Lisa Hogan
Summary
Diligent Family Advocate versed in insurance benefits, claims, and procedures. Offers great attention to detail and time management abilities to successfully handle large volume of claims. Highly accurate and thorough with focus on completing error-free work in line with processing guidelines. Highly trained professional with a background in verifying insurance benefits and creating appropriate patient documentation. An established Insurance Verification Specialist known for handling various office tasks with undeniable ease.
Overview
9
9
years of professional experience
Work History
Family Advocate
Anthem Inc.
12.2023 - Current
- Maintained knowledge of benefits claim processing, claims principles, medical terminology, and procedures and HIPAA regulations
- Verified patient insurance coverage and benefits for medical claims
- Managed large volume of medical calls on daily basis
- Monitored and updated claims status in claims processing system
- Identified and resolved discrepancies between patient information and claims data
- Used administrative guidelines as resource or to answer questions when processing medical claims
- Assessed medical claims for compliance with regulations and corrected discrepancies
- Advocated conference calls to providers about claims.
- Maintained timely documentation of case progress, ensuring clear communication among all involved parties.
- Managed heavy caseload using well-developed time management, organizational and task prioritization skills.
- Documented data and completed accurate updates to case records.
Customer Service Representative
Anthem, Blue Cross Blue Shield
05.2017 - 12.2023
- Enhanced customer satisfaction by promptly addressing concerns and providing accurate information.
- Maintained knowledge of benefits claim processing, claims principles, medical terminology, and procedures and HIPAA regulations
- Monitored and updated claims status in claims processing system.
- Maintained strong knowledge of basic medical terminology to better understand services and procedures.
- Streamlined call center processes for improved efficiency and reduced wait times.
- Resolved customer complaints with empathy, resulting in increased loyalty and repeat business.
- Assisted customers in navigating company website and placing online orders, improving overall user experience.
- Collaborated with team members to develop best practices for consistent customer service delivery.
- Developed strong product knowledge to provide informed recommendations based on individual customer needs.
- Maintained detailed records of customer interactions, ensuring proper follow-up and resolution of issues.
- Exceeded performance metrics consistently.
- Provided coaching and mentoring to new hires, contributing to their successful integration into the team.
- Managed high-stress situations effectively, maintaining professionalism under pressure while resolving disputes or conflicts.
- Handled escalated calls efficiently, finding satisfactory resolutions.
- Educated customers about billing, payment processing and support policies and procedures.
- Developed highly empathetic client relationships and earned reputation for exceeding service standard goals.
- Developed rapport with customers through active listening skills.
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Retail Sales Associate
Burlington
02.2015 - 06.2017
- Boosted customer satisfaction by providing exceptional service and addressing concerns promptly.
- Maintained a clean and organized store environment, enhancing the overall shopping experience for customers.
- Enhanced customer satisfaction by providing efficient and accurate cash transactions.
- Maintained a balanced cash drawer, ensuring accurate accounting at the end of each shift.
- Prevented loss by vigilantly monitoring potential theft or fraud situations in store.
- Mentored new employees on cashier duties and best practices, improving overall staff performance.
- Developed rapport with regular customers, offering personalized service that fostered brand loyalty.
- Operated cash register for cash, check, and credit card transactions with excellent accuracy levels.
- Worked flexible schedule and extra shifts to meet business needs.
- Welcomed customers and helped determine their needs.
- Restocked and organized merchandise in front lanes.
- Assisted customers with returns, refunds and resolving transaction issues.
- Answered questions about store policies and addressed customer concerns.
- Tallied cash drawer at beginning and end of each work shift.
- Used POS system to enter orders, process payments and issue receipts.
Education
High School Diploma -
Merrillville High School
Merrillville, INBachelor's Degree - Business Management
University of Phoenix
Columbus, GA05.2016
Skills
- Microsoft Word
- Microsoft PowerPoint
- Microsoft Publisher
- Windows 8
- HTML
- Microsoft Excel
- Windows 2000
- XP
- Vista
- JavaScript and any basic computer functions
- HIPAA
- Medical Terms and Procedure Knowledge
- Microsoft Office
- Insurance Calculation
- Medical Terminology
- Benefits Guidelines
Timeline
Family Advocate
Anthem Inc.
12.2023 - Current
Customer Service Representative
Anthem, Blue Cross Blue Shield
05.2017 - 12.2023
Retail Sales Associate
Burlington
02.2015 - 06.2017
High School Diploma -
Merrillville High School
Bachelor's Degree - Business Management
University of Phoenix
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