Investigates and resolves complex claims to recover payments for health plans, customers and government entities.
Analyzing claims, initiating contact with members and providers, updating database.
Increased customer satisfaction by addressing and resolving complaints in a timely manner.
Enhanced company reputation by providing exceptional customer service and support.
Developed and maintained positive customer relations and coordinated with team members to properly handle requests and questions.
Responded to customer questions via telephone and written correspondence regarding insurance benefits, provider contracts, eligibility, and claims processing.
Sr Customer Service Representative
United Healthcare Group
08.2016 - 2020
Provided expertise and customer service support to providers.
Compliance with applicable legal/ regulatory requirements.
Resolved customer service issues using company processes and policies and provided updates to customers.
Demonstrated excellent multitasking abilities by managing multiple concurrent tasks while ensuring timely completion. Gather data/information to perform investigation.
Reduced call wait times by implementing effective time management
Assist providers with insurance benefits and claims.
General Manager
Sodexo
2000 - 03.2016
Prepares and updates financial reports to ensure compliance with federal, state and local regulations.
Responsible for all cash management and reporting.
Accountable for the execution of service product and quality.
Provide team leadership with recruiting, training and ensuring growth
Promote business solutions for sustained growth and effective day to day operations with increased sales objectives.
Manage and coordinate all pilot programs created at Sodexo HQ ~ HALO POS ,Opt Healthy , Food Service Safety Testing, Aspretto Coffee Service, Café Service Pilot Stations
Promoted and supported workplace diversity.
Education
High School Diploma -
Albert Einstein High
Kensington, MD
06.1976
Skills
Customer support
Goal-oriented mindset
Customer relations
Data entry proficiency
Paperwork processing
Telephone reception
Records management
Client services
RELATED EXPERIENCE
Regional Halo Point of Sales Support
District Marketing Coordinator
District Safety Coordinator
Graduate of the School of Retail Management
Sustainability and the Environment
Ethics in the Workplace
Servsafe Foodsafety Certification
Microsoft Office: Excel, Outlook, Word, Power Point, Publisher