Summary
Overview
Work History
Education
Skills
Certification
Interests
Timeline
Michael B. Wilson

Michael B. Wilson

Detroit,MI

Summary

I am a Senior professional that is compassionate, customer focused, and dependable. I have an avid commitment to providing outstanding customer service in a professional setting. I Possess strong verbal, written and interpersonal communication skills. I am self-motivated, a team player, and able to work independently as well as in a team environment. Efficient in decision making and can lead a team in the direction of achieving department goals.

Overview

20
20
years of professional experience
1
1
Certification

Work History

Health Plan Representative, Senior CSR

Ascension Personalized Care
05.2023 - Current
  • Empower team members with skills to improve their confidence, knowledge, and communication skills.
  • Lead day to day activities of team members to ensure they are adhering to the company’s policies.
  • Manage 50 incoming emails per day from providers and members.
  • Handle escalated calls using defined protocols and independent judgment.
  • De-escalate complex issues and complaints from members using troubleshooting skills.
  • Verify claims, billing, insurance, and pharmacy benefits to assure the information is correct & completed.

Health Plan Representative, CSR

Ascension Personalized Care
09.2022 - 05.2023
  • Managed approximately 40 incoming calls per day
  • Handled Written, and electronic inquiries within 24-48 hour time frames.
  • Reviewed healthcare claims and route to the appropriate department for corrections.
  • Verified and Audited benefit calculations to assure payment worksheets are completed.
  • Independently managed workload and handle multiple tasks to ensure timely completion of work assignments.

Mortgage Operations Insurance Specialist

Rocket Mortgage TPO
06.2020 - 06.2022
  • Facilitated transactions between borrowers and mortgage brokers.
  • Managed approximately 70 incoming calls per day from clients, insurance agencies and loan officers.
  • Assisted with loan servicing business to business websites to verify insurance.
  • Performed follow up and research tasks to ensure problem resolution.
  • Completed daily work activities to meet operational requirements and goals.

Eligibility Counselor

Conifer Health Solutions
03.2018 - 05.2020
  • Responded to phone 80 phone calls, Written, and electronic inquiries.
  • Collected demographic information for identification purposes.
  • Presented a Medicaid application at the patient's bedside, interviewed, and obtained signatures to submit when applicable to the State of Michigan.
  • Gathered documents, input information, and submitted them to the Department of Health and Human Services.

Patient Access Rep II

Conifer Health Solutions
02.2016 - 03.2018
  • Educated patients regarding financial responsibilities, liabilities, and insurance plans.
  • Presented an IMM form at the patient's bedside and explained their rights when applicable.
  • Performed registration duties in the ED by collecting and storing patient demographic information.
  • Obtained, reviewed, verified, and corrected insurances and patient information.
  • Initiated authorization request from Insurance companies.

Customer Service Associate

Aerotek Professional Services, Health Alliance Plan CSS
09.2015 - 02.2016
  • Educated existing and potential members on policies, procedures, products, benefit plan and coverage provisions related to all HAP/AHL/ HMO/ PPO/ Medicare/Medicare Advantage Plans.
  • Responded to 40 inquiries received by telephone,
  • Handled complaints, and appeals by following all department standards, policies, and procedures.

CSR

Aerotek Professional Services, Wright & Filippis
07.2015 - 09.2015
  • Assisted with shipping and receiving of items, filed records in the appropriate folder for auditing purposes.
  • Received and unloaded incoming materials, compared information on packing slip with purchase order to verify accuracy of shipment.
  • Responded to telephone inquiries regarding services offered through the company.

Referring Physician Advocate

Henry Ford Health Systems
10.2012 - 10.2013
  • Coordinated the needs of physicians by fulfilling appointment requests.
  • Assisted with physician-to-physician consultations to patient clinic appointments.
  • Responded to 80 Inbound calls from providers for patient appointment scheduling.
  • Worked with cross-functional teams to solve complex customer issues.
  • Maintained documentation of calls and updated departmental files through an online database.

Admitting Officer

Henry Ford Health Systems
03.2005 - 10.2012
  • Responded to 50 telephone inquiries regarding services offered through the healthcare facility.
  • Performed registration duties in the ED by collecting and storing patient demographic information.
  • Monitored all telephone activity from physicians and patients to assure customer satisfaction.
  • Responded to customer's concerns and grievances in a professional, prompt, and courteous manner.
  • Updated patient information in the MPAC system to assist in the billing process.
  • Maintained documentation of calls received and problems encountered through an online database.

Education

Associate of Applied Science - Health Information Management

DeVry University, Downers Grove, IL
07.2016

Skills

  • Microsoft Office Suite, Internet, Lotus Notes, Outlook, Excel, Insurance panels, Care plus, Medical Terminology
  • ICD-10 CM, 3M Encoder, Epic, Facets, Citrix, Open Enrollment, Genesys Cloud, EHR
  • Customer support
  • Goal-oriented mindset
  • Customer relations
  • Data entry proficiency
  • Staff training
  • Telephone reception

Certification

Safety, Environment of Care, and Emergency Management

Workplace Violence Prevention

Fraud Waste and Abuse Training

Voluntary Transformative Community Service with Americorps



Interests

  • I like working with my hands and fixing things
  • Volunteering for community initiatives to give back to local communities and make a positive impact
  • Cooking
  • I enjoy helping others and giving back to the community

Timeline

Health Plan Representative, Senior CSR - Ascension Personalized Care
05.2023 - Current
Health Plan Representative, CSR - Ascension Personalized Care
09.2022 - 05.2023
Mortgage Operations Insurance Specialist - Rocket Mortgage TPO
06.2020 - 06.2022
Eligibility Counselor - Conifer Health Solutions
03.2018 - 05.2020
Patient Access Rep II - Conifer Health Solutions
02.2016 - 03.2018
Customer Service Associate - Aerotek Professional Services, Health Alliance Plan CSS
09.2015 - 02.2016
CSR - Aerotek Professional Services, Wright & Filippis
07.2015 - 09.2015
Referring Physician Advocate - Henry Ford Health Systems
10.2012 - 10.2013
Admitting Officer - Henry Ford Health Systems
03.2005 - 10.2012
DeVry University - Associate of Applied Science, Health Information Management

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