Mary McCollum
Provider Account Liaison
East Nassau
Summary
Motivated individual with experience in provider community. Skilled in building provider relationships and understanding provider needs. Strong communication and interpersonal skills for providing superior customer service. Great at partnering with internal teams to work toward a common goal. Organized and dependable candidate successful at managing multiple priorities with a positive attitude. Willingness to take on added responsibilities to meet team goals.
Overview
18
18
years of professional experience
Work History
Insurance Technician
East Greenbush Central School District
07.2024 - Current
- Provided exceptional customer service while answering inquiries regarding policies, coverages, and billing information.
- Coordinated employee benefits for health, vision, dental, life, medical reimbursements, COBRA and workers compensation.
- Ensured compliance with industry regulations by staying up-to-date on changes and implementing necessary adjustments to workflows.
- Managed high volume workloads effectively while maintaining a commitment to quality service delivery.
- Notified insurance agents and accounting departments of policy cancellations and changes.
- Maintained up-to-date knowledge of insurance products and trends, ensuring employees received accurate information and appropriate coverage recommendations.
- Ensured accurate record-keeping by diligently maintaining and updating attendance records in the employee database system.
- Provided valuable input during staff meetings to help inform decisions related to attendance policies, procedures, and intervention strategies.
- Streamlined the attendance process for efficiency with timely data entry and attention to detail.
- Maintained accurate records of all workers compensation claims, ensuring timely reporting to regulatory agencies and insurance carriers.
- Partnered effectively with Human Resources personnel to manage leave-of-absence requests in relation to Workers'' Compensation issues.
- Maintained confidentiality and discretion when handling sensitive employee information, fostering a workplace culture of trust and respect.
Provider Account Liaison
Highmark, Inc.
08.2019 - 04.2024
- Developed and maintained strong working relationships with Specialist and Dental Providers within assigned territory.
- Fostered lasting relationships with providers through effective communication and quick response, resulting in long-term loyalty and satisfaction.
- Collaborated with team members from multiple departments to maximize team success. This included Provider Service, Sales, Grievance and Appeals, and Medical Records Retrieval.
- Contributed to team objectives in fast-paced environment.
- Performed effectively in self-directed work environment, managing day-to-day operations and decisions.
- Met with Providers by phone, in person, and via Zoom to discuss and ascertain needs, resolve issues with claims, credentialing, or to provide general education on website or systems.
- Fielded customer complaints and facilitated negotiations, resolving issues and reaching mutual conclusions.
- Built relationships with Providers and community to promote long term business growth through Galas, Expos, or volunteer opportunities.
- Performed BCBS Provider Data Audits audits to ensure the information located in the NENY Provider Directory was accurate.
- Recorded accurate and efficient records of communications with Providers in our FACETS database.
- Was Provider Account Liaison representing NENY on the Highmark Academy Provider Orientation Project
Customer Service Representative
BlueShield Of Northeastern New York
08.2015 - 08.2019
- Answered constant flow of customer or provider calls courteously and professionally with minimal wait times.
- Responded to member emails, letters, phone and live chat inquiries in a timely manner.
- Clarified customer issues and determined root cause of problems provide resolution and maximize satisfaction.
- Participated in team meetings and training sessions to stay informed about product updates and changes.
- Actively listened to customers, handled concerns quickly and escalated major issues to supervisor.
- Cross-trained on Member, Provider and Pharmacy calls and provided backup support for organizational leadership.
- Trained new team members regarding company operations, policies and services.
- Educated Members and Providers about billing, claims, benefits, and policies.
- Performed simple claims adjustments.
Sales Manager
Metro Mattress
08.2007 - 08.2015
- Conducted team meetings to reinforce goals and objectives and set clear expectations about policies and procedures.
- Maintained ethical and positive working environment to reduce turnover and promote high retention rates.
- Coached and counseled sales personnel, assisting with individual selling efforts and helping sales representatives reach targets.
- Demonstrated products to show potential customers benefits and advantages and encourage purchases.
- Handled customer issues, enabling quick resolution, and client satisfaction.
- Coached employees in successful selling methods and encouraged cross-selling to drive revenue.
- Exceeded sales quotas and increased profitability through effective sales strategy and business planning.
Education
No Degree - Communications
SUNY At Albany
Albany, NY 05.2001 -
Skills
Attention to Detail
Analytical and Critical Thinking
Excellent Communication
Flexible and Adaptable
Dependable and Responsible
Team Player
Creative problem solving
Timeline
Insurance Technician
East Greenbush Central School District
07.2024 - Current
Provider Account Liaison
Highmark, Inc.
08.2019 - 04.2024
Customer Service Representative
BlueShield Of Northeastern New York
08.2015 - 08.2019
Sales Manager
Metro Mattress
08.2007 - 08.2015
No Degree - Communications
SUNY At Albany
05.2001 -
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