Highly-motivated employee with desire to take on new challenges. Strong work ethic, adaptability and exceptional interpersonal skills. Adept at working effectively unsupervised and quickly mastering new skills. Dedicated to optimizing times and service quality with a collaborative and analytical approach. Proficient in typical customer needs, behaviors and preferences. Dedicated to training and mentoring staff to effectively resolve caller inquiries, build loyalty and enhance business revenue.
Overview
19
19
years of professional experience
1
1
Certification
Work History
Advocate4me Senior
UHC
East Northport, NY
11.2021 - Current
Advised upper management on potential strategies for enhancing customer service.
Ensured compliance with industry regulations related to customer service.
Mentored team members by demonstrating best practices for customer service.
Adhered to HIPAA requirements to safeguard patient confidentiality.
Responded to member inquiries and requests for services via phone.
Provided guidance on insurance policies and procedures to members.
Interfaced with other departments to ensure timely resolution of issues.
Created detailed documentation outlining procedures for new team members.
Provided customer service by answering inquiries, resolving complaints, and providing general information to clients regarding healthcare services.
Office Medical Biller
Beati Acupuncture & Wellness Clinic
Hauppauge, NY
07.2019 - 10.2021
Processed medical insurance claims electronically and manually to ensure timely payment from insurance companies.
Resolved discrepancies between insurance payments and billed amounts by contacting insurers regarding unpaid claims.
Verified that all information on the claim was accurate before submitting it for payment.
Identified any denied or rejected claims and worked with providers to resolve them.
Submitted appeals as needed when a claim was not paid in full or denied by an insurer.
Entered data into computer systems for processing of claims according to payer specifications.
Performed with precision by entering data accurately and researching to resolve questions.
Applied HIPAA privacy and security regulations while handling patient information.
Communicated with insurance representatives to complete claims processing or resolve problem claims.
Submitted claims to insurance companies.
Office Manager
Duet Wedding Photo & Video
Huntington, NY
01.2005 - 01.2011
Developed and implemented office policies and procedures.
Supervised staff members, organized schedules and delegated tasks.
Maintained filing system for records, correspondence and other documents.
Resolved customer inquiries in a timely manner while maintaining positive relationships with clients.
Managed front desk operations including greeting visitors, answering questions or directing them to appropriate personnel.
Tracked invoices and payments to ensure accuracy of accounts receivable and payable information.
Reviewed contracts for accuracy prior to signing off on behalf of the company.
Provided training to new hires on office policies and procedures.
Monitored payments due from clients and promptly contacted clients with past due payments.
Reviewed files and records to obtain information and respond to requests.
Managed, scheduled and coordinated office functions and activities for employees.
Trained and mentored administrative staff members in company policies, daily task execution and industry best practices.