ASHLEY HAROLD
Houston,TX
Summary
Dedicated customer service representative with a proven track record in guiding members through intricate health plan choices, ensuring understanding and timely resolutions. Expertise in addressing complex inquiries and facilitating effective communication to enhance member satisfaction and retention.
Overview
10
10
years of professional experience
Work History
Health Plan Advisor
UnitedHealthcare
Remote, TX
07.2023 - Current
- Guided members through health plan options and benefits at UnitedHealthcare.
- Assisted members in understanding health plan options and benefits at UnitedHealthcare.
- Enhanced member decision-making by clarifying health plan options and benefits.
- Provided education to clients on preventive care services and wellness programs.
- Supported clients by explaining preventive care services and wellness programs.
- Improved client understanding of preventive care services and wellness programs.
- Reviewed complex member cases with careful attention to detail.
- Managed case reviews for complex member situations with strong attention to detail.
- Facilitated accurate resolution of complex member cases through detailed reviews.
- Communicated with claimants to clarify appeal details and gather necessary information.
- Reviewed appeals cases to ensure compliance with regulations and policies.
- Prepared detailed reports summarizing findings from appeal investigations.
- Coordinated timelines for processing appeals to ensure timely resolutions.
- Coordinated with internal teams to resolve disputes and address claimant concerns.
INBOUND CUSTOMER SERVICE
DIRECTV
04.2022 - 04.2023
- Direct, coordinate, and provide the highest level of customer service to ensure consistent customer satisfaction
- Resolve the most complex issues including but not limited to repair, maintenance, billing, and/or order.
- Develop innovative ways to sell products and services to customers.
CUSTOMER SERVICE REPRESENTATIVE
MedForce
09.2018 - 04.2022
- Screened and routed patient calls to appropriate departments, ensuring accurate registration.
- Responded to patient questions and needs by editing, canceling, and rescheduling appointments.
- Answered phones to address inquiries from patients, vendors, insurance companies, and medical facilities.
CUSTOMER SERVICE ASSOCIATE
Walgreens
04.2016 - 08.2018
- Delivered courteous, friendly, and efficient service to enhance customer satisfaction.
- Recommended items for sale and suggested trade-up or companion items to increase customer purchases.
- Ensures compliance with state and local laws regarding regulated products.
Education
DENTAL ASSISTANT CERTIFICATION -
Altierus Career College
01-2018
HIGH SCHOOL DIPLOMA -
Glenda Dawson High School
01-2016
Skills
- Health plan guidance
- Claims
- Insurance Verification
- Case management
- Client advocacy
- Patient management
- Medical Terminology
- Care education
- Compliance Standards
- Reporting systems
- Program analysis
- Data Entry
- Microsoft Office proficiency
- Analytical Skills
- Claims information gathering
- Customer Service
- Records maintenance
Personal Information
Title: CUSTOMER SERVICE REPRESENTATIVE
Timeline
Health Plan Advisor
UnitedHealthcare
07.2023 - Current
INBOUND CUSTOMER SERVICE
DIRECTV
04.2022 - 04.2023
CUSTOMER SERVICE REPRESENTATIVE
MedForce
09.2018 - 04.2022
CUSTOMER SERVICE ASSOCIATE
Walgreens
04.2016 - 08.2018
DENTAL ASSISTANT CERTIFICATION -
Altierus Career College
HIGH SCHOOL DIPLOMA -
Glenda Dawson High School