Microsoft Office
Jo Ann Harris-Guy
National Sales Support Coordinator
Charlotte,NC
Summary
Self-motivated and driven healthcare administration and customer support professional with comprehensive experience providing strategic advice and guidance to customers on health benefits, compliance, and wellness programs. Proven track record of communicating professionally and effectively with customers, providers, insurance carriers and third-party agencies regarding mistaken payments, grievances, and claims. Protects patients' privacy, while taking the time to listen to and understand their unique situation and serve them with a positive customer service attitude. Consistently achieves established metrics and goals assigned through product knowledge, detailed research and empathetic support. Experienced remote worker who thrives in a fast-paced environment while performing multiple tasks cohesively. Reliable [Job Title] enthusiastically pursuing opportunity to add immediate value to growing team. Inspired to help others and driven to apply unfailing work ethic to meet objectives. Industrious and committed with skills for multitasking and managing time well.
Overview
10
10
years of professional experience
2
2
years of post-secondary education
1
1
Certificate
Work History
NATIONAL SALES SUPPORT COORDINATOR
United Insurance Group – LTC Global, Inc.
Ft. Myers
04.2022 - Current
- Work with assigned Agents to guide each through the contracting/certification process with Medicare and ancillary insurance carriers
- Schedule online meetings with Agents needing assistance in completing MAPD contracts and accessing certifications
- Communicate with Contracting to request carrier status updates and questioning any discrepancies
- Monitor daily Ready to Sell reports to accurately record each Agent’s status, writing numbers and appointed states
- Update daily documentation in each Agent’s crm showing appointment completions and items pending.
CUSTOMER SERVICE REPRESENTATIVE I
Centene - Carolina Complete Health
Charlotte
02.2021 - 08.2021
- Received inbound calls from members or providers to ensure proper resolution for all inquiries
- Accessed member or provider information
- Maintained performance and quality standards based on established call center metrics while working in multiple technology systems
- Conducted research to assist with member coverage questions.
MEDICARE APPEALS & GRIEVANCES COORDINATOR I
Centene (via Collabera Staffing)
Clayton
11.2018 - 07.2019
- Analyzed and resolved verbal and written member claims and authorization appeals from providers and pursued resolution of formal grievances from members
- Maintained organized files on individual appeals and grievances
- Supported the pay-for-performance programs, including data entry, tracking, organizing and researching information
- Assisted with HEDIS production functions including data entry, calls to provider’s offices and claims research.
INSURANCE REIMBURSMENT SPECIALIST
Express Scripts (Accredo)
St. Louis
11.2017 - 11.2018
- Provided daily communication with patients, payers and physician offices regarding program status and financial responsibility including claim rejection resolution
- Determined program eligibility and communicated patient responsibility timely and accurately
- Verified patient benefits and facilitated prior authorization and reauthorization processes within the required timeframes and/or patient enrollment
- Completed accurate entry of billing information to ensure timely payment and avoid delay in patient therapy.
CUSTOMER SUPPORT | FNOL CLAIMS SERVICE ASSOCIATE
Allianz Global Corp (via Ajilon Staffing)
O’Fallon
01.2017 - 05.2017
- Initiated the claims process for property, general liability, bodily injury and excess claims for 30 adjusters daily
- Maintained a comprehensive working knowledge of key claims databases and systems
- Evaluated Accord information to ensure accurate entry, coding, documentation and adjuster assignment for each line of service.
CUSTOMER SUPPORT | LICENSED MEDICARE BENEFITS ADVISOR
Aon-Hewitt
Charlotte
03.2014 - 09.2016
- Communicated directly with AT&T retirees in multiple states to assist them with the transition to the individual insurance market and utilized needs-based analysis to recommend different healthcare plans based on each customer’s unique specifications
- Maintained a comprehensive working knowledge of Medicare Advantage, Medicare Supplement, Cost Plans, and Prescription Drug Plans
- Developed customized benefits plans detailing multiple options that illustrated a clear value proposition to the customer.
CUSTOMER SUPPORT | LICENSED INSURANCE SALES AGENT
United Health Care/Optum
Charlotte
08.2013 - 12.2013
- Educated current and newly eligible Medicare/Group Retiree customers on various insurance benefits and policies to help clients choose plans that will offer the best coverage and enroll them into the appropriate Medicare policy
- Verified that each customer’s confidential HIPAA information remained in compliance with CMS guidelines
- Drove change management to support high-performance sales expansion while ensuring compliance with established standards and regulations.
Education
Associate of Science - Health Administration
Colorado Technical University
Colorado Springs, CO 01.2011 - 05.2013
Skills
Complaint resolution
undefinedCertification
Licensed Insurance Producer, North Carolina Department of Insurance (Life & Health)
Software
Goggle Chat
FileNet
Peoplesoft
TruCare
Amisys
Zoom
Portico
Timeline
NATIONAL SALES SUPPORT COORDINATOR
United Insurance Group – LTC Global, Inc.
04.2022 - Current
CUSTOMER SERVICE REPRESENTATIVE I
Centene - Carolina Complete Health
02.2021 - 08.2021
MEDICARE APPEALS & GRIEVANCES COORDINATOR I
Centene (via Collabera Staffing)
11.2018 - 07.2019
INSURANCE REIMBURSMENT SPECIALIST
Express Scripts (Accredo)
11.2017 - 11.2018
CUSTOMER SUPPORT | FNOL CLAIMS SERVICE ASSOCIATE
Allianz Global Corp (via Ajilon Staffing)
01.2017 - 05.2017
CUSTOMER SUPPORT | LICENSED MEDICARE BENEFITS ADVISOR
Aon-Hewitt
03.2014 - 09.2016
CUSTOMER SUPPORT | LICENSED INSURANCE SALES AGENT
United Health Care/Optum
08.2013 - 12.2013
Associate of Science - Health Administration
Colorado Technical University
01.2011 - 05.2013
Licensed Insurance Producer, North Carolina Department of Insurance (Life & Health)
Individual Proficiencies
- Attention to Detail
- Problem-Solving
- Interpersonal and Communication Skills
- Independent and Teamwork
- Fast Learner
- Entrepreneurial
- Time and Task Management
- Confidentiality
Education Licensure
Associate of Science, Health Administration, Colorado Technical University
Work Availability
monday
tuesday
wednesday
thursday
friday
saturday
sunday
morning
afternoon
evening
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Professional Specialties
- Customer Service and Support
- Healthcare Billing and Claims
- Research
- Grievance and Appeals
- Regulatory Compliance
- HIPPA Standards and Regulations
- Benefits Verification
- Medicare Claims
- Eligibility Verification
- Insurance Sales and Sales Support Coordinator
Quote
There is a powerful driving force inside every human being that, once unleashed, can make any vision, dream, or desire a reality.
Tony Robbins
Individual Proficiencies
- Attention to Detail
- Problem-Solving
- Interpersonal and Communication Skills
- Independent and Teamwork
- Fast Learner
- Entrepreneurial
- Time and Task Management
- Confidentiality
Education Licensure
Associate of Science, Health Administration, Colorado Technical University
Professional Specialties
- Customer Service and Support
- Healthcare Billing and Claims
- Research
- Grievance and Appeals
- Regulatory Compliance
- HIPPA Standards and Regulations
- Benefits Verification
- Medicare Claims
- Eligibility Verification
- Insurance Sales and Sales Support Coordinator
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