Dawn Spears
Oshkosh
Summary
Resourceful Enrollment Representative known for high productivity and efficient task completion. Skilled in customer service, data management, and process optimization. Excel at communication, problem-solving, and adaptability, ensuring smooth enrollment processes and positive interactions.
Overview
5
5
years of professional experience
Work History
Billing and Enrollment Representative For Humana Military
Humana Government Business, Inc
Louisville
2021.12 - 2022.12
- Assisting active duty or retired customers with enrolling them in Tncare Prime or Select.
- Assisting customers with enrolling to a new primary care manager, telling them who they are assigned too.
- Complete data entry with submitting forms into the system.
- Explaining to the customer what one plan is vs the other.
- Providing prompt and professional telephone service.
- Mil.com (So beneficiary can see what primary care manager is in the area)
- Microsoft Office
- Microsoft Word
- Microsoft Note
- Excel
- Received military ID to be able to process primary care manager updates for beneficiaries
- Humana Government Business, Inc 301 N. Hurstbourne Pkwy Louisville, KY 40222 (888)-431-4748
Debit Card Fraud Claims
ACT
Johnson City
2017.09 - 2021.12
- Set schedules, Always tried to make sure everyone showed up on time and worked their full shift.
- Make sure claims are done correctly.
- Letter Reports
- Submit stuck claims.
- Daily Leadership Meetings
- Submit agents daily metrics and rankings to Bank Of America through Excel.
- Set up new claims by collecting data from customer.
- Completed data entry into computer system.
- Answer qualifying questions based on each customer’s different answers to the proper question.
- Provided accurate status information on existing claims.
- Provide prompt and professional telephone service.
- Supported the claims unit by accomplishing related tasks in an efficient and professional manner.
- Debit Card Fraud Claims: ACT Johnson City, TN 3035 Boones Creek Rd 37615 (423)-283-5023
Claims Assistant
Sedgwick Claims
West Des Moines
- Set up claims from email with customers information.
- Copy and paste all emails.
- Read all documents sent in by legal teams to make sure another customer’s information was not mixed in with someone else’s causing a data breach or hippa violation.
- Print packets.
- Prepare packets to be sent via Fed Ex or USPS.
- Time management
- Self starter
- Microsoft Office
- Microsoft Word
- Excel
- Workday
- Adobe
- Copy claim number to excel
- Sharepoint
- Work logs
- Empathy
- Help others
- Filed claims for FMLA, Military leave, Pregnancy Leave, Short Term Disability, and Long Term Disability.
- Sedgwick Claims 4200 University Ave Suite #317, West Des Moines, IA 50266 (515)-327-4840
Education
Diploma -
Westfield High School
Associates Degree -
Pharmacy Technician
Skills
- Data Entry
- Microsoft Word
- Microsoft Outlook
- Excel
- Multitasking
- Time Management
- Empathy
- Engagement
- Leadership
- Dependability
- Attention To Detail
- Organization
- Knowledge Of Computers
- Work From Home Tasks and duties
- Self Starter
Timeline
Billing and Enrollment Representative For Humana Military
Humana Government Business, Inc
2021.12 - 2022.12
Debit Card Fraud Claims
ACT
2017.09 - 2021.12
Claims Assistant
Sedgwick Claims
Diploma -
Westfield High School
Associates Degree -
Pharmacy Technician