Energetic, ambitious person with 19 Years Customer Service experience in a fast paced health care environment. 2 1/2 Years Customer Service experience in a fast paced health insurance company. Superior customer service skills face to face and on the phone. Multi-line phones. Able to work from home/ independently. Flexible, dependable, ready for a challenge. Personable and professional under pressure. Authorized to work in the US for any employer
Overview
29
29
years of professional experience
1
1
Certification
Work History
Utilization Management Intake Rep
Health Alliance Medical Insurance / Remote
11.2022 - Current
Provides accurate, pertinent information to incoming department communication and appropriately distributes other communication to the most fitting departmental or organizational resource in a timely manner.
Assists providers with all in/outpatient procedures and admission
Performs selected authorization functions under the supervision of an RN, following department policy and procedure, and forwards the balance to appropriate department resources.
Documents all communication regarding member activity in the electronic system concisely and clearly, based on standardized department guidelines.
Initial phone or digital contact to greet all customers professionally and provide accurate information about the status of pre-authorization requests (inpatient or outpatient)
Works as an integral part of the designated team.
Reviews initial authorization requests, manual data entry as needed and coordinating operational functions for utilization management decisions.
Communicates with staff at provider offices, approves services based on established guidelines, accesses electronic medical records, assists Nurse Coordinators with requests for more clinical information or research available network provider options.
Correlates with nurses and medical directors scheduling peer to peer reviews
Applying data into Excel and Outlook
Superuser with the Epic system.
Several Way to Be certificates from coworkers and managers for taking on extra tasks, being a problem solver and helping when needed.
Deputy Clerk
Douglas county circuit clerk
12.2015 - 09.2022
Answers phones
File paperwork for court cases
Clerk in the courtroom
Data entry
Work with attorneys and their staff and multiple other departments with various court cases
Coordinated scheduling for court hearings, optimizing efficiency of courtroom operations.
Processed court documents and maintained accurate records for legal proceedings.
Trained new staff on clerical procedures and use of case management software.
Implemented improvements to filing systems, enhancing retrieval speed and accuracy.
Oversaw daily operations of clerk's office, ensuring high standards of service delivery.
Maintained confidentiality by adhering to strict privacy guidelines when handling sensitive information.
Provided quality clerical support through data entry, document management, email correspondence, and overseeing operation of office equipment.
Provided exceptional customer service to the public, answering inquiries and directing individuals to appropriate resources.
Contributed to a positive work environment through effective communication skills and a collaborative approach to problem solving.
Patient Service Rep
Carle Physician Group
07.1996 - 11.2015
Patient contact in the office and on the phone
Schedule appointments within department and outside referrals
Multi-line phone system
Management of Doctors Schedules
Training of new employees
Management of work lists to contact patients or another department
Referrals to outside medical facilities
Prior authorizations from insurance companies
Help patients with any of their needs as far as forms, refills, referrals and anything else they may need.
Managed patient scheduling and appointment coordination to ensure efficient clinic operations.
Facilitated effective communication between patients and healthcare providers to enhance service quality.
Resolved patient inquiries and complaints promptly, fostering a positive care environment.
Participated in ongoing training programs related to HIPAA compliance, maintaining up-to-date knowledge on regulatory requirements.
Verified insurance eligibility and coverage for patients.
Handled sensitive patient concerns with professionalism and empathy, fostering an atmosphere of trust within the clinic.
Filed and maintained patient records in accordance with HIPAA regulations.
Provided exceptional customer service to patients, answering questions and addressing concerns.
Managed patient registration process, confirming data accuracy and completeness.
Entered patient demographic and insurance data into electronic medical record system.
Awards and Acknowledgments
I have received numerous Gold Stars from patients for going above and beyond for their care.
I am the "Go to Person" in the Department
Epic Superuser when we went to the new computer system
Aidet Training for customer service skills
Several "Way To Be" certificates from co workers for helping when needed.
Education
1 year in Stenography/closed captioning -
Lakeland Community College
Mattoon, IL
07.2025
Diploma -
Tuscola High School
Tuscola, Illinois
01.1990
Skills
Microsoft Word
Organizational skills
Office experience
Microsoft Excel
Multi-line Phone Systems
Patient Care
Phone Etiquette
Insurance verification
Medical terminology
Medical Office Experience
Medical Records
Customer service
EMR super user (5 years)
Data entry
Medical Scheduling
Insurance Verification
Microsoft Outlook
Administrative experience
HIPAA
Medical Terminology
Communication skills
Computer skills
Clerical experience
Order Entry
Typing
Microsoft Office
Patient confidentiality
Certification
Driver's License
Additional Information
Exceptional communication skills
Works well under pressure
Very detailed oriented
Customer Service oriented
Multi-line phones
Quick learner
HIPPA compliant
Works well independently from home
Currently serving on Partnership Council committee
Virtual Assistant at Inspire Health; DFW Medical Practice Consultants (remote work)Virtual Assistant at Inspire Health; DFW Medical Practice Consultants (remote work)