Summary
Overview
Work History
Education
Skills
Timeline
Generic

Mariah Lee

1000 Farrah Ln. Apt #1433,TX

Summary

Encouraging manager and analytical problem-solver with talents for team building, leading and motivating, as well as excellent customer relations aptitude and relationship-building skills. Proficient in using independent decision-making skills and sound judgment to positively impact company success. Dedicated to applying training, monitoring and morale-building abilities to enhance employee engagement and boost performance.

Overview

11
11
years of professional experience

Work History

Healthcare Customer Service Representative

Acclara
12.2020 - Current
  • Consult with clients and prospects, assessing their healthcare needs and guiding them through the enrollment process.
  • Provide detailed explanations of different healthcare insurance plans, including coverage options, benefits, premiums, deductibles, and copayments.
  • Assist clients in completing the enrollment forms and submitting required documentation, ensuring accuracy and compliance with healthcare regulations.
  • Address billing inquires, set up payment arrangements, and guide clients on premium payments and payment methods.

Healthcare Customer Service Representative

CareMetx
12.2018 - 12.2020
  • Analyzed customer service calls to identify areas of improvement and provide feedback to agents.
  • Monitored customer conversations for quality assurance purposes, ensuring that all policies were followed.
  • Maintained detailed records of call center performance and provided reports to management.
  • Evaluated customer interactions for compliance with company standards and regulations

Insurance Verification Specialist

HCA
08.2015 - 12.2018
  • Conducted thorough benefit verifications for patients by liaising with insurance providers and analyzing insurance policies to determine coverage details, including medication and treatment options.
  • Collaborated closely with healthcare providers and insurance companies to obtain prior authorizations for prescribed medications, streamlining the approval process and minimizing delays in patient care.
  • Assisted in the resolution of medication-related claims issues, including denials and rejections, by working with insurers and internal teams to ensure patients received the necessary medications in a timely manner.
  • Acted as an advocate for patients, ensuring they were informed about their insurance coverage, co-pays, and out-of-pocket expenses.

Call Center Representative

Memorial Hermann Hospital
05.2013 - 08.2015
  • Assisted in coordinating patient appointments, referrals, and follow-up care, promoting timely access to healthcare services.
  • Maintained accurate and up-to-date patient records, ensuring compliance with privacy and confidentiality regulations.
  • Scheduled patient appointments and tests, optimized appointment calendars, and coordinated with various healthcare facilities.
  • Assisted in verifying patient insurance coverage and benefits, ensuring accurate billing and claims processing.

Education

MBA - Healthcare Administration

University of Houston Clearlake
Houston
12.2025

Bachelor of Science - Psychology

University of Houston Downtown
Houston
05.2015

Skills

Appointment Scheduling

Data entry

Customer Service

Call Center

Remote Operations

Claims

Enrollment

Insurance Verification

Problem-Solving

HIPAA Compliance

Quality Assurance

EMR Updating

Payment Processing

Eligibility Determination

De-Escalation Account

Management Decision-Making

Product Knowledge

Timeline

Healthcare Customer Service Representative

Acclara
12.2020 - Current

Healthcare Customer Service Representative

CareMetx
12.2018 - 12.2020

Insurance Verification Specialist

HCA
08.2015 - 12.2018

Call Center Representative

Memorial Hermann Hospital
05.2013 - 08.2015

MBA - Healthcare Administration

University of Houston Clearlake

Bachelor of Science - Psychology

University of Houston Downtown

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Mariah Lee