Seasoned insurance specialist with excellent planning and problem solving abilities. Offering several years of experience and a willingness to take on any challenge. Organized, driven and adaptable professional with successful history managing high caseloads in fast-paced environments.
Overview
16
16
years of professional experience
Work History
Case Manager
Wake County Health and Human Services
07.2023 - Current
Provided excellent customer service and attention to customers when face-to-face, or through phone conversations.
Managed time effectively to ensure tasks were completed on schedule and deadlines were met.
Demonstrated strong problem-solving skills, resolving issues efficiently and effectively.
Retained strong medical terminology understanding in effort to better comprehend procedures.
Determining the eligibility of applicants/recipients to receive assistance
Collaborating with community providers to meets needs of clients.
Preparing and maintaining files and records and reports.
Customer Service Representative
Aetna Provider Care Helpline | Xerox
11.2011 - 06.2023
Provide prompt customer service to providers, members and pharmacies.
Successfully resolve claims rejections for Aetna members.
Participated in team meetings and contributed to team goals and objectives.
Managed high-volume inbound and outbound calls to address customer inquiries and claims.
Collaborated with fellow team members to manage a large volume of claims.
Transcribed data to worksheets and entered data into the computer to prepare documents and adjust accounts.
Maintain compliance with safety and regulatory guidelines with HIPAA
Inventory Technician
Pacific Coast Feather Company
12.2009 - 08.2011
Conducted cycle counts and physical inventories to ensure accuracy of warehouse stock.
Inspected incoming materials for damage.
Created reports detailing inventory levels, movement trends, and other related data.
Processed incoming shipments, verifying contents against invoices or packing slips.
Assisted in maintaining a clean work environment by disposing of waste material appropriately.
Entered information into the system to update status reports.
Ensured compliance with industry regulations and standards regarding inventory management.
Ensured that all products were stored safely in accordance with industry standards and regulations.
Coordinated receipt of incoming materials and verified accuracy of items received.
Education
Associated Business Administration -
Vance Granville Community College
Bachelor Degree - undefined
University of Phoenix
09.2016
Skills
Outstanding customer service
A team player
Observation and attention to details
Knowledge of HIPPA regulations
Problem solving and critical thinking
Effective communication
Well organized and a fast learner
Proficient with most computer programs
Able to work independently in a fast-paced office environment