Lee Irorere
Columbus,OH
Summary
A professional with 6 years of experience in project management skills, customer service, auto liability and healthcare liability claims. A Master’s in Healthcare Administration and Bachelors in Marketing and willing to learn new trends in behavioral health to provide optimal health. Bright and ambitious person who thrives in a motivating environment, can assist others while challenging and expanding knowledge.
Overview
6
6
years of professional experience
Work History
Claims Adjuster
Progressive
07.2022 - 07.2023
- Conducted interviews with 30-50 customers daily to gather information from all material parties involved in auto accidents for Fortune 500 company.
- Investigated basic and complex liability coverage claims and determined insurance coverage levels and restrictions by thoroughly examining policy forms and company standards.
- Wrote effective responses for claims submitted, completed auto damage estimates and worked with mechanic shops to finalize repairs.
- Issued checks averaging $1-3K to customers for payment damages, liability decision letters and non-compliant letters to customers who refused to provide recorded statements for claim process.
- Awarded company STAR Award and Shout-Out Recognition by saving company approximately $100K; by ensuring active policies and coverage details while maintaining optimal customer service experiences.
- Judiciously handled complex claims and dishonest claimants through strong attention to detail in recorded statements and collecting evidence such as police reports and surveillance videos.
Care Concierge
QurHealth
01.2022 - 03.2022
- Proactively engaged with 20-30 customers weekly by welcoming them to QurHealth and assisting them with enrollment/onboarding process.
- Built credible and authentic relationships with customers, patients, and caregivers by answering questions related to usage of medical app and available resources accessible through mobile app.
- Provided individualized customer service based on unique customer needs.
- Collaborated with customers to build morale and identify opportunities to improve service and/or customer experience.
- Assisted customers by helping them navigate healthcare services and products, and scheduling healthcare consultations with QurHealth clinicians.
- Navigated QurHealth mobile application product analysis, including features and performance to ensure optimal performance for users/was project manage for QurHealth mobile application.
- Highly recommended by CEO after position was eliminated due to organizational changes and restructuring.
Customer Care Coordinator
United Health Group
06.2021 - 12.2021
- Initiated outbound calls to 20-30 members daily who qualified for Medicare & Medicaid.
- Occasionally received inbound calls and handled those with same care and compassion.
- Thoroughly reviewed details of claims and discussed benefits and insurance in clear and effective delivery style.
- Contacted providers and scheduled appointments on behalf of members/patients intentionally considering their schedules and distance from their home to providers.
- Reduced patient financial responsibility by securing in-network providers, doctors, & specialists and studied insurance plans to provide additional resources for members in need.
- Awarded 6 Company Diamond Awards for Performance and Quality; consistently surpassing customers expectations and outcomes.
- Acknowledged by customers more than 10 times consecutively through positive customer feedback and compliments, including being referred to as “jewel to company” and being highly requested by incoming callers.
Insurance Services Representative
Nationwide Mutual Insurance Group
01.2020 - 11.2020
- Responded to 30-60 members daily with empathy and understanding while gathering information and rendered guidance to appropriate resolutions.
- Boosted optimum customer experience by establishing trust and building relationships while creating loss report claims.
- Utilized claims call center best practices in all activities, including customer complaint handling and claim escalation.
- Obtained information from policyholders, claimant, and other parties while verified coverage under various policies or policy provisions based on variances of state, jurisdiction and regulatory requirements.
- Collaborated with claim adjusters by assigning them direct and prompt access to claims to achieve rapid claim resolution.
- Accelerated customer satisfaction and convenience by referring them to preferred repair shops or scheduled drive-up auto appointments and coordinated turn-key rental car options.
Member Advocate
Aetna, CVS Health Company
10.2017 - 12.2019
- Analyzed the creation of medical charts and implemented ICD & CPT codes in a template for assigned project.
- Supported 20-40 patients daily with comprehensive coordination of medical services including intake, screening, and referrals to Aetna Medical Services Programs
- Executed non-medical client research, while maintaining integrity to protect confidentiality in accordance with HIPAA laws
- Managed inbound and outbound touchpoints to solve members’ needs in regard to their health insurance plan and created behavior changes
- Educated and influenced members on use of tools and resources available that align to specific needs that drove effective benefit utilization and 60% customer retention rates.
Education
Master of Science - Healthcare Administration
Franklin University
Columbus, OH06.2020
Bachelor of Science - Marketing
Franklin University
Columbus, OH08.2017
Skills
- Project Management, Organization, Healthcare, Risk Management
- Collaboration, Planning, Data Entry, Interpersonal Communication
- Critical Thinking, Quality Assurance, Customer Retention, Underwriting
- Leadership, Customer Service, Time Management, Data Analysis
Affiliations
"Lee was asked to gain a basic understanding of product capabilities, however, he didn’t stop at a basic understanding and went above and beyond to learn the product and its functionality. Lee also took initiative by recommending new features and modifying existing features to suit our intended customer.” Rasesh Kunduru, CEO QurHealth.
Timeline
Claims Adjuster
Progressive
07.2022 - 07.2023
Care Concierge
QurHealth
01.2022 - 03.2022
Customer Care Coordinator
United Health Group
06.2021 - 12.2021
Insurance Services Representative
Nationwide Mutual Insurance Group
01.2020 - 11.2020
Member Advocate
Aetna, CVS Health Company
10.2017 - 12.2019
Master of Science - Healthcare Administration
Franklin University
Bachelor of Science - Marketing
Franklin University
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