Kevin Hughes
Seaman,OH
Summary
Seasoned Advocare4Me Rep-SR at United Healthcare, adept in claims processing and data verification, showcases exceptional problem-solving and team leadership skills. Spearheaded process improvements, significantly enhancing customer service and efficiency. Proven track record in coaching for performance, managing over 40 associates at Wal-Mart, and mastering CRM software.
Overview
9
9
years of professional experience
Work History
Advocare4Me Rep-SR
United Healthcare
Dublin, Ohio
10.2021 - Current
- Currently I am part of Recovery Resolutions tier 3 claim’s
- Research complex claims issues and verify data integrity on auto-adjudicated claim’s
- Verify network status for Out of Network claim issues
- Reprocess cost share and denial corrections as needed if errors in auto adjudication
- I am a SME to others in my department
- Adjust and Re-enter claim’s when the situation applies
- I was in the LEAD program for the Summer of 2024
Team Leader
Meijer
Cincinnati, Ohio
08.2017 - 10.2021
- Ensure that all interactions between administration, employees, customers, and outside services run smoothly
- Manage 30 team members on two teams
- Responsible for inventory control, budget, customer service, training new hires, scheduling of employees, and policy enforcement
- Coached employees to improve on performance, attendance, and address behavior
Assistant Store Manager
Wal-Mart
Fort Wright, Kentucky
01.2016 - 08.2017
- Managed 42 associates and eight departments
- Coordinate with top executives and teams
- Provide continuous ways to improve efficiency and increase customer service
- Responsible for inventory control, budget control, customer service, training management, labor control, and policy enforcement
- Responsible for following federal regulations, policies, and guidelines
- Manage employee on boarding / off boarding and Department Training
Education
Medical Coding and Billing -
DeVry University
06-2021
Skills
- Claims processing
- Data verification
- Performance coaching
- Problem solving
- Process improvement
- CRM software expertise
- Customer service
- Team leadership
Timeline
Advocare4Me Rep-SR
United Healthcare
10.2021 - Current
Team Leader
Meijer
08.2017 - 10.2021
Assistant Store Manager
Wal-Mart
01.2016 - 08.2017
Medical Coding and Billing -
DeVry University
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