Ashley LaPointe DiCristina
Sarasota,FL
Summary
Proven track record in enhancing client satisfaction and streamlining claim processes at Aetna, A CVS Health. Expert in Salesforce and Availity, demonstrating exceptional client relationship building and critical thinking skills. Achieved significant improvements in operational efficiency and customer service standards, contributing to increased client retention and satisfaction.
Overview
7
7
years of professional experience
Work History
Insurance Customer Service Specialist
Aetna, A CVS Health
01.2024 - Current
- Maintained strong relationships with both new and existing clients through proactive communication and followups.
- Participated in ongoing training sessions to stay up-to-date on industry trends, product offerings, and regulatory changes.
- Reduced wait times by quickly addressing customer questions regarding billing, policy changes, and claim status updates.
- Collaborated effectively with internal departments like claims adjusters, underwriting staff, allowing seamless coordination between parties involved in the client relationship management process.
- Researched and analyzed complex claims to determine next steps and possible outcomes.
- Enhanced claim processing efficiency by streamlining workflows and implementing best practices.
- Conducted detailed assessments of claims documents, ensuring accuracy and completeness before submission for approval.
- Reduced turnaround time for claim settlements by prioritizing tasks and managing deadlines effectively.
- Reduced errors in claim submissions by providing clear guidance to policyholders on required documentation and information needed for processing.
- Ensured accurate documentation and record-keeping, adhering to company policies and industry regulations.
- Managed high call volumes while maintaining quality service standards, leading to positive feedback from customers.
- Reviewed incoming communications for urgency or importance; prioritized correspondence accordingly for executive review or action.
- Scheduled appointments and handled calenders for senior leadership.
- Handled administrative tasks such as expense report processing or invoice reconciliation efficiently; allowing executives to focus on high-priority responsibilities without distraction.
Care Coordinator, Referrals and Authorizations
ChenMed
06.2020 - 01.2024
- Maintained accurate and up-to-date documentation of patient records in accordance with HIPAA regulations.
- Used company software and databases to maintain records of services performed and patient conditions.
- Managed patient caseloads effectively, ensuring timely follow-up and appropriate interventions.
- Improved communication among healthcare providers, streamlining the coordination of services for patients.
- Coordinated discharge planning, ensuring a smooth transition from hospital to home or other facilities.
- Verified insurance benefits and eligibility for many types of specialists and procedures before referring clients.
- Scheduled appointments with specialists on behalf of clients.
- Obtained prior authorization for Medical and Surgical procedures.
- Ensured results from Specialist appointments were retrieved and reviewed by physicians.
- Notified and reminded clients of appointments.
- Managed a high volume of referrals daily while consistently meeting deadlines for processing requests and scheduling appointments.
- Collaborated with Medical Director and Physicians to develop tailored care plans, optimizing patient outcomes.
- Developed strong relationships with specialist offices, fostering collaboration in providing high-quality patient care.
- Recorded patient history to accurately track conditions, progress and diagnosis for comprehensive medical records.
- Handled confidential information with utmost discretion, ensuring sensitive data was protected from unauthorized access.
- Planned and executed events for employees and clients and managed logistics and vendor relations.
- Managed high-level Physician calendars, prioritizing appointments and meetings to optimize time management.
- Streamlined office procedures by implementing efficient systems and tools, resulting in improved workflow.
- Led, directed, managed and mentored six administrative staff members.
- Optimized existing Salesforce workflows and processes, resulting in increased efficiency and productivity.
- Implemented automated workflows within the CRM system to increase efficiency and reduce manual tasks for staff members.
- Enhanced patient satisfaction with prompt attention to inquiries and professional communication skills.
- Managed high call volumes, directing callers to appropriate departments or handling inquiries as needed.
- Managed agendas, travel arrangements, and appointments for 3 upper management staff members/Physicians.
Spa Administrative Assistant
Ritz-Carlton
10.2017 - 06.2020
- Answered and routing 100 plus calls, delivering messages to staff and greeting visitors.
- Delivered excellent customer service through prompt responses to guest inquiries, addressing concerns effectively, and building strong relationships.
- Assisted in onboarding new employees, providing training materials, and coordinating orientation schedules to ensure a smooth integration into the team.
- Coordinated and scheduled meetings and conference calls to optimize scheduling of senior staff.
- Managed phone and email correspondence and handled incoming and outgoing mail and faxes.
- Built and maintained excellent customer relationships through timely response to inquiries and going above and beyond to accommodate unusual requests.
- Identified and recommended changes to existing processes to improve accuracy, efficiency, and quality service.
- Contributed to Spa's positive reputation through exceptional guest services.
- Tracked guest satisfaction surveys to recognize trends and create action plans for improving guest services.
- Oversaw daily operations, addressing any issues promptly to minimize disruptions to guest services.
- Maintained strict confidentiality in all aspects of personal, financial, and corporate information.
- Served as a liaison between executives, staff members, clients, and stakeholders to maintain effective communication channels.
- Handled scheduling for Spa executive's calendar and prepared meeting agenda and materials.
- Increased spa revenue by developing and promoting special spa packages and seasonal offers.
- Ensured compliance with health and safety regulations, maintaining a clean and hygienic environment for both guests and staff members alike.
- Implemented effective marketing strategies to attract new clients and retain existing ones, resulting in increased bookings and repeat business.
- Advised clients on proper skincare routines, promoting healthy skin as the foundation for flawless makeup application.
- Scheduled onsite and offsite makeup appointments for clientele.
- Developed customized makeup plans for bridal parties, contributing to memorable wedding experiences.
- Increased customer loyalty through exceptional service and tailored makeup applications.
- Kept up-to-date with style industry standards, trends, and techniques to provide optimal aesthetics services to every client.
- Conducted makeup workshops and demonstrations, educating clients on current trends and techniques.
- Taught master classes to inspire potential makeup artists or help people expand knowledge and skills.
- Meticulously documented client records, efficiently tracking preferences and allergies to ensure personalized experiences during subsequent appointments.
- Developed strong relationships with vendors in the industry, securing competitive pricing on high-quality products for the spa inventory.
Education
High School Diploma -
Roswell High School
Roswell, GALaGrange College
La Grange, GAMedical Esthetician/Makeup Artist -
Paul Mitchell The School - Esani
Roswell, GASkills
- Client Relationship Building
- Complaint Handling
- Policy understanding
- Upselling strategies
- Critical Thinking
- Medical Terminology
- Insurance Claim Forms
- Eligibility Determination
- Skilled in Salesforce
- Proficient in Medicare
- Sales strategy
- Product Knowledge
- Prior Authorization Knowledge
- Insurance Verification Expertise
- Medical coding familiarity
- CRM Software
- Executive Support
- Meticulous attention to detail
- Customer Service
- Scheduling
- Client Relationships
- Recordkeeping
- Relationship Building
- Office Administration
- Document Preparation
- Strong Organization
Work Availability
monday
tuesday
wednesday
thursday
friday
saturday
sunday
morning
afternoon
evening
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Work Preference
Work Type
Full TimeLocation Preference
RemoteImportant To Me
Career advancementCompany CultureWork from home optionHealthcare benefitsTimeline
Insurance Customer Service Specialist
Aetna, A CVS Health
01.2024 - Current
Care Coordinator, Referrals and Authorizations
ChenMed
06.2020 - 01.2024
Spa Administrative Assistant
Ritz-Carlton
10.2017 - 06.2020
High School Diploma -
Roswell High School
LaGrange College
Medical Esthetician/Makeup Artist -
Paul Mitchell The School - Esani