyzed trends documented and utilized to build recommendations to reduce errors and improve process performance.