Summary
Overview
Work History
Education
Skills
Objective
Work Availability
Quote
Timeline
Generic

Brenda Kowalski

Tonawanda,NY

Summary

  • Over 10 years' experience as a Benefit Advocate with the leading and largest healthcare insurance provider, United Healthcare. Assisting members to resolve logistical issues prior visits to their providers, as well as resolving issues following services or procedures rendered or performed with an overriding focus maximizing utilization of their healthcare insurance benefits, consistently meeting and/or exceeding on their expectations
  • Knowledgeable and/or familiar with ICD-10 coding protocols and procedures as well as with various medical terminologies and procedures
  • Trains new personnel upon supervisors' requests, allowing for a shadowing process to demonstrate critical proficiencies required for the position, monitoring individuals' work activities for quality, expediency, and proper employee/customer interactions. Conducting informal performance assessments and consulting with upper management for employee status/progress reports
  • Strong communications, detail oriented, analytical, and problem solving skills
  • Leverages technology to enhance productivity, Windows MS Office, proprietary industry software (Iset, Nexidia,Cams, etc.), and more
  • Utilized as a knowledgeable and respected resource, highly regarded by all levels of management, peers,and customers, the "go-to" professional, to provide sound judgment, well-informed decision-making, and solutions to complex compliance, Flexible Spending account logistics, and customer relations issues, through the formulation and implementation of effective strategic action plans when others cannot

Overview

19
19
years of professional experience

Work History

Benefit Advocate-Commitment Fulfillment Team Representative

United Healthcare
12.2012 - Current
  • Supports a wide range of commercial plans through member services for United Healthcare. Including assisting members to address and resolve complex issues, including incorrect providers to medical coding, medical record requirements, as well as escalations, Coordination of benefits' updates, and more. Contacting members over the phone and email with full resolution of issues in a timely manner
  • Assists members with benefit questions including medical and pharmacy benefits and provide comprehensive information to individuals so they can make educated decisions in the health care
  • Guides, directs, and assists members for all aspects of their flexible spending accounts, as well as their health reimbursement accounts
  • Informs members regarding the status of their prior authorizations and pre-determinations. Consulting with coaching individuals for available options, including appeals or referrals to clinical services
  • Proficient in coordinating benefits for members with other insurance policies, including Medicare
  • Recognized and credited for consistently meeting and/or exceeding all corporate and member expectations

Front Desk Receptionist

Kalu Salon and Spa
10.2012 - 12.2012
  • Coordinated and booked all salon and spa appointments for individuals or group parties
  • Handled all Salon transactions
  • Executed all daily opening and closing procedures
  • Provided any product education to guests
  • Checked in guests and made sure that all technicians were on schedule

Front End Manager/Receptionist

Euphoria Salon and Spa
03.2004 - 09.2012
  • Create staffing schedule for front desk receptionists
  • Addressed all guest concerns with patience and defused any escalated situations
  • Ordered all Salon and spa supplies
  • Verified end of day reports against credit and cash profits
  • Hold staff meetings for team building and communication
  • Coordinated all salon and spa bookings and helped maintain staff be on schedule
  • Monthly product inventory
  • Assisted salon leader with tracking salon retail sales and promotions
  • Conducted interviews with potential employees
  • Delegate house responsibilities to staff
  • Schedule staff trainings, conduct trainings

Education

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Lancaster High School
2001

Skills

  • Service Quality
  • Health Plan Benefits
  • Benefits Interpretation
  • Eligibility Determinations
  • New Employee Orientation
  • Open Enrollment
  • Customer Inquiries
  • Office Organization
  • Customer Service Process Improvement
  • Confidential Records Management
  • Customer Relations Skills
  • Escalated Calls Management
  • Troubleshooting and Problem Resolution
  • Active Listening Skills
  • Complex Problem-Solving
  • Insurance Terminology
  • Consultative Selling Techniques
  • Excellent Verbal Communication Skills

Objective

Highly- motivated, knowledgeable, and results-driven professional, to secure a positon with your company

as a Customer Service Representative, other key roles Marketing, Sales, or other position as applicable,

utilizing my skills, training, expertise, and experience

Work Availability

monday
tuesday
wednesday
thursday
friday
saturday
sunday
morning
afternoon
evening
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Quote

The aim of life is to live, and to live means to be aware, joyously, drunkenly, serenely, divinely aware.
Henry Miller

Timeline

Benefit Advocate-Commitment Fulfillment Team Representative

United Healthcare
12.2012 - Current

Front Desk Receptionist

Kalu Salon and Spa
10.2012 - 12.2012

Front End Manager/Receptionist

Euphoria Salon and Spa
03.2004 - 09.2012

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Lancaster High School
Brenda Kowalski