Karrina M. Hillian
Summary
Results-driven management professional with proven ability to lead teams to success. Strong focus on team collaboration, operational efficiency, and achieving measurable outcomes. Adept at strategic planning, process improvement, and fostering culture of accountability and excellence. Known for adaptability and consistently meeting changing organizational needs.
Overview
11
11
years of professional experience
Work History
Member Advocate Medicare Market
Blue Cross Blue Shield of Massachusetts
08.2024 - Current
- Interfaces with customers via telephone, written correspondence, fax, web, and/or electronic mail
- Research customer information utilizing appropriate systems, policies, regulations, procedures and other reference materials to effectively respond to and resolve customer issues
- Elevates sensitive customer requests when necessary
- Comply with State and Federal regulations and mandates, which are continually changing, thus creating a very dynamic environment, candidate is responsible to take initiative to stay current on policies and procedures required to support the customer and to ensure compliance
- Accountable to remain current on knowledge of diverse products and proactively recommend items needed by customers to increase customer satisfaction and improve transaction profitability
- Self-motivated, with a strong sense of personal responsibility.
- Worked effectively in fast-paced environments.
- Skilled at working independently and collaboratively in a team environment.
- Excellent communication skills, both verbal and written.
- Worked well in a team setting, providing support and guidance.
- Organized and detail-oriented with a strong work ethic.
- Learned and adapted quickly to new technology and software applications.
- Demonstrated strong organizational and time management skills while managing multiple projects.
Express Claims Specialist 2
STATE FARM
02.2023 - 08.2024
- Receives claims, confirms policy coverage and acknowledgment of the claim
- Renders a Liability determination
- Answering inbound calls and making outbound calls to customers and third parties
- Establishes reserves and authorizes payments within reserving authority limits
- Supporting our customers through personalized, caring, and simple interactions
- Lead team discussions on the better handling of claims for our insured, third parties and claimants
- Average call time, adherence to schedule and meeting required
- Setting the standard for in the insurance industry for the claims department
- Supporting Team Managers with the upkeep of team notifications and files through PowerPoint, One Note and SharePoint
- Adheres to client and carrier guidelines and participates in claims review as needed
- Communicates claim status with the client and claimant
- Receiving and processing escalated calls and claims for the maintenance of completed tasks
- Task work, included but not limited to pay outs, rental reservations, and repair facilities
- Developed strong working relationships with external partners such as adjusters, legal counsel, and medical professionals to facilitate efficient claim resolution processes.
- Enhanced customer satisfaction with timely communication, empathy, and clear explanations of claim outcomes.
Senior Customer Advocate (Medical and Dental Claims Specialty)
CIGNA HEALTHCARE
11.2023 - 08.2024
- Answer inbound calls from members with questions about medical claims, benefits, eligibility, and prior authorization
- An average of 50-80 calls daily
- Take calls back-to-back while toggling through several applications on multiple screens
- Remain customer-focused at all times to meet tailored needs, providing positive outcomes for member's well-being
- Resolve customer complaints through independent problem-solving skills and one-call resolution
- Understanding and striving to meet or exceed call center metrics while providing accurate information to callers with a courteous and professional demeanor
Titles and Registration Specialist 2
CARVANA
06.2022 - 02.2023
- This role requires data entry experience
- Responsible for registration of newly acquired vehicles purchased at Carvana LLC
- Inputting all information provided at the time of purchase
- Works closely with DMV and other registration offices based on the state in which each car is purchased
- Ensuring all documents are correct and able to send tags and registration to each individual customer with in a 14-day period!
- Provide temporary tags in the cases where needed
- Update records for each customer
- Provide excellent service to all Carvana customer
- Responsible to have knowledge of multiple state regulations and requirements to register a vehicle in said state
- Specific use of Microsoft Excel, Power Point and Outlook to build and pull reports relating to business needs and practices
- Utilized specific systems including Jira, Salesforce, Confluence, Carma, DLRDMV, Dealer Track, Registration USA and ABS daily
- Running reports such as Ready To Work, Out of State and In State (GA) on all sale deals to process registration
- Organizing in state and out of state deal packages to be processed by specialists on the registration floor
- Selected to be apart of the activities team within the company
- Organizing team outings, activities, and team building
- Promoted to a leadership role (Specialist 2) and conducted team meetings to give updates to the team regarding KPI's and other measures of production
- Working closely with the Team Lead to create a productive, concise and enjoyable department
- Enhanced patient registration accuracy by diligently reviewing and verifying information on registration forms.
- Maintained a high level of confidentiality when handling sensitive patient data, adhering to HIPAA regulations.
- Served as a point of contact for other departments requiring access or updates to patient information, fostering efficient inter-departmental collaboration.
Child Support Agent II
Department of Human Services State of Georgia DCSS
03.2019 - 06.2022
- Establishes child support obligations and ensures that such obligations are met
- Communicates with clients and other constituents via telephone, email correspondence and direct contact to ensure that support obligations are met
- Manages a caseload to ensure that child support obligations are met
- Performs other professional responsibilities as assigned by supervisor
- Evidence of exceptional critical thinking skills, good judgment and decision making abilities to monitor and manage a caseload to ensure that child support obligations are met
- Ability to use customer service skills to include active listening and negotiation ability
- Excellent oral, written, presentation and interpersonal communication skills
- Strong proficiency in the use of Microsoft Office Suite and/or standard software applications typically used in a corporate office environment
- Improved child support collection rates by implementing efficient case management strategies.
- Collaborated closely with legal teams to prepare court documents related to paternity establishment, enforcement actions, or modification hearings.
Team Lead
ALS RESOLVION
02.2017 - 03.2019
- Team lead of a crew of 8-10 team members
- Responsible for repossession of vehicles behind on payments with multiple lien holders with a focus on Hyundai Motor Finance and Kia Motor Finance
- Santander Financial and Exeter Motor Finance
- Expected to meet and exceed 100% of the $15K budget goal set each month
- Case file load up to 250 accounts worked per day
- Work closing with agents across the nation to ensure securing the units assigned for repossession and surrender of vehicles in case file each month
- Extension knowledge of the repossessions process from finance to auction
- Met and exceeded monthly goals and quotas
- Work closely with upper management to obtain great location information for difficult to find past customers of major lenders
- Speaking with references, neighbors, employers, etc
- Also work with subjects to turn most accounts and collateral into voluntary surrenders back to the lien holder(s) on file
- Asset to the company and have completed long term goals in a short-term period
- Exemplified excellent leadership skills regarding assisting new hires with training and program familiarity
- As well as been able to train in the fields of A/R , billing, and coding for the director and owner of the company
- Utilizing systems such as, Wombat, IDICORE, and other various skip tracing tools
- Managed schedules, accepted time off requests and found coverage for short shifts.
- Trained new team members by relaying information on company procedures and safety requirements.
- Influenced positive change within the organization through strategic thinking, innovation, problem-solving abilities, and consistent leadership style.
- Coached team members in techniques necessary to complete job tasks.
- Enhanced overall team performance by providing regular coaching, feedback, and skill development opportunities.
Collector 1
Hyundai Capital America
09.2015 - 01.2017
- Responsible for working the 0-59 days past due on current Hyundai and Kia leasing and purchasing past due accounts
- With an over $1million dollar budget
- Automatically for the dialed unit
- Work special projects within the company
- Hold team meetings regarding strategy and collection practices by policy and procedure of the company
- Commission plus salary based
- Earn great incentives through company side competitions and contests
- Assist manager with team goals and aspirations
- Maintain a superior level of professionalism
- And have been recognized as a top collector within the company
- Contacted customers to discuss payment schedules and set up or immediately process payments.
- Collaborated with team members to achieve monthly targets, promoting a positive work environment and boosting overall productivity.
- Negotiated with account holders to devise repayment plans and minimize collections receivables.
- Persistently reached out to customers with extremely past due accounts to recover lost revenue.
Apple Mac Supervisor
APPLE
06.2013 - 01.2015
- Remote position
- Responsibilities include regular supervising and leadership of a team ranging from 7-12 members
- Sales and knowledge of all Apple products and services
- Responsible for team quota for sales
- Attended and Graduated from Apple Univ
- Trainings for the new products being launched
- Answer incoming escalated calls transferred from team members in a fast-paced environment
- Addressing escalated issues and concerns as well as account-specific customer inquiries; providing clear and concise information and updating customer account information that team representatives need assistance with
- Tailor unique solutions for each customer
- Use tools and resources to identify creative solutions and anticipate customer needs, in our commitment to maintain a first point of contact resolution
- Able to leverage reporting to improve customer service and financial results
- Knowledge on how to pull meaningful insight from data and reporting
- Meet and exceed performance goals that include, but are not limited to, customer survey results, average call handle time, schedule adherence, quality and compliance standards
- Requires internet services and POTS line for incoming and outgoing calls through service provider
- Adept at performance management, setting realistic and attainable objectives, holding regular reviews and sharing constructive feedback
- Hold weekly team meetings to update team on productivity and goals
- Demonstrated commitment to the organization''s core values, leading by example and fostering a culture of excellence.
- Conducted performance evaluations for staff members, identifying areas of improvement and guiding professional development plans.
Education
Associates - Psychology And Education
Cosumnes River College
Sacramento, CA01.2005
Skills
- Cross-cultural communication
- Assertiveness
- Customer Service
- Problem-Solving
- Multitasking and Organization
- Team Leadership
- HIPAA Compliance
- Patient Education
- Relationship Building
- Insurance Verification
- Insurance Billing
- Payment Processing
- Eligibility Determination
- Training Coordination
- Medical Billing
- Regulatory Compliance
- System Updating
- Registration management
- Financial Procedures Adherence
- Insurance company knowledgeable
- Patient identity verification
- Teamwork and Collaboration
- Attention to Detail
- Problem-solving abilities
- Multitasking
- Collaboration and Teamwork
- Excellent Communication
- Critical Thinking
- Organizational Skills
- Effective Communication
- Adaptability and Flexibility
- Organization and Time Management
- Decision-Making
- Detail Oriented
Awards
Certified Asset Recovery Specialist (C.A.R.S), RISC Educational Systems, 08/01/17
Timeline
Member Advocate Medicare Market
Blue Cross Blue Shield of Massachusetts
08.2024 - Current
Senior Customer Advocate (Medical and Dental Claims Specialty)
CIGNA HEALTHCARE
11.2023 - 08.2024
Express Claims Specialist 2
STATE FARM
02.2023 - 08.2024
Titles and Registration Specialist 2
CARVANA
06.2022 - 02.2023
Child Support Agent II
Department of Human Services State of Georgia DCSS
03.2019 - 06.2022
Team Lead
ALS RESOLVION
02.2017 - 03.2019
Collector 1
Hyundai Capital America
09.2015 - 01.2017
Apple Mac Supervisor
APPLE
06.2013 - 01.2015
Associates - Psychology And Education
Cosumnes River College
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