Erin Miller
Ardmore,PA
Summary
Dynamic and focused professional with a strong desire to cultivate the necessary skills to thrive in a demanding healthcare related organization. Recognized for strength, tenacity as well as functional knowledge to meet the demands of the Medical Claims Representative Trainee role at Progressive.
Overview
12
12
years of professional experience
Work History
Customer Service Representative
Cigna Tel Drug
Horsham, PA
11.2013 - 05.2015
- Consulted with customers to evaluate their needs and determined their best option
- Developed highly empathetic client relationships and earned a reputation for delivering exceptional customer service
- Consistently met and exceeded department goals and objectives
Senior Specialty Pharmacy Representative
Cigna Tel Drug
Horsham, PA
06.2015 - 01.2018
- Communicates effectively with customers, healthcare professionals and Cigna employees
- Responds to questions and concerns about service and handles calls appropriately
- Supports Cigna Home Delivery ONERX escalated call line on a daily basis
- Supports weekend Cigna Home Delivery ONERX informational chats and acts as Horsham's Follow Up Management Systems warrior
Case Management Analyst
Cigna Behavioral Health
Ardmore, PA
02.2018 - Current
- Completes scheduling of peer reviews for all lines of business(Cigna East, TruCare, Care Allies, Cigna West and Quani)
- Provides verbal determination to facilities regarding the results of peer reviews
- Completes follow-up on cases after peer review including assisting with alternate level of care authorizations, discharge planning, and making referrals to behavioral health specialty case engagement
- Works closely with internal matrix partners to ensure legal, Federal and State Mandates are in compliance, and NCQA and URAC accreditation guidelines are met
- Proficiently communicates with matrix partners including appeals coordinators, Case Managers, Medical Directors, individual HCP's, and facilities
Education
Master of Science - Health Administration
Saint Joseph's University
Philadelphia, PA05.2015
Bachelor of Science - Human Development And Family Studies
Pennsylvania State University
University Park, PA12.2008
Skills
- Detail Oriented
- Exceptional Communication Skills
- Expertise in Establishing rapport and Client Trust
- Strategic Thinker
Timeline
Case Management Analyst
Cigna Behavioral Health
02.2018 - Current
Senior Specialty Pharmacy Representative
Cigna Tel Drug
06.2015 - 01.2018
Customer Service Representative
Cigna Tel Drug
11.2013 - 05.2015
Master of Science - Health Administration
Saint Joseph's University
Bachelor of Science - Human Development And Family Studies
Pennsylvania State University