Maria Houghton
Avon,MN
Summary
- Medical professional with significant experience in member service, client advocacy, and claims processing.
- Demonstrates exceptional problem-solving abilities, effective communication skills, and strong focus on team collaboration.
- Reliable and adaptable, always ready to meet changing needs while ensuring high standards are maintained.
- Strong ability to build positive relationships, manage inquiries, and deliver results that align with organizational goals.
Overview
5
5
years of professional experience
Work History
Member Service Advocate, Medicare and Blueride
Blue Cross Blue Shield of Minnesota
05.2022 - 05.2025
- Promoted a positive work environment through teamwork, open communication, and excellent customer service skills.
- Developed strong relationships with Blueride members by providing personalized support and assistance.
- Improved member satisfaction by promptly addressing Medicare supplement inquiries and providing accurate information.
- Collaborated with cross-functional teams to resolve complex member concerns, ensuring satisfaction and loyalty.
- Provided comprehensive medical claim support, explaining various charges clearly, helping to ensure 184,000 Medicare members understanding and satisfaction.
- Participated in regular training sessions to stay current with health insurance industry trends and enhance knowledge base.
Teleservice and Claim Representative
Meduit, Inc.
09.2020 - 05.2022
- Navigated complex software systems to access clinical provider information quickly and accurately during calls.
- Prioritized workload effectively under pressure while maintaining a calm disposition during peak call periods.
- Set up medical appointments within the Healthpartners medical community according to provider schedule availability, achieving at least 90% accuracy in performance metrics.
- Recorded and updated patient information using EPIC as needed.
- Conducted regular adjudication audits on received claims to maintain quality control standards within the department.
- Handled sensitive account information securely following company protocols to maintain confidentiality at all times.
Education
Certificate - Medical Coding Specialist
Rochester Community And Technical College
Rochester, MN05-2009
Bachelor of Science - Elementary Education
St. Cloud State University
St. Cloud, MN01-1993
Skills
- Data entry proficiency
- Strong interpersonal skills
- Payment processing
- Medical claim problem resolution
- Dispute and Issue resolution
- Relationship building
- Tracking complaints
- Teamwork and collaboration
- Attention to detail
- Problem-solving abilities
- Calm and professional under pressure
Timeline
Member Service Advocate, Medicare and Blueride
Blue Cross Blue Shield of Minnesota
05.2022 - 05.2025
Teleservice and Claim Representative
Meduit, Inc.
09.2020 - 05.2022
Certificate - Medical Coding Specialist
Rochester Community And Technical College
Bachelor of Science - Elementary Education
St. Cloud State University
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