Summary
Overview
Work History
Education
Skills
Timeline
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ANYA PINK

Norcross,GA

Summary

Compassionate and Highly experienced professional with over 15 years in customer service across healthcare, sales, and logistics. Proven ability to resolve complex issues and effectively manage high call volumes. Proficient in key billing codes such as CPT-4 and ICD-9, demonstrating a strong background in claims management. Prepared to make a significant impact in the next role by accurately assessing and processing claims, resolving complex issues, and ensuring customer satisfaction. Collaborative team player focused on achieving results and adapting to changing needs. Recognized for analytical thinking, strong communication skills, and meticulous attention to detail. Possesses a solid foundation in customer service and administrative tasks, coupled with a keen interest in healthcare claims processing. Quick to learn industry-specific software and master medical coding for accurate claim submissions. Ready to utilize and develop problem-solving and communication skills in a Customer Engagement role.

Overview

22
22
years of professional experience

Work History

Case Manager

RemX/McKesson
09.2024 - Current
  • Reduced customer complaint response time by 50% through improved documentation processes
  • Exceeded customer satisfaction targets by 20% by enhancing CRM usage and customer communication
  • Reduced case processing time by 25% through streamlining documentation processes
  • Handled documentation for over 100 cases monthly, maintaining high accuracy with HUB Services/Covermymeds
  • Receive, record and report Adverse Events as per the Pharmaceutical Manufacturer requirements
  • Maintain service levels in case management, including any other Key Performance Indicators established at the Program level

Realtor/Licensed Sales Agent

Keller Williams Realty
06.2021 - Current
  • Company Overview: Real Estate Sales
  • Assist clients in making competitive offers or counteroffers, negotiate terms and prices on their behalf, and guide them through the process of closing a deal
  • Real Estate Sales-2-3mil annual sales volume.
  • Resolved client concerns related to home purchases to maintain high satisfaction ratings.
  • Compared recently sold area properties to determine competitive market prices.

Tier II Customer Advocate

CNX
08.2022 - 08.2024
  • Company Overview: HealthCare Insurance
  • Review and research healthcare claims from members and providers (doctors, clinics, etc.) by navigating multiple computer systems and platforms to verify necessary data/information for processing
  • Address incoming inquiries related to various health plan options, including Medicare and Medicaid, providing clear, accurate, and timely information to members
  • Ensure proper benefits are applied to each claim, utilizing appropriate claims processing policies, grievance procedures, state mandates, CMS/Medicare guidelines, and benefit plan documents
  • Manage high volume of 40-60 Inbound calls daily to resolve conflicts effectively, processing and addressing appeals, complaints, and grievances while striving to achieve positive outcomes
  • HealthCare Insurance

Member Client Support Representative

Horizon Blue Cross Blue Shield of New Jersey
03.2003 - 06.2008
  • Company Overview: Healthcare Insurance
  • Review and process health insurance claims and claims from health system partners with a high level of accuracy and efficiency, ensuring proper documentation, coding, and billing
  • Utilize appropriate medical coding and billing software to verify claims and ensure they align with industry standards, guidelines, and policies for correct reimbursement
  • Managed 50-60 calls per day in a fast paced environment
  • Healthcare Insurance

Education

Real Estate License - Sales

Atlanta Partners Real Estate School
Atlanta, GA
03-2021

Graduate Certificate - Medical Technology

Drake College of Business
Newark, NJ
07.2013

No Degree - Business Administration

Essex County College
Newark, NJ
01-2003

Skills

  • Computer Application Expertise
  • Skilled in CRM Customization
  • Expertise in MS Windows
  • Skilled in Document Creation
  • Excel Reporting Skills
  • Explorer
  • Chrome
  • Edge
  • Teams
  • Outlook
  • Detail-Oriented Data Entry
  • Typing 40 WPM
  • Salesforce Administration Skills
  • Develop and Support Key Relationships with Customers
  • Maintain Accurate Documentation Practices
  • Empathetic Client Engagement
  • Proactive Self-Development and Team Growth
  • Citrix
  • CoverMyMeds Proficiency
  • Confluent
  • Atlassian
  • Sales Expertise
  • Customer service
  • Problem-solving
  • Active listening
  • Adaptability and flexibility
  • Patient assessment

Timeline

Case Manager

RemX/McKesson
09.2024 - Current

Tier II Customer Advocate

CNX
08.2022 - 08.2024

Realtor/Licensed Sales Agent

Keller Williams Realty
06.2021 - Current

Member Client Support Representative

Horizon Blue Cross Blue Shield of New Jersey
03.2003 - 06.2008

Real Estate License - Sales

Atlanta Partners Real Estate School

Graduate Certificate - Medical Technology

Drake College of Business

No Degree - Business Administration

Essex County College
ANYA PINK