Jonathan Mcclure
8101 Research Forest Dr,TX
Summary
Skilled Senior Service Advocate well-versed in offering in-depth support and service to members by utilizing a personalized and caring approach. Focused on achieving challenging productivity and quality benchmarks to maximize team success. Prepared to bring 3 years' experience in management/project leads to new long-term position.
Skills
- Client Advocacy
- Workflow Management
- Case Coordination
- Microsoft Office
- Data Collection and Entry
- Claims Review
- Data Entry
- Claims Processing
- Documentation Abilities
- Medicaid Knowledge
- Background in Insurance
- Data Entry Software
- Insurance Terminology
Work History
Senior Service Advocate
Aetna
Houston, TX
09.2021 - Current
- Governed and completed supervisor escalations quickbase.
- Analyzed customer inquiries and complaints to determine appropriate solutions.
- Assisted customers in navigating the company's website for relevant information regarding products or services.
- Identified trends in customer service requests for further process improvement initiatives.
- Maintained accurate records and documented client data in company databases.
- Built and maintained strong relationships with patients by successfully resolving issues and responding promptly to phone inquiries.
- Maintained confidential patient documentation to prevent data compromise and comply with HIPAA regulations.
- Researched routine and complex issues in order to develop most successful plan to resolve concerns.
- Reached out to clinical professionals to compile history documents and obtain necessary paperwork for procedures.
- Reviewed incoming emails, letters, phone calls., triaging them according to departmental needs.
- Drafted correspondence in response to customer inquiries utilizing effective writing techniques. Managed secure messaging project.
- Coordinated with internal departments to streamline processes related to customer service operations.
- Developed and maintained positive relationships with customers through timely responses and follow-up calls.
- Resolved complex customer issues by researching information from multiple sources.
- Supported other teams as needed by taking on additional tasks or projects when needed.
- Handled escalated customer concerns in a professional manner to ensure satisfaction was achieved.
Nursing Home Worker
Sagora Senior Living
Tomball, TX
01.2019 - 07.2021
- Provided compassionate care to elderly patients in a nursing home setting.
- Provided emotional support to residents and their families during difficult times.
- Participated in team meetings to discuss patient progress and plan care strategies.
- Facilitated recreational activities designed to improve physical strength and cognitive functioning.
- Encouraged socialization among residents through group activities or outings.
- Responded promptly to requests from staff or residents for assistance with tasks related to daily living.
- Demonstrated excellent communication skills when interacting with both staff members and residents.
- Communicated with patients to determine feelings, need for assistance or social and emotional support.
- Planned and served meals and snacks to patients according to prescribed diets.
- Measured and recorded food and liquid intake and output, reporting changes to medical or nursing staff.
- Supported daily living activities by serving meals, feeding, ambulating and turning over and positioning patients.
Education
Entrepreneurship - Business
12.2012
Associate of Arts - Business
01.2012
Overview
5
5
years of professional experience