Gary A. Rowlet
Forest City,IA
Summary
Highly motivated and accomplished Health Insurance and Customer Service Specialist with a solid track record of performance in department reviews. Key strengths include the ability to meet and exceed targets, a knack for managing on-time projects and the ability to maintain productivity levels. Adept at coordinating with company staff at all levels as well as working independently.
Overview
20
20
years of professional experience
Work History
Network Data Specialist I
ELEVANCE HEALTH
01.2023 - Current
- Maintains critical provider information on all claims and provider databases
- Validates the data to be housed on provider databases and ensuring adherence to business and system requirements of customers as it pertains to contracting, network management and credentialing.
- Remote position
Financial Ops Recovery Specialist I
ELEVANCE HEALTH
05.2022 - 01.2023
- Review and validate Pre-Payment or Post-Payment claims for potential savings
- Using various techniques including systems-based queries, specialized reporting and other research to recover claim over-payments made to providers.
Medical Management Specialist II
ELEVANCE HEALTH
11.2018 - 05.2022
- Gathered clinical information regarding cases and determines the appropriate area to refer to or assign the case.
- Interfacing with providers and/or facilities to provide information related to cases.
- Working various duties for the dept. as needed such as building post-acute cases, assisting the claims dept. working action grams and notifying providers for clinical or a discharge date.
Utilization Management Rep II
ELEVANCE HEALTH
06.2016 - 11.2018
- Processed incoming requests, collection of information needed for review from providers, utilizing Scripts to screen basic and complex requests for precertification and/or prior authorization.
- Determines contract and benefit eligibility, provides authorization for inpatient admission, outpatient precertification and prior authorization.
Website Assistant
Joseph Technologies
09.2015 - 06.2016
- Assisted with employees in various tasks of designing and creating websites for customers, and listening to their needs and expectations for a superior product.
Customer Service Rep
MorphoTrust USA
09.2014 - 09.2015
- Contractor for the federal government
- Received calls from customers and explaining the process and guidelines of applying for TSA Pre-check through the Transportation Safety Administration
- Kept track of collecting and analyzing customers statuses on Excel Spreadsheets
Customer Service Rep 2
American Enterprise Group
06.2010 - 08.2012
- Received inbound calls from customers, and answered questions about their Medicare supplemental policies
- Responded to inquiries from medical providers and agents
- Assisted in the claims department when needed
- Achievement: Promoted to Customer Service Rep 2 in Oct 2011
Customer Service Rep
ADP Benefit Services
08.2009 - 06.2010
- Received inbound calls from COBRA Health participants, and answered questions concerning their health insurance policies
- Assisted various companies with updates of participant coverage
- Temporary position
Customer Service Rep 3
Wells Fargo Home Mortgage
11.2005 - 05.2008
- Assisted WFHM customers with questions regarding their mortgages
- Successfully cross-sold mortgage products to benefit the homeowner
- Achievement: Promoted to Customer Service Rep 2 in May 2006
- Achievement: Promoted to Customer Service Rep 3 in August 2007
Education
Financial Services Academy Certificate -
Des Moines Area Community College
Des Moines, IA01.2014
Diploma - undefined
St. John High School
Bancroft, IAAccredited Customer Service Representative Certificate - undefined
Des Moines Area Community College
Des Moines, IA01.2014
Skills
- Microsoft office proficiency
- Compiling data
- Data quality management
- Data verification
- Teamwork and collaboration
- Problem-solving
- Time management
- Attention to detail
- Problem-solving abilities
- Multitasking Abilities
- Excellent communication
- Organizational skills
- Active listening
- Project management
Section name
Between August 2012 and August 2014, I attended college at Des Moines Area Community College in Des Moines, IA, and earned several college certificates.
Timeline
Network Data Specialist I
ELEVANCE HEALTH
01.2023 - Current
Financial Ops Recovery Specialist I
ELEVANCE HEALTH
05.2022 - 01.2023
Medical Management Specialist II
ELEVANCE HEALTH
11.2018 - 05.2022
Utilization Management Rep II
ELEVANCE HEALTH
06.2016 - 11.2018
Website Assistant
Joseph Technologies
09.2015 - 06.2016
Customer Service Rep
MorphoTrust USA
09.2014 - 09.2015
Customer Service Rep 2
American Enterprise Group
06.2010 - 08.2012
Customer Service Rep
ADP Benefit Services
08.2009 - 06.2010
Customer Service Rep 3
Wells Fargo Home Mortgage
11.2005 - 05.2008
Diploma - undefined
St. John High School
Accredited Customer Service Representative Certificate - undefined
Des Moines Area Community College
Financial Services Academy Certificate -
Des Moines Area Community College
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