Summary
Overview
Work History
Education
Skills
Timeline
Generic

MAXINE ERRAR-HENRY

Sunrise,US

Summary

Healthcare professional with 10 years hands-on experience in a fast -paced environment into the Medical and Insurance field. My resume present my qualification and background for obtaining a position that will utilized my interpersonal skills, knowledge and experience.

Overview

10
10
years of professional experience

Work History

Research Resolution Specialist

United Healthcare
SUNRISE, FL
02.2017 - 04.2022
  • Demonstrated leadership by making improvements to work processes and trained 50-100 employees on a daily basis.
  • Collaborated with managers, employees to discuss new opportunities.
  • Conducted studies of appeals and grievance procedures to confirm adherence to legal requirements while facilitating disposition of Medicare cases.
  • Exceeded employees and members satisfaction 98% by finding creative solutions to problems.
  • Worked successfully with diverse group of coworkers to accomplish goals and address issues related to our products and services.
  • Planned and completed group projects, working smoothly with others.
  • Displayed strong telephone etiquette, effectively handling difficult calls.

Provider Customer Service Representative

United Healthcare
SUNRISE, FL
01.2015 - 02.2017
  • CRT usage to retrieve member, providers claims information.
  • Educated provider on there explanation of benefits.
  • Increased customer satisfaction ratings 98% by effectively answering questions, suggesting effective solutions and resolving issues quickly.
  • Prevented key account losses by researching discrepancies and correcting problems.
  • Engaged in conversation with member and providers to understand needs, resolve issues and answer product questions.
  • Presented existing, prospective members, on products information to aid in decision-making.
  • Strengthened customer retention by offering discount options.

Appeals and Grievances Coordinator/Customer Service Associate

United Healthcare
SUNRISE, FL
02.2012 - 01.2015
  • Investigated members appeals and grievances and recommend appropriate actions based on Medicare and Medicaid guidelines.
  • Research and resolve written complaint quality of services, quality of care. 2 level appeals, submitted by member, physician and providers.
  • identified needs of customers promptly and efficiently.
  • Assisted with 50-100 customer requests and answered questions to improve satisfaction.
  • Promoted high customer satisfaction by resolving problems with knowledgeable and friendly service.
  • Provided excellent service and attention to customers through inbound and outbound phone conversations.
  • Reviews Complaint Tracking Module for Medicare and Medicaid members and input and compile data gathered from various sources.
  • Prioritized and organized tasks to efficiently accomplish service goals.

Education

Associate of Science - Radiologic Technology

MedVance Institute/ FORTIS Institute
Sunrise, FL
10.2009

Skills

  • Call Volume and Quality Metrics
  • Computer skills microsoft & excel
  • Efficient and Detail-Oriented
  • Excellent Attention to Detail
  • Conflict Resolution and Trainer
  • HIPAA Regulations
  • Knowledge of Medicare & Medicaid Regulations
  • Strong Analytical and Problem Solving Skills

Timeline

Research Resolution Specialist

United Healthcare
02.2017 - 04.2022

Provider Customer Service Representative

United Healthcare
01.2015 - 02.2017

Appeals and Grievances Coordinator/Customer Service Associate

United Healthcare
02.2012 - 01.2015

Associate of Science - Radiologic Technology

MedVance Institute/ FORTIS Institute

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MAXINE ERRAR-HENRY