Melissa McCardel
Steubenville
Summary
Organized employer Service Representative with 10 years of experience. Hardworking and enthusiastic . Pursues opportunities to learn new skills and contribute to group success. Offers strong administrative, relationship-building and problem-solving abilities. Enthusiastic about helping patients get necessary medical support by obtaining authorizations, coordinating paperwork. Detail-oriented and proactive with good relationship-building skills, a hardworking nature and an adaptable approach.
Overview
20
20
years of professional experience
1
1
Certification
Work History
Employer Services Representative
The Health Plan
11.2020 - Current
- Reviews Claims and identifies issues and communicates those to management and gets claims processed
- Responded to members , providers and client requests for benefit information as needed
- Communicates to Management , Account Executives and clients on a daily basis
- Managed high call volume while maintaining professionalism, empathy, and attention to detail in each interaction.
- Fostered strong relationships with clients, providing personalized service and assistance on various insurance products.
Customer Service Representative
The Health Plan
10.2014 - 11.2020
- Answering phone calls from members and providers
- providing members and providers with plan benefits and gathering information needed to solve issues
- assisting account executives and management with tasks as needed
- completing faxes and correspondence as needed and getting it to the correct department
Receptionist
Neurobehavioral Medicine Consultants
05.2011 - 10.2014
- Enhanced patient satisfaction by efficiently managing the front desk operations and addressing inquiries in a timely manner.
- Ensured accurate record-keeping by diligently updating patient information and verifying insurance coverage.
- Facilitated effective communication between patients, medical staff, and insurance companies to ensure seamless coordination of care.
- Assisted healthcare providers with administrative tasks, enabling them to focus on quality patient care.
- Managed high call volumes, directing calls to appropriate departments while maintaining a polite and professional demeanor.
Mental Health Technician
Fox Run Center For Children And Adolescents
05.2005 - 04.2011
- Improved patient well-being by providing compassionate care and support during their mental health journey.
- Assisted in the development of individualized treatment plans to address specific patient needs a
- Monitored patients'' progress, documenting changes in behavior and updating treatment plans accordingly.
- Provided crisis intervention and de-escalation techniques for patients experiencing emotional distress or exhibiting aggressive behaviors.
- Educated patients on coping strategies and self-help techniques to better manage their mental health symptoms.
Targeted Case Manager
Northwood Health Systems
12.2003 - 05.2005
- Enhanced client well-being by developing personalized case management plans.
- Monitored and tracked client progress, adjusting case plans as needed to achieve desired outcomes.
- Collaborated with community partners to expand available services and resources for clients, fostering stronger support networks.
- Provided crisis intervention services, deescalating tense situations and connecting clients with appropriate emergency resources.
- Educated clients on available resources and their rights within the system, empowering them to advocate for themselves effectively.
- Coordinated care transitions between various providers, minimizing gaps in service provision for clients.
Education
Bachelor of Science - Psychology
West Liberty State College
West Liberty, WV12.2003
Skills
- Resolving Customer Issues
- Creative Solutions
- Resourceful Researching
- Collaborative Environments
- Information Updates
- Identifying Opportunities
- Strong Telephone Etiquette
- Investigate Claims
- Understanding Customer Needs
- Billing Adjustments
- Administrative and Office Support
- Membership Inquires
Certification
- Certified Medical Coder
Timeline
Employer Services Representative
The Health Plan
11.2020 - Current
Customer Service Representative
The Health Plan
10.2014 - 11.2020
Receptionist
Neurobehavioral Medicine Consultants
05.2011 - 10.2014
Mental Health Technician
Fox Run Center For Children And Adolescents
05.2005 - 04.2011
Targeted Case Manager
Northwood Health Systems
12.2003 - 05.2005
Bachelor of Science - Psychology
West Liberty State College
- Certified Medical Coder
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