Hardworking and reliable Occupation Consultant with strong abilities in resolving issues with customer service, multitasking and time management abilities. Highly organized, proactive and punctual with team-oriented mentality.
Overview
23
23
years of professional experience
Work History
Operation Consultant
Highmark BCBS Western NY - WV
03.2023 - 02.2024
Fielded advocate questions through a SharePoint site
Conducted team refreshers on an ongoing basis
Managed inventory levels to meet departmental goals.
Senior Customer Service Advocate
Highmark BCBS WV
03.2002 - 02.2023
Informed customer about billing procedures, processed payments and provided payment option setup assistance
Asked probing questions to determine service needs and accurately input information into the electronic system
Answered 50+ inbound calls per day and directed to designated individuals or departments
De-escalated problematic customer concerns, maintaining a calm, friendly demeanor
Fielded customer complaints and queries, fast tracking them for problem resolution
Consulted with customers to determine best methods to resolve service and billing issues
Reviewed account and service histories to identify trends and issues
Documented conversations with customers to track requests, problems and solutions.
Claims Analyst
Mountain State BCBS
03.2001 - 03.2002
Reviewed customer claims, identified discrepancies and determined appropriate course of action
Conducted investigations to gather evidence in support of claims resolution
Assessed medical records for coverage eligibility and benefit accuracy.
Education
High School Diploma -
Parkersburg High School
Parkersburg, WV
05.1985
Skills
Claims Analysis
Planning
Problem resolution
Claim Adjustment
Coordination
Work Ethic
Decision making
Teaming
Organizational skills
Collaboration
Critical thinking
Basic math
Conflict resolution
Relationship building
Team management
Flexible and Adaptable
Timeline
Operation Consultant
Highmark BCBS Western NY - WV
03.2023 - 02.2024
Senior Customer Service Advocate
Highmark BCBS WV
03.2002 - 02.2023
Claims Analyst
Mountain State BCBS
03.2001 - 03.2002
High School Diploma -
Parkersburg High School
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