JENNIFER SWIFT
Cobleskill,NY
Summary
Seasoned Provider Relations Specialist possessing in-depth knowledge of various insurance plans and policies. Expertise in handling large scale accounts, high volume calls and emails, efficiently resolving disputes and identifying ways to improve processes. Communicative and detail-oriented individual with excellent interpersonal abilities.
Overview
11
11
years of professional experience
Work History
Estate Management
Family Business
01.2021 - Current
- Oversee family's estate, managing property maintenance, leases, budgeting, and expenses
- Negotiate all contracts, managed all construction jobs, and supervised ground maintenance
- Ensure all administrative paperwork is accurate and complete.
Provider Relations Specialist
Capital District Physicians Health Plan
05.2015 - 05.2021
- Served as a liaison between providers and health insurance company
- Investigated escalated concerns and recommended appropriate actions based on existing policies and contractual terms
- Oversaw and cultivated strong relationships with multiple large scale accounts
- Collaborated with other departments, including Claims, COB, Credentialing, Network/Contracting as well as Member Services to provider client with full circle customer service.
Census Enumerator
United States Census Bureau
02.2020 - 08.2020
- Surveyed residents of Schoharie County during the 2020 census
- Compiled, recorded and coded information derived from specified forms into predefined databases
- Evaluated, analyzed, and coordinated automation operations to support office and field
- Explained the purpose of the census interview, answered residents' questions, elicited information following a script, and recorded census data.
Provider Services Representative
Capital District Physicians Health Plan
06.2013 - 05.2015
- High volume inbound call center.
- Streamlined operations by managing incoming calls for medical providers seeking information or assistance for all product lines including Commercial, Medicaid and Medicare.
- Addressed service related issues including claims, appeals, and benefits and eligibility.
- Mentored junior team members and performed training, orientation and coaching for performance improvement.
Education
Certification - Medicinal Plants
Cornell University
Ithaca, NY2022
Certification - Home Health Aide
New York State Department Of Health
Cobleskill, NY2004
GED -
Middleburgh Junior/Senior High School
Middleburgh, NY2000
Skills
- HIPPA Compliance
- Salesforce, Facets, & Microsoft Proficiency
- Strong Customer Service
- Dispute/Conflict Resolution
- Contract/Policy Interpretation
- Data Entry/Review
Timeline
Estate Management
Family Business
01.2021 - Current
Census Enumerator
United States Census Bureau
02.2020 - 08.2020
Provider Relations Specialist
Capital District Physicians Health Plan
05.2015 - 05.2021
Provider Services Representative
Capital District Physicians Health Plan
06.2013 - 05.2015
Certification - Medicinal Plants
Cornell University
Certification - Home Health Aide
New York State Department Of Health
GED -
Middleburgh Junior/Senior High School