MATTHEW S UMRAWSINGH
Orlando,FL
Summary
Results-oriented Plan Advisor Representative professional with over 5 years of experience. Proven track record of successful initiatives and streamlined organizational processes. Expertise in driving sales and outreach projects, crafting persuasive marketing strategies, and resolving customer issues. Skilled in developing and implementing program plans aligned with organizational goals, timelines, and resource requirements.
Overview
9
9
years of professional experience
Work History
Plan Advisor Representative
Government Employees Health Association (GEHA)
06.2024 - Current
- Ensures complaints have been categorized correctly supporting Government Employees Health Association (GEHA).
- Review, research, investigate claims processing with UMR CPS (claims processing system).
- Answer incoming phone calls from GEHA customers and identify the type of assistance the customer needs (i.e. benefit and eligibility, billing and payments, authorizations for treatment and explanation of benefits (EOBs).
- Initiate inbound and outbound contact to members or providers while ensuring UMR plan benefits and processing is completely accurate on submitted claim review requests.
- Educates UHC Network Management and UHC Providers regarding UMR plan benefits and processes.
- Ensure that the proper benefits are applied to each claim by using the appropriate processes and procedures (e.g. claims processing policies and procedures, grievance procedures, state mandates, CMS/Medicare guidelines, benefit plan documents / certificates).
Clinical Administration Coordinator
UMR, UnitedHealthcare
09.2022 - 06.2024
- Resolved escalated customer communications, concerns, and conflicts effectively.
- Accurately and professionally oversees all operations including answering phones (50-70+ calls daily).
- Initiated care coordination cases for non-clinical assessment/intervention and provides appropriate triage.
- Communicated denials and explains to providers and members how to initiate an appeal.
- Managed patient registration, insurance verification, and forwarding non-routine requests to appropriate personnel.
- Key achievements:
- Achieved and maintained a 95% productivity score, surpassing Optum’s productivity goal of 85%.
- Successfully trained employees who surpassed Optum’s monthly production goal of 85%.
Lead Project Coordinator
Landman, Corsi, Ballaine & Ford P.C.
02.2018 - 09.2022
- Provided office services support including bill payment, receipt of shipments, access requests, asset liquidation and repair and maintenance follow-up.
- Facilitated meetings, including agenda preparation, scheduling and meeting recaps, and follow-up on identified issues.
- Managed office services support and coordination for internal clients including assistance with custodial, maintenance, technology, and facility.
- Provided on-site support for vendors or partners working within our spaces.
- Key achievements:
- Converted over 2500 case files from hard copy to digital format within the first year of employment.
- Implemented new legal record production system, reducing project turnover time by 20%.
Licensed Assistant Loan Officer
Homebridge Financial
06.2016 - 03.2018
- Filed and maintained accurate records, prioritizing confidentiality.
- Managed multiple phone lines, ensuring prompt and efficient handling.
- Coordinated meetings and events, documenting agendas, and minutes.
- Communicated with clients regularly to ensure a smooth loan process.
Education
Associate of Applied Science - Business Administration And Marketing
Valencia College
Orlando, FLSkills
- UMR CPS medical claim processing and workflows
- UMR CPS medical claims adjustments
- Detail Orientation
- Strong research and analytical skills
- Skilled in MS Office Suit (Word, Excel, PowerPoint, Outlook) & Google Suites
Technical Skills:
Timeline
Plan Advisor Representative
Government Employees Health Association (GEHA)
06.2024 - Current
Clinical Administration Coordinator
UMR, UnitedHealthcare
09.2022 - 06.2024
Lead Project Coordinator
Landman, Corsi, Ballaine & Ford P.C.
02.2018 - 09.2022
Licensed Assistant Loan Officer
Homebridge Financial
06.2016 - 03.2018
Associate of Applied Science - Business Administration And Marketing
Valencia College
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