Dynamic individual with hands-on experience in healthcare and talent for navigating challenges. Brings strong problem-solving skills and proactive approach to new tasks. Known for adaptability, creativity, and results-oriented mindset. Committed to making meaningful contributions and advancing organizational goals.
Overview
14
14
years of professional experience
Work History
Care Coordinator
Senior Services of Van Buren County
South Haven, MI
08.2017 - Current
Maintained patient condition records using databases.
Coordinated patient care by implementing prompt follow-ups and tailored interventions.
Established effective connections with community entities, improving patient care coordination.
Performed routine assessments of care plan efficiency, implementing changes based on patient and provider feedback.
Partnered with social services to link patients to housing, nutrition, and financial aid resources.
Coordinated activities for Senior Fresh, Commodities, food services, and Feeding America food trucks.
Oversaw Medicare programs and services.
Advocated for client needs, promoting access to essential resources and services within the community.
Built strong relationships with clients to deliver emotional support and companionship.
Medical Claims Processor
Blue Cross Blue Shield of Michigan
Grand Rapids, MI
05.2016 - 07.2017
Processed high volumes of medical claims accurately and efficiently under tight deadlines, ensuring prompt payment for services rendered.
Researched and resolved complex medical claims issues to support timely processing.
Maintained knowledge of benefits claim processing, claims principles, medical terminology, and procedures and HIPAA regulations.
Verified patient insurance coverage and benefits for medical claims.
Implemented quality assurance measures that improved overall claims processing accuracy by enhancing verification protocols.
Licensed Health Producer
Dialogue Direct-Blue Cross Blue Shield of Minnesota and New York
Holland, MI
09.2012 - 06.2016
Subject Matter Expert
Evaluated the effectiveness of training initiatives by tracking participant progress and gathering feedback for continuous improvement.
Clarified intricate insurance policies to help clients choose suitable coverage options.
Carried out analysis to collect information crucial for making informed health insurance product suggestions.
Guided clients in selecting health insurance plans that best suited their individual needs.
Stayed informed on industry changes and regulations, offering clients competitive insights.
Answered inbound calls from existing and future policyholders to answer inquiries and discuss insurance options.
Contributed to team success by sharing best practices on sales techniques, product knowledge, and customer service skills with fellow agents.
Mentored junior staff, fostering a culture of continuous learning and professional growth within the team.
Education
Medical Administration -
Everest Institute
Kalamazoo, MI
2009
Skills
Case management
Documentation
Patient education
Organizational skills
Medical terminology
Insurance practices
Strategic planning
Database coordination
Problem-solving
Time management
Multitasking and organization
Conflict resolution
Electronic medical record software
Medicare compliance
Industry networking
Insurance regulations
Compliance monitoring
Policy analysis
Timeline
Care Coordinator
Senior Services of Van Buren County
08.2017 - Current
Medical Claims Processor
Blue Cross Blue Shield of Michigan
05.2016 - 07.2017
Licensed Health Producer
Dialogue Direct-Blue Cross Blue Shield of Minnesota and New York