Summary
Overview
Work History
Education
Skills
Certification
Timeline
Generic

Kelcee Swinford

Roseburg,OR

Summary

Personable Enrollment Specialist with talents in customer service. Easily adapts to changing assignments and multiple priorities. Excellent telephone and email skills. Consistently remains calm in stressful circumstances. Helpful Member Service Representative diffusing volatile customer situations, generating additional revenue and building productive relationships with both staff and customers. Customer-centered and friendly professional with 10-year background maintaining customer satisfaction and contributing to company success goals. Friendly Insurance Verification Specialist promoting a background in keeping sensitive patient data confidential while maintaining knowledge of Medicaid and private policy benefits. Possessing great relationship building and communication skills. Looking to tackle new challenges with a company that values dynamic skills and a strong work ethic.

Overview

26
26
years of professional experience
1
1
Certification

Work History

Member Service Representative

Umpqua Health Alliance
Roseburg, OR
09.2022 - Current
  • Greet members in a friendly and professional manner.
  • Answer questions about members health insurance.
  • Developed a working knowledge of insurance plans, including Medicare and Medicaid regulations and requirements.
  • Verified patient eligibility for insurance coverage by contacting insurance carriers and obtaining the necessary authorization numbers.
  • Assisted with customer inquiries, complaints, and requests for information regarding insurance policies.
  • Verified accuracy of customer data entered into the system.

Outreach and Enrollment Specialist / CHW

Aviva Health And Wellness
Roseburg, OR
02.2016 - Current
  • The Outreach and Enrollment Specialist will work to provide insurance enrollment opportunities for community residents who lack access to healthcare and health insurance. This position will also provide enrollment and application follow-up assistance, build/strengthen enrollment collaborations with local partner organizations, maintain an ongoing presence in the community (i.e. attending key local events) and increase health insurance coverage and access to quality primary health, dental, and behavioral care for community residents. This position will also be responsible for Oregon Mothers Care Program.
  • Provides unbiased information to consumers about health insurance, the new marketplaces, qualified health plans, Medicaid (Oregon Health Plan.)
  • Assists patients in enrolling and navigating through the patient portal.
  • Provides assistant to patients regarding the 340B pharmacy program (i.e.IDP).
  • Facilitates enrollment of eligible health center patients and services area residents into affordable health insurance coverage through the Oregon One System.
  • Collaborates with provider teams, patients, Oregon Health Plan and other state agencies to ensure proper enrollment and eligibility determination to facilitate proper care.
  • Networking with community untied resource network (CURN) to maintain and obtain knowledge of community resources in order to make referrals accordingly to patients.
  • Supports outreach/enrollment assistance personnel as needed, complies with and successfully completes all applicable federal and/or state consumer assistance training required for carrying out consumer assistance functions.
  • Provides enrollment assistance (including but not limited to completing coverage applications, gathering required documentation and troubleshooting the enrollment process) for uninsured children and adults to access subsidized, low-cost, and free health insurance programs through Oregon One System.
  • Provides structured patient education on health coverage, engages in follow-up conversations and offers renewal assistance for enrolled individuals.
  • Distributes outreach materials to patients, community members, partner organizations and businesses to build coverage option awareness.
  • Develops, discovers, and attends community events to promote coverage options and the mission and services of the organization.
  • Attend and represent the organization at professional meetings, in-service trainings, and other meetings as required.

Patient Registraion / ER Checkin /Radiology Assistant

Mercy Medical Center (Conifer Health Solutions)
Roseburg, OR
05.2001 - 02.2016
  • Verified type of radiology procedure prior to exams using HIPAA guidelines for two identifiers.
  • Adhered to strict HIPAA guidelines to maintain patient and medical record confidentiality.
  • Performed general administrative tasks to support radiology department.
  • Updated patient demographic information in [System] to prevent treatment and recordkeeping errors.
  • Screened patients before and during admissions processes.
  • Verified insurance and collected critical data elements to properly identify and bill patients.
  • Registered patients using proper data entry procedures and fully compliant ICD-10 and CPT codes.
  • Interpreted physician orders to coordinate appropriate tests and verify compliance with admission criteria.
  • Called patients to schedule [Type] appointments, consistently double-checking information and availability.
  • Assisted with hospital admissions and paperwork.
  • Maintained office supplies inventory by checking stock and ordering new supplies.
  • Created and maintained accurate and confidential patient files according to regulatory mandates.
  • Managed incoming telephone calls, took messages and directed callers to personnel.
  • Communicated with patients to gather intake data and verify chart information.
  • Updated patient financial information to promote accurate record keeping.

Loan Processor

Umpqua Bank
Roseburg, OR
08.2001 - 02.2011
  • Supported loan officiant and underwriter teams by ensuring timely, judicious and accurate loan processing.
  • Reviewed and verified borrowers' income, credit reports, property appraisals and supplemental information to prepare documents for underwriting.
  • Completed closing process by collaborating with attorneys, title companies and government clerks.
  • Organized loan files, updated databases, prepared general correspondence and communicated with stakeholders.
  • Managed conditions sent from underwriting departments.
  • Maintained fast-paced schedule by consistently providing satisfactory application approval turnaround times.
  • Maintained complete confidentiality of submitted information according to release guidelines.
  • Evaluated financial statements and contacted institutions and customers to clarify details.
  • Created and completed loan submission packages.
  • Filed completed packages quickly and efficiently.
  • Communicated with customers in person and via telephone to answer questions, process transactions and resolve issues.
  • Discussed loan needs and financial histories with clients and conveyed information regarding application processes.
  • Helped customers make decisions about loans and lines of credit based on availability, terms and benefits.
  • Reviewed loan agreements to verify completeness and accuracy according to applicable policies.
  • Analyzed applicant financial and credit status, evaluating assets and risk to determine loan feasibility.
  • Listened carefully to customer complaints and swiftly resolved issues by taking appropriate action.
  • Assessed feasibility of loan approval by reviewing financial histories, available credit and current employment.
  • Spent ample time with each applicant to break down complex information into terms that easy to understand.
  • Identified valuable solutions for customers with credit problems.
  • Met with applicants to obtain information for loan applications and answer questions about processes.
  • Cultivated partnerships with individuals and firms to better promote products meeting customers' needs.
  • Met with applicants to obtain information to streamline loan application process, fielding questions regarding steps.
  • Reviewed credit histories from applicants and determined feasibility of granting requested loans.

Service Deli Clerk

Salesforce
Rosebur, OR
12.2000 - 02.2001
  • Received new inventory and rotated stock by dates to keep items fresh and usable.
  • Worked with customers placing large or specialized orders, providing samples and recommendations and responding to requests.
  • Updated food displays, cases and other customer-facing areas to increase sales of special items.
  • Operated cash register to accept and process cash, check, card and mobile payments.
  • Maintained work areas to reduce potential for illness or injury.
  • Answered telephone inquiries about available menu items, products and services and delivered appropriate information so customers could make valid choices.
  • Stored perishable food items in freezer or refrigerator to protect from spoilage.
  • Checked and recorded refrigerator and freezer temperatures to maintain food quality and freshness.
  • Stayed calm and professional in situations and resolved conflicts to customer satisfaction.
  • Documented and entered special orders for event catering and party trays.
  • Completed orders by slicing, weighing, packaging and pricing meats and cheeses.
  • Organized ingredients and restocked supplies to prepare for busy periods.
  • Sanitized and kept work areas tidy by cleaning surfaces, equipment and floors, removing trash and maintaining machinery.

Assistant Office Manager /Patient Care Coordinator

Serenity Lane Drug Treatment Center
Roseburg, OR
05.1998 - 09.2000
  • Assigned projects to administrative staff, boosting office productivity and streamlining processes.
  • Liaised with customers, addressed inquiries, handled meeting requests and answer billing questions to provide outstanding customer care.
  • Automated office operations, managing client correspondence, record tracking and data communications in database and case management software.
  • Improved productivity initiatives, managing accounts, coordinating itinerary and scheduling client appointments.
  • Provided effective quality control oversight and eliminated downtime to maximize revenue.
  • Prepared and disseminated public information.
  • Demonstrated consistent operational excellence to maintain stellar office reputation.
  • Collaborated staff to maximize buy-in for customer service and functional initiatives.
  • Increased staff productivity with streamlined processes and improved automation.
  • Drove client retention and increased revenue by driving effective customer relationship management protocols.

Education

High School Diploma -

Roseburg High School
Roseburg, OR
06.1998

Skills

  • Customer Account Review
  • Records Maintenance
  • Insurance Practices
  • Customer Complaint Resolution
  • HIPAA Compliance
  • Medicare Compliance
  • Requirements Reviews
  • Insurance Eligibility
  • Client Consultations
  • New Agent Training
  • Insurance Coverage Verification
  • Telephone and Email Skills
  • Service-Oriented
  • Relationship Building
  • Quality Assurance Requirements
  • Financial Needs Assessment
  • Client Interviews
  • Time Management
  • Call Center Customer Service
  • Customer Engagement
  • Data Entry
  • Policy Changes
  • Form Completion and Submission
  • Insurance Understanding

Certification

  • [Community Health Worker(CHW) [Oregon Health Authority] - [2022-2025]

Timeline

Member Service Representative

Umpqua Health Alliance
09.2022 - Current

Outreach and Enrollment Specialist / CHW

Aviva Health And Wellness
02.2016 - Current

Loan Processor

Umpqua Bank
08.2001 - 02.2011

Patient Registraion / ER Checkin /Radiology Assistant

Mercy Medical Center (Conifer Health Solutions)
05.2001 - 02.2016

Service Deli Clerk

Salesforce
12.2000 - 02.2001

Assistant Office Manager /Patient Care Coordinator

Serenity Lane Drug Treatment Center
05.1998 - 09.2000

High School Diploma -

Roseburg High School

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Kelcee Swinford