Kimberly Neeley
Tavares,FL
Summary
Compassionate Case Manager accustomed to treating diverse patient needs while managing dynamic conditions. Collaborative professional possessing excellent clinical knowledge and judgment combined with strong documentation and problem-solving abilities. Well-versed in managing emergent cases with poise. Accomplished Case Manager adept at handling high caseloads without sacrificing quality of care. Operates exceptionally well in high-pressure environments. Recommends best resources and courses of action to benefit patient needs and return each to optimal quality of life.
Overview
21
21
years of professional experience
Work History
Case Manager
United Biosource
08.2022 - 07.2023
- Provided day-to-day oversight and coordination of caseload to ensure all case elements and tasks were completed timely and ensure cases moved through the process as required
- Acted as a single point of contact responsible for prior authorization and appeal processing communications to patients, healthcare providers, field reimbursement representatives, and other external stakeholders
- Communicated patient benefits and responsibilities timely and accurately
- Assessed and referred patients appropriately for special programs/services when appropriate
- Performed quality checks on cases and reported trends to leadership
- Was responsible for good housekeeping techniques, adhering to quality and production standards while complying with all applicable company, state, and federal safety and environmental programs and procedures
- Troubleshot complex cases, spanning multiple disease states, while interacting with key stakeholders (internal/external) to ensure the optimal start to treatment
- Reported Adverse Drug Events that the patient has experienced in accordance with pharmaceutical requirements
- Recognized a product quality complaint and forwarded caller/written information to a manufacturer
- Other duties, as assigned.
- Transitioned clients to different providers based on progress or needs.
- Assessed clients' needs, developed service plans and monitored progress towards goals.
- Assisted individuals with eligibility for available benefits.
- Monitored and kept meticulous records of patient treatment plans and response of patient to medication.
- Handled administrative procedures to meet objectives set by boards of directors or senior management.
- Consulted with staff on resolution of complex service issues.
- Maintained up-to-date case records with case activity status.
- Maintained accurate case records and documentation according to agency guidelines.
- Adhered to ethical principles and standards to protect clients' confidential information.
- Coordinated support services and optimized communication between healthcare workers and patients.
- Compiled reports on cases and submitted them to supervisors as required.
- Promoted high customer satisfaction by resolving problems with knowledgeable and friendly service.
- Completed day-to-day duties accurately and efficiently.
Recovery specialist
Enterprise Holdings
09.2021 - 06.2022
- Remained calm, stayed professional, and provided exceptional service on calls, even when interacting with difficult claims
- Completed skip tracing to locate individuals responsible for past-due balances
- Acted as an intermediary between insurance companies and customers by researching and assessing information to determine claim validity
- Called insurance companies to ascertain pertinent information regarding policies and confirmation of coverage
- Made counter offers with insurance companies to avoid arbitration
- Worked independently at home while meeting the quota of 6 claims per hour
- Corresponded with insurance customers and agents to obtain or relay information on account status changes
- Examined automobile policies with third-party liability, accident benefits, and collision benefits
- Used skills to establish productive working relationships with renters, insurance companies, and attorneys
- Reviewed audits made by insurance companies and provided needed invoices as evidence to negotiate payment.
Club service associate
Bluegreen Vacations
10.2020 - 01.2021
- Was responsible for exceeding customer service goals to enhance the owner's experience by booking reservations, providing product knowledge, assisting with payment arrangements for HOA dues, processing payments on Loans, and exceeding KPIs, including Call Monitors
- Also provided first-call resolution on escalated issues.
Customer care specialist (WFH)
Apple Leisure Group
04.2019 - 04.2020
- Conversed with customers by phone to determine destination, mode of transportation, travel dates, financial considerations, and accommodations required to purchase a vacation package
- Offered promotional travel incentives by various travel carriers
- Took customer's payments for vacation packages or set up payment arrangements.
Customer service operations agent
Marriott Club International
08.2015 - 06.2019
- Handled incoming calls from owners and potential owners who purchased tour packages
- Worked closely with the Sales team to assure customers/owners going to tour the chosen resort
- Resolved escalated customer service issues on property or knowledge of package purchased
- Processed customers' payments on packages
- Assisted training of new hires and quality assurance monitors monthly for 10+ agents
- Exceeded monthly KPI’s.
Collection Resolution Specialist - Lead
Hilton Grand Vacation
06.2017 - 04.2019
- Communicated with owners, BBB, and attorneys via telephone, USPS, and e-mail
- Tracked each owner assisted through SalesForce and met deadlines based on compliance
- Assisted owners with Loss Mitigations based on financial hardships and provided resolution either by payment arrangements, forbearance, or warranty deeds
- Processed PCCs (Post-Close Cancellations) of owner's timeshare contracts within the rescission period or as a resolution to escalation
- Oversaw ordering office supplies and items needed to send off deeds after post-PCCs were complete.
- Prepared Collections Letters per policy.
- Followed up on outstanding claims and investigated disputes.
- Authored settlement agreement documents containing resolutions and obtained signatures from both parties to finalize agreements.
- Determined extent of liability by reviewing evidence, laws and administrative or judicial precedents.
- Identified root causes of customer concerns, tracked resolution process steps, and documented all actions taken.
- Created reports on the status of outstanding cases and communicated results to management team members.
- Advised senior management on best practices for resolving complex customer service disputes.
- Specialized in negotiation and resolution of environmental conflicts involving natural resource allocation and regional development planning.
Resolution specialist
Starwood Vacation Ownership
05.2002 - 07.2015
- Effectively managed a high volume of incoming and outbound owner calls
- Addressed and resolved owner product complaints empathetically and professionally
- Mastered owner service management systems and databases, i.e
- Salesforce, Microsoft Word, Excel, Windows, PowerPoint
- Assisted Consumer Affairs in resolving escalations on behalf of Executive Leadership
- Tracked each handled owner escalation via SalesForce
- Effectively made outbound calls to owners to discuss written complaints and solve issues
- Assisted new owners with booking reservations first year of ownership
- Exceeded monthly KPIs
- Assisted training of all new hires within the department
- Processed owner mortgage and HOA payments
- Worked closely with Inventory Services to resolve availability complaints.
Education
High School Diploma -
Cypress Creek High School
01.2004
Skills
- Proficient in the use of PowerPoint, Microsoft Excel, Microsoft Word, Outlook email, SalesForce, Symposium, DAS Systems, Microsoft Windows, Mac IOS, Webex, and Teams
- Self-starter and problem solver able to work with little to no supervision and always looking for ways to improve
- Database Coordination
- Organizational Standards
- Payment Collection
- Claims Processing
- Attention to Detail
- Critical Thinking Skills
- Customer Service
- Case Management
- Client Relationship Building
- Customer Support
- Customer Retention
- Complaint Resolution
- Excellent Communication
- Performance Goals
- Handling Customer Complaints
- Conflict Resolution
- Workflow Management
- Strong Work Ethic
- Listening Skills
- Customer and Department Relationship Management
- De-Escalation Techniques
- Follow-Up Skills
- Risk Management
- Database Maintenance
- Correspondence Writing
- Paperwork Processing
- Pleasant Telephone Demeanor
- Patient Support
- Client Advocacy
- Care Coordination
- Referral Coordination
- Chronic Disease Management
- Timely Paperwork Processing
- Health History Documentation
- Records Management
- Problem-Solving
- Case Needs Assessment
- Organization and Multitasking
- Stakeholder Collaboration
- Case Documentation
- Email and Telephone Etiquette
- Cross-Functional Collaboration
- Positive Attitude
- Documentation Proficiency
- Case Management Tracking
- Patient Needs Assessment
- Documentation and Reporting
- Relationship Building
- Medical Records Management
- Data Entry and Analysis
- MS Office
Timeline
Case Manager
United Biosource
08.2022 - 07.2023
Recovery specialist
Enterprise Holdings
09.2021 - 06.2022
Club service associate
Bluegreen Vacations
10.2020 - 01.2021
Customer care specialist (WFH)
Apple Leisure Group
04.2019 - 04.2020
Collection Resolution Specialist - Lead
Hilton Grand Vacation
06.2017 - 04.2019
Customer service operations agent
Marriott Club International
08.2015 - 06.2019
Resolution specialist
Starwood Vacation Ownership
05.2002 - 07.2015
High School Diploma -
Cypress Creek High School
Volunteer Experience
A highly motivated and experienced client resolution specialist with expertise in managing customer advocacy teams, developing, and implementing customer advocacy strategies, and improving customer satisfaction rates. Managed a team of 10+ customer advocate representatives and increased customer satisfaction rates. Adept at building strong relationships with customers and team members. Looking to leverage my leadership skills and experience to drive success in a client resolution role.
References
References available upon request.
References
References available upon request.
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