Qualified Advanced Technical Support Specialist with years of helpdesk and customer service experience. Adept at engaging customers by identifying issues and streamlining steps to resolve technical issues effectively.
Overview
8
8
years of professional experience
Work History
Technical Support Specialist
Virtual Benefits Administrator
07.2023 - Current
Efficiently handle client support requests, ensuring adherence to service level agreements and turnaround time guidelines
Monitor the VBA Help Desk mailbox for client inquiries and issues
Proficient in creating and managing support tickets in the Incident Tracking tool
Exceptional problem-solving capabilities and strong communication skills
Skilled in conflict resolution, active listening, and maintaining a positive attitude
Collaborative team player with keen attention to detail and dependability
Flexible and adept at time management.
Senior Account Manager
Cardinal Health
10.2021 - 08.2022
Oversee assigned Medical Products and Distribution customer(s) regarding insurance benefits
Analyze and assist with EOBs and eligibility issues
Manage DME order status to enhance order accuracy and minimize disruptions
Improve the perfect order by addressing inventory issues, substitution maintenance, product standardization, and price accuracy
Verify insurance through Emdeon, Availity, and Navinet
Review clinical notes, identify doctor's written orders, and process prior authorizations
Gather intake information, assess patient insurance benefits, and create patient records in the EMR system
Qualify equipment based on insurance requirements and generate sales orders
Communicate with dispatch to coordinate deliveries.
Senior Claims Specialist
Skygen USA
04.2018 - 10.2021
Analyzed UB-04s/CMS-1500 medical claims for accuracy, completeness, and eligibility
Determined coverage by examining benefits and calculated benefits for payment
Resolved claim edits in the billing system and clearinghouse
Provided second-tier support for various medical claims, including medical, therapy, ocular, PHO, and commercial dental
Managed daily processing agent workflows, claims inventory, and pipeline
Reviewed, moved, and transmitted electronic patient/provider files via the clearinghouse
Coordinated benefits data for medical, ocular, and commercial dental claims
Ensured appropriate rejection of claims and authorizations
Demonstrated complete knowledge of insurance regulations, policies, and payment guidelines
Managed On-Time tickets, addressed emails, and communicated potential issues for timely resolution.
Senior Call Center Specialist
Vestica Healthcare/Skygen USA
12.2015 - 04.2018
Handled 200+ inbound calls daily for a Medicaid call center, providing stellar customer service
Demonstrated in-depth knowledge of insurance referrals, verifications, and authorizations
Identified needs and assisted with benefits and eligibility, billing and payments, or explanation of benefits (EOBs)
Managed provider calls, communicating precise insurance coverage and verifying eligibility
Conducted authorization and insurance verifications for a seamless healthcare process.
Education
PROJECT MANAGEMENT -
Gener8tor Skills Accelerator
01.2023
ADMINISTRATIVE ASSISTANT -
Gener8tor Skills Accelerator
01.2023
BEHAVIORAL SCIENCE -
University Of Phoenix
01.2005
Skills
Software Debugging
Customer Experience Management
Debugging
Performance Optimization
Core Business Competencies
Medical and Commercial Dental Claims SME
Strong Insurance and Claims knowledge
Claims Analyst
High Integrity and Leadership
3rd Party TPA for MCOs
Problem-Solving Skills
Strong Verbal and Written Communication Skills
Provider Relations
Client Experience Focused
Team Lead and liaison
Timeline
Technical Support Specialist
Virtual Benefits Administrator
07.2023 - Current
Senior Account Manager
Cardinal Health
10.2021 - 08.2022
Senior Claims Specialist
Skygen USA
04.2018 - 10.2021
Senior Call Center Specialist
Vestica Healthcare/Skygen USA
12.2015 - 04.2018
PROJECT MANAGEMENT -
Gener8tor Skills Accelerator
ADMINISTRATIVE ASSISTANT -
Gener8tor Skills Accelerator
BEHAVIORAL SCIENCE -
University Of Phoenix
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