Summary
Overview
Work History
Education
Skills
References
Timeline
Generic

KELLY VANDENELZEN

De Pere,WI

Summary

Detail-oriented team player with strong organizational skills. Ability to handle multiple projects simultaneously with a high degree of accuracy. Highly-motivated employee with desire to take on new challenges. Strong work ethic, adaptability, and exceptional interpersonal skills. Adept at working effectively unsupervised and quickly mastering new skills.

Overview

15
15
years of professional experience

Work History

Patient Service Representative

Aurora Medical Center
10.2019 - Current
  • Provided exceptional customer service to patients, answering questions and addressing concerns.
  • File and maintain patient records in accordance with HIPAA regulations.
  • Verify insurance eligibility and coverage for patients.
  • Enter patient demographic and insurance data into electronic medical record system.
  • Recommend service improvements to minimize recurring patient issues and complaints.
  • Train new hires.
  • Schedule and confirm patient appointments with patients and healthcare professionals.
  • Scan completed forms, identification and insurance cards, maintaining patient documents folder.
  • Register patients by verifying records to update computer system and patient charts.
  • Ensured all necessary paperwork is completed prior to patient visits.
  • Obtain insurance verification and authorization to submit financial clearance of patient accounts.
  • Inform patients about payment options, billing policies, and procedures related to their visit or procedure.
  • Process referrals from primary care physicians to specialists for further treatment or evaluation.

ACCOUNT INSTALLATION MANAGER

HUMANA
09.2013 - 01.2024
  • Work directly with Sales, Brokers, Agents and Company Contacts to install new and existing Humana Groups with Medical, Vision, Dental, Spending Accounts, Life and Go365 products.
  • Broad understanding of health benefits plan setups (deductibles, copays, drug coverage, accumulators, eligibility).
  • Prepare for and facilitate a new TPA or employer client Kick-off Meeting for the purposes of requirements gathering and discovery.
  • Facilitate Post Implementation Review Meetings with internal partners and employer client.
  • Assist with escalated client issues, project issues, etc. as identified or requested by the client through direct support.
  • Ensure operational and system readiness for client launch through collaboration and consultation with internal partners.
  • Part of team to develop KY Chamber/KY Association Group PEO procedures, guidelines, timeframes, start up.
  • Strong interpersonal communication skills, including team leadership, conflict resolution, and meeting leadership/facilitation with various internal and external leaders.
  • Develop strong relationships with clients, agents and internal partners to grow business networks and sales.
  • Demonstrate ability managing projects, utilizing proven project management processes.
  • Ability to work cross-functionally to proactively communicate and to resolve issues with the highest sense of urgency.
  • Strong focus on book of business client satisfaction and client retention

ASO TEAM LEAD

Humana
06.2011 - 09.2013
  • Single Point of Contact for dedicated BHCG/ASO Medical and ASO/RX Teams.
  • Team Lead for 24 employees.
  • Established open and professional relationships with team members to achieve quick resolutions for various issues.
  • Minimized resource and time losses by addressing employee or production issue directly and implementing timely solutions.
  • Coached team members in techniques necessary to complete job tasks.
  • Communicated work goals and deadlines to employees to increase productivity and meet project benchmarks.
  • Delegated tasks to team members according to project requirements and employee strengths.
  • Resolved problems and escalated high-level issues to supervisor within established timeframes.
  • Took appropriate measures to correct service quality deficits.
  • Suggested changes to standard operational and working practices, providing leadership needed to develop and implement continuous improvements.

PHARMACY CUSTOMER CARE SPECIALIST

Humana
12.2008 - 06.2011
  • Assisted callers with RX/Medical benefits and RX/Medical claims questions
  • Educated members, providers, agents/brokers and employers regarding plan benefits and coverage
  • Assisted with placing orders for RightSource and mail order questions for dedicated USAA/Coalition members
  • Cross trained on Medical and Mail Order Pharmacy.
  • Identified customer issues with products or services, investigated causes and initiated resolutions.
  • Streamlined operational efficiencies by managing accounts and contracts and processing system orders and cancellations.
  • Achieved high satisfaction rating through proactive one-call resolutions of customer issues.
  • Responded to customer needs through competent customer service and prompt problem-solving.
  • Completed 7,001 items from our Pharmacy project tanks per year.
  • Worked multiple systems -DOS, Metavance, Argus, GCP, Excel, Word, Cognos, Avaya, PAAG, GCP, Landing Page, Discoverer, Power Point, ERoom
  • Took up to 160 inbound calls per day, worked open files and helped resolve members situations/questions.
  • Maintained high satisfaction score by consistently resolving first-call issues.

Education

HIGH SCHOOL DIPLOMA -

Kaukauna High School
Kaukauna, WI

Skills

  • Multitasking Abilities
  • Interpersonal Communication
  • Project Management Experience
  • Proven ability to work collaboratively to deliver results
  • Strong problem-solving skills
  • Proven written and verbal communication skills
  • Experience with multiple computer based systems
  • Responsiveness, relationship building and Accountability
  • Teamwork and Collaboration

References

References available upon request.

Timeline

Patient Service Representative

Aurora Medical Center
10.2019 - Current

ACCOUNT INSTALLATION MANAGER

HUMANA
09.2013 - 01.2024

ASO TEAM LEAD

Humana
06.2011 - 09.2013

PHARMACY CUSTOMER CARE SPECIALIST

Humana
12.2008 - 06.2011

HIGH SCHOOL DIPLOMA -

Kaukauna High School

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