Carla Cashaw
Aubrey
Summary
Knowledgeable and dedicated customer service professional with extensive experience in the health insurance industry; as well as office management. Solid team player with outgoing, positive demeanor and proven skills in establishing rapport with clients. Motivated to maintain customer satisfaction and contribute to company success. Specialize in quality, speed and process optimization. Articulate, energetic and results-oriented with exemplary passion for developing relationships, cultivating partnerships and growing businesses.
Overview
19
19
years of professional experience
Work History
Senior Member Advocate
Businessolver
08.2021 - 10.2024
- Inbound/Outbound calls and Chat
- Worked closely with other departments as needed to resolve cross-functional matters impacting members'' experiences positively.
- Managed escalated cases effectively, working closely with supervisors to ensure successful outcomes for all parties involved.
- Provided exceptional customer service to employees, addressing concerns regarding their benefits packages.
- Educated employees on available benefit options, enabling informed decision-making during open enrollment periods.
- Served as a liaison between employees, insurance carriers, and brokers to resolve complex benefits-related issues effectively.
Office Manager
Franklin Cleaning Services
03.2012 - 07.2021
- Prepared vendor invoices and processed incoming payments.
- Managed supervisor itinerary and appointments and streamlined scheduling procedures.
- Handled all incoming business and client requests for information via phone & email.
- Completed bi-weekly payroll for employees.
- Planned marketing initiatives and leveraged referral network to promote business development. Increased sales by 50%.
Claims Customer Support
Healthsmart Preferred Care
01.2010 - 03.2011
- Coordinated with contracting department to resolve payer issues.
- Prepared insurance claim forms or related documents and reviewed for completeness.
- Directed incoming calls to internal personnel and departments, routing to best-qualified department.
- Answered incoming phone calls to articulate product value to prospective customers and support current policyholders.
- Consulted with outside parties to resolve discrepancies and create effective solutions.
Customer Support Specialist
HRAdvance
02.2009 - 01.2010
- Served customer account and technical needs across 150+ daily calls, consistently meeting productivity and quality targets.
- Verified insurance coverage by telephone and online to guarantee proper reimbursement of benefits and estimate patients' financial responsibilities.
Intake Coordinator
United Healthcare
03.2006 - 01.2009
- Scheduled surgeries, managed pre-certifications using ICD9,CPT & HCPCS codes, and verified insurance coverage.
- Enhanced patient outcomes by providing knowledgeable education on procedures, medications and other physician instructions.
Education
GED -
North Central Community College
Corinth, TX01.2018
Skills
- Documentation and control
- Policy and Procedure Modification
- Expense Reporting
- Team Leadership
- Payroll and budgeting
- Contract negotiations
- Complaint resolution
- Medical terminology knowledge(CPT, ICD9, & HCPCS)
- Professional telephone demeanor
- Corporate Communications
- Strategic Planning
- Coverage assessments
- Claims Adjustments
- Insurance Knowledge
Timeline
Senior Member Advocate
Businessolver
08.2021 - 10.2024
Office Manager
Franklin Cleaning Services
03.2012 - 07.2021
Claims Customer Support
Healthsmart Preferred Care
01.2010 - 03.2011
Customer Support Specialist
HRAdvance
02.2009 - 01.2010
Intake Coordinator
United Healthcare
03.2006 - 01.2009
GED -
North Central Community College
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