Sami Rynders
Virginia,United States
Summary
Organized and dependable candidate successful at managing multiple priorities with a positive attitude. Willingness to take on added responsibilities to meet team goals. Enjoy sharing knowledge with others. Happy to learn and grow as an employee.
Overview
5
5
years of professional experience
Work History
Claims Coordinator
HCSC - Blue Cross Blue Shield Of Illinois
Jacksonville, IL
03.2023 - Current
- Performed High dollar claim review and processing.
- Monthly Employee Call Reviews and provide Health Advocates with monthly feedback and training.
- Researched problems regarding Medical, Pharmacy and claim's with speed and accuracy.
- Responded to CAS questions through chat and TTDB in a timely manner.
Customer Advocate Specialist
HCSC - Blue Cross Blue Shield Of Illinois
Jacksonville, IL
07.2022 - 03.2023
- Researched problems regarding Medical, Pharmacy benefits and claim's with speed and accuracy.
- Developed weekly CAS emails to share knowledge, tips and tricks with Health Advocates.
- Responded to representative's questions through multiple ques.
- Supported representative's while they took member calls, responded to Health Advocates tech times and help with any area that they may need improvement in.
- Preformed manual calculations on medical claims and preformed overrides for RX mediations.
- Provided accurate information while also providing our members with great customer service while deescalating member calls.
Health Advocate Concierge
HCSC - Blue Cross Blue Shield Of Illinois
Jacksonville, IL
05.2020 - 07.2022
- Assist members with questions regarding medical, pharmacy and behavioral health questions.
- Resolves problems related to benefits, eligibility and claims.
- Takes phone calls, chats and assists written team with secure messages.
- Involved with putting together pharmacy knowledge workshop.
- Quarterly call calibrations - to have outside perspective on call strategies and overall to better our performance while assisting members.
Key Holder
Dollar General
Ashland, IL
03.2019 - 07.2019
- Assisted with team responsibilities by cleaning, managing cash registers.
- Oversaw store operations by counting cash drawers and supervising staff.
- Restocked store shelves and put away weekly truck.
Pharmacy Technician
Walgreens Pharmacy
Springfield, IL
09.2018 - 12.2018
- Assisted pharmacist by filling prescriptions for customers and responding to patient questions regarding prescription and medication-specific issues.
- Restocked automated medication dispensing equipment.
- Coordinated with insurance representatives to process claims and calculate correct co-pay information for patients.
- Answered incoming phone calls and addressed questions from customers.
Education
High School Diploma -
A-C Central High School
Ashland, IL 05.2017
Skills
- Health insurance plan knowledge
- Customer support
- Inbound call management
- Medical, Behavioral Health and Pharmacy knowledge
- Provider and Pharmacy outreach
- Sharing knowledge with peers
- Processing claims and going over benefits
- Providing feedback to advocates and CAS
- Proficiency in Excel, Word, PowerPoint and other computer applications
Timeline
Claims Coordinator
HCSC - Blue Cross Blue Shield Of Illinois
03.2023 - Current
Customer Advocate Specialist
HCSC - Blue Cross Blue Shield Of Illinois
07.2022 - 03.2023
Health Advocate Concierge
HCSC - Blue Cross Blue Shield Of Illinois
05.2020 - 07.2022
Key Holder
Dollar General
03.2019 - 07.2019
Pharmacy Technician
Walgreens Pharmacy
09.2018 - 12.2018
High School Diploma -
A-C Central High School
Similar Profiles
Nicolas PenaNicolas Pena
Tier 2 Licensed Sales Agent at HCSC - Blue Cross Blue Shield of IllinoisTier 2 Licensed Sales Agent at HCSC - Blue Cross Blue Shield of Illinois
JEROME BANKSJEROME BANKS
Senior Content Analyst at HCSC - Blue Cross Blue Shield of IllinoisSenior Content Analyst at HCSC - Blue Cross Blue Shield of Illinois
Michael CrowleyMichael Crowley
Senior Manager, Security Platform Ops at HCSC - Blue Cross Blue Shield Of IllinoisSenior Manager, Security Platform Ops at HCSC - Blue Cross Blue Shield Of Illinois
Darien AllisonDarien Allison
Assistant Manager at Foot LockerAssistant Manager at Foot Locker
Ambica Sony KodeAmbica Sony Kode
Software Developer at Jitsol IncSoftware Developer at Jitsol Inc