Summary
Overview
Work History
Education
Skills
Timeline
Generic

Jean L. Michaelis

McDonald,PA

Summary

I am innovative and entrepreneurial, and I enjoy solving problems by utilizing root cause analysis. My career has been focused on analysis and customer service,

Overview

46
46
years of professional experience

Work History

Driver

Lyft
02.2023 - Current
  • Providing transportation to customers in the Pittsburgh region
  • I am providing transportation services to customers in the Pittsburgh area. I have a five-star rating on Lyft

Customer Service and Fulfillment Specialist

Addecco/General Electric Aviation
11.2022 - 02.2023
  • Quoting spare parts, consumables, and service for GE Additive customers
  • Confirming customer purchase orders, verifying necessary information, and entering orders in the ERP system
  • Communicating with customers concerning urgent shipments, include lead times and tracking information
  • Creating and sending invoices to customers’ accounts payable departments as orders are shipped

Credit Analyst I

Opusing/Eaton Corporation
04.2022 - 08.2022
  • In four short months, I recovered 10 million dollars
  • Mastered three Business Systems
  • Applying payments
  • Cash Reconciliation
  • Payment Collection
  • Customer Service
  • Running Credit Card Payments
  • Creating Monthly Invoices
  • Uploading Invoices to Customer’s Payment Portals

Human Resources Technician

Manpower/Citi Bank
08.2021 - 12.2021
  • Schedule appointments
  • Send emails
  • Contact applicants
  • Other duties as assigned

COVID-19 Vaccination Call Center Rep

Manpower/Maximus
05.2021 - 07.2021
  • Take phone calls from customers looking for a location to receive COVID-19 vaccinations.
  • Conducted research to answer customer inquiries on various subjects

Shareholder Engagement Specialist

Robert Half/Innisfree
04.2021 - 05.2021
  • The purpose of the call is to make sure shareholders received the voting material for the stockholder meeting.
  • If they’d like to vote, we are the voting agent.
  • If they need materials, we’ll send it out.
  • Persuade voters to vote on behalf of the Client

Customer Service/Benefits Verification Specialist

CareMetx
12.2020 - 01.2021
  • Providing excellent customer service via phone and email
  • Aiding anyone calling in and verifying their benefits
  • Answering any calls or concerns someone may have with their benefits

Customer Service Representative

LoanCare
05.2020 - 09.2020
  • Receive phone calls from customers, real estate professionals, and other lenders
  • Solved problems and issues
  • Persuaded customers to agree to sign up for Auto Drafts and other services
  • Informed customers about mortgage laws and rules
  • Researched documents and internet websites for information
  • Served as a help desk for website issues

Customer Service/Medicare Appeal Analyst

Aetna Insurance
03.2017 - 01.2020
  • Review of contract materials; Interpret Medicare Regulations and Guidance;
  • Strong written and verbal communication skills;
  • Draft letters to members in a clear and concise manner
  • Update internal system, documenting the activity of case file review with clarity and accuracy
  • Maintain accountability for resolving each case within established internal timeframes - Recognize trends and provide solutions
  • Contact members and medical providers to gather information and appeal decisions
  • Work cooperative with medical professionals to deliver excellent customer service
  • Contact inpatient facility to assist with the transitions from acute care hospitals to Skilled Nursing Facilities and Acute In-patient Rehabilitation Facilities
  • Assure that members and their representative understand the next level of Medicare Appeals
  • Provide the clinical staff with the most appropriate Medicare Guidelines necessary to make a correct and complete coverage decision
  • Contact third party contractors when the medical decisions they have made need to be updated because they were overturned
  • Submit cases that were upheld to the Independent Review Entity (IRE) (Maximus)

Maximus Collector

EGS-Direct TV
02.2016 - 08.2016
  • Contact customers via telephone
  • Analyze customer accounts
  • Negotiate account payment
  • Solve customer problems
  • Collect payments

Customer Service/Appeals Specialist

Palmetto GBA
07.2002 - 08.2015
  • Research Medicare guideline to term payment is to be granted for medical claim of various amounts including claims valued at over $100,000.00
  • Responsible for responding to appeal requests from medical professionals, billing companies, beneficiaries and their legal representatives utilizing CPT codes, ICD9 codes and Medicare Guidelines
  • Applied rules and regulations as published on the Center for Medicare/Medicare Services website
  • Determined if a Medicare claim should be processed or was correctly rejected because the claim does not include all the information necessary to process the initial claim
  • Made several recommendations improving production, quality and customer service
  • Contacted medical providers to request necessary information for the prompt payment of the claim
  • Wrote letters to all interested parties explaining why payment cannot be made
  • Answered high level customer service concerns or problems via electronic voice communication
  • Researched Medicare Laws for applicable guidelines and appropriate actions
  • Made payments when appropriate
  • Worked in a team environment, problem solving and supporting co-workers

Senior Correspondence Analyst/ Indemnification Specialist

Nationwide Insurance
10.1979 - 07.2002
  • Responsible for creating and developing the Over-Payment Referral Process Improvement Team and communicating the results to the staff
  • Responsible for preparing and presenting training to staff in Wheelersburg, Ohio to correct a very large case involving incorrectly processed claims
  • Responsible for preparing and presenting training to Review Examiners on the Indemnification process that returns money to Medicare Beneficiaries who pay their doctors for services for which they are not responsible
  • Possess excellent oral and written communication, problem-solving and customer service skills used to persuade Medicare providers to refund money to Medicare Beneficiaries
  • Responsible for creating and developing the 'Reduce Appeals through Education Team'.
  • Improved and expanded the monthly Provider Usage Report which provided the Management team with a detailed description of the reasons Medicare claims decisions were reversed by the Appeals Staff

Education

Master of Science - Marketing and Communications

Franklin University
Columbus, OH
12.2008

Bachelor of Science - Business Administration

Mt. Vernon Nazarene University
Mt. Vernon, OH
12.2006

Skills

  • Time management
  • Problem solver
  • Customer service
  • Entrepreneurial- Expert in Time Management
    - Skilled Problem Solver
    - Strong Customer Service Advocate
    - Proven Entrepreneurial Mindset

Timeline

Driver

Lyft
02.2023 - Current

Customer Service and Fulfillment Specialist

Addecco/General Electric Aviation
11.2022 - 02.2023

Credit Analyst I

Opusing/Eaton Corporation
04.2022 - 08.2022

Human Resources Technician

Manpower/Citi Bank
08.2021 - 12.2021

COVID-19 Vaccination Call Center Rep

Manpower/Maximus
05.2021 - 07.2021

Shareholder Engagement Specialist

Robert Half/Innisfree
04.2021 - 05.2021

Customer Service/Benefits Verification Specialist

CareMetx
12.2020 - 01.2021

Customer Service Representative

LoanCare
05.2020 - 09.2020

Customer Service/Medicare Appeal Analyst

Aetna Insurance
03.2017 - 01.2020

Maximus Collector

EGS-Direct TV
02.2016 - 08.2016

Customer Service/Appeals Specialist

Palmetto GBA
07.2002 - 08.2015

Senior Correspondence Analyst/ Indemnification Specialist

Nationwide Insurance
10.1979 - 07.2002

Master of Science - Marketing and Communications

Franklin University

Bachelor of Science - Business Administration

Mt. Vernon Nazarene University

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Jean L. Michaelis