MaryBeth Schwarz
Guilderland,New York
Summary
Detail-oriented professional with extensive experience in client support and issue resolution. Recognized for effective collaboration and service optimization, driving member satisfaction and operational efficiency.
Overview
28
28
years of professional experience
Work History
Employer Service Representative
Elevance Health
Latham, NY
01.2003 - Current
- Researches client inquiries and resolves issues timely using available resources and contacts to support and maintain client relationship and member satisfaction.
- Provided direct support to clients and Client Management teams and served as a resource to other operational areas.
- Triages requests that come through all channels.
- Supports resolution of escalated eligibility, claims, and benefits issues by coordinating with appropriate partner teams.
- Serves as liaison for appeals, medical management, precertification escalations, CMS and MSP requests, finance items, VIP requests, SIU forms, COB, plan-to-plan escalations, subrogation, legal inquiries, and other assigned issues.
- Provides support and expertise to internal partners with client specific questions or issues.
- Utilizes NEST/SWEEP process to correct system issues and perform clean-up once a fix has been implemented.
- Tracks individual issues through to completion and closure.
- Serves as mentor to incoming team members.
Claims Examiner
Empire Blue Cross Blue Shield
Colonie, NY
01.2003 - 01.2004
- Coded and processed claims for payment to ensure timely reimbursement
- Researched and analyzed claims issues to identify and resolve discrepancies
- Provided support and mentoring to team members
Customer Service Representative
Empire Blue Cross Blue Shield
Colonie, NY
05.1998 - 01.2003
- Assisted members with inquiries about claims, eligibility, and benefits.
- Resolved member complaints efficiently through effective communication.
- Promoted high customer satisfaction by resolving problems with knowledgeable and friendly service.
- Keyed, processed, and adjusted claims.
Education
English Literature
SUNY Plattsbugh
Plattsburgh, NYSkills
- Client relationship support
- Issue resolution
- Service optimization
- Attention to detail
- Collaboration
- Effective communication
Timeline
Employer Service Representative
Elevance Health
01.2003 - Current
Claims Examiner
Empire Blue Cross Blue Shield
01.2003 - 01.2004
Customer Service Representative
Empire Blue Cross Blue Shield
05.1998 - 01.2003
English Literature
SUNY Plattsbugh