Michele Timmons
Houston,TX
Summary
Versatile professional with extensive experience in mortgage banking, insurance, benefits administration, and customer service. Licensed insurance agent in Texas with expertise in FHA, VA, and TX Home Equity loans, managing 40+ cases weekly. Skilled in claims management, fraud analysis, Enrollment Specialist and benefits counseling, with advanced proficiency in Salesforce, SAP, and multiple industry platforms. Willing to relocate: Anywhere
Overview
11
11
years of professional experience
1
1
Certification
Work History
Enrollment Specialist
Centauri Health Solutions
Houston, TX
- Current
- Medicare and Medicaid enrollment specialist, for several different Health plans. I screened the member and for those that qualified I submitted an application on their behalf. These programs were regulation by the federal government and state Laws. I also managed the member account to ensure accuracy and time management. I took inbound and outbound calls to assist members with the screening process.
Medicare Sales Representative
eHealth
Houston, TX
07.2024 - 04.2025
- Sold Medicare and Medicaid plans to recipients, achieving high client satisfaction by being appointed with all major carriers
Customer Service Representative
AppleOne
Houston, TX
03.2024 - 07.2024
- Resolved customer account inquiries for an energy company, answering all questions to ensure customer satisfaction
Benefits Verification Specialist
TalentBridge
Houston, TX
09.2023 - 03.2024
- Verified patient benefits by conducting high-volume outbound calls and completing accurate data entry in Patient Plus
- Processed incoming verification orders with accuracy, ensuring timely updates in Patient Plus after each call
- Contacted insurance companies to verify medication payment, improving efficiency for specific medication approvals
- Utilized DRG system and performed detailed faxing and data entry to maintain comprehensive patient records
Claims Manger (Remote)
Apex Systems - Contract
Houston, TX
10.2022 - 08.2023
- Ensured program compliance and accurate record keeping by closely adhering to guidelines and file closeout expectations
- Applied analytical skills to interpret and evaluate case information, utilizing DRG system consistently
- Promoted from Case Manager to Appeals team, achieving timely completion of all cases and daily outreach
- Determined document authenticity and calculated payouts or recaptures for 40 cases weekly, following policy protocol for irregular cases
Hr CRC Specialist (Remote)
Apex Systems
Houston, TX
01.2022 - 10.2022
- Supported rollout of HR cases and technological tools, enabling quick resolution of associate needs
- Reviewed, managed, and responded to case/task workload in Panorama HR case management system
- Coordinated review and resolution of attendance-related matters, including roster review and trouble ticket management
- Executed site communication tools in partnership with site GMA and ensured data integrity in HRIS (Peoplesoft)
- Created and managed LOA cases, supporting employees until return to work
Benefits Counselor (Remote)
Loop Recruiting
Houston, TX
07.2021 - 12.2021
- Managed employee benefits programs for multiple organizations, ensuring alignment with company and employee needs
- Designed and administered benefits programs, educating and assisting employees in enrollment activities
- Conducted benefits verification for medications such as Eylea and Eyea HD, improving accuracy in coverage determination
Independent Contractor Driver
Metro Lift/Yellow Cab
Houston, TX
10.2019 - 06.2021
- Followed a 12-hour daily manifest for contracted routes, maintaining constant communication with dispatch
- Operated vehicles safely and ensured timely pickups and drop-offs, consistently presenting a professional demeanor
- Maintained vehicle cleanliness and reported mechanical issues daily, upholding high service standards
- Completed all duties with discretion and confidentiality, treating each passenger with respect and professionalism
Remote - Fraud Analyst II
Jack Henry & Associates INC.
Houston, TX
06.2017 - 12.2019
- Protected financial institutions from fraud using Falcon and CCS, supporting SMS Guardian and transaction support
- Monitored and analyzed customer account transactions to detect suspicious activity, safeguarding Debit, Credit, and ATM cards
- Answered inbound calls for fraud, lost or stolen cards, and transaction assistance, ensuring policy compliance in a fast-paced environment
- Monitored Skype and emails, taking corrective action on fraudulent activity and assisting cardholders and institutions
- Maintained equipment and adhered to JHA Code of Conduct, ensuring daily responsibilities were met
Customer Service Representative
A1 Personnel
Houston, TX
09.2016 - 06.2017
- Managed heavy call volume to handle EZ Tag accounts and Violation Enforcement tolls, addressing customer concerns
- Processed payments, cleared violations, and provided account adjustments and waivers, generating receipts for customers
- Updated inquiries regarding EZ Tag accounts and missed tolls, maintaining accurate records
- Educated customers on HCTRA policies and procedures, ensuring compliance and customer understanding
FHA Insuring Specialist
Stewart Lending Services
Houston, TX
02.2015 - 10.2015
- Reviewed and identified required documents to submit loans for endorsement, ensuring compliance with regulations
- Utilized Document Post Closing and Insuring Tracking system to accurately reflect loan status
- Maintained up-to-date knowledge of government regulations and client requirements, performing online functions via FHA connections
Education
High school diploma -
Cleveland Heights High School
Cleveland, OH12-1985
Skills
- EDI
- VPN
- Process improvement
- Marketing
- Banking
- Medical coding
- Analytics
- Kronos
- NCQA standards
- Medical collection
- Workday
- Quality control (5 years)
- Bookkeeping
- Salesforce
- Medical office experience
- Call center management
- Phone etiquette
- Property management
- Payroll
- Accounts receivable
- HRIS
- Software troubleshooting
- Office management
- Data analytics
- SharePoint
- Medical records
- Schedule management
- Windows
- Customer relationship management
- Personal injury law
- Proofreading
- Medical billing
- Sales
- 10 key typing
- Medicare
- Microsoft Excel
- Data management
- Computer skills
- Employment & labor law
- Customer support
- Hospital experience
- Call center
- Research
- Documentation review
- QuickBooks
- Leadership
- Social media management
- Senior care
- FHA connections
- Analysis skills
- Mortgage servicing
- SAP
- Relationship management
- Project management
- Administrative experience
- Adobe Acrobat
- Financial management
- Mentoring
- English
- Debits & credits
- Insurance verification
- Human resources
- Front desk
- Loan origination
- EMR systems
- Data collection
- Typing
- Recruiting
- NetSuite
- Google Docs
- Epic
- Supervising experience
- Account management
- Patient Plus system
- Accounting software
- CRM software
- Revenue cycle management
- ICD-10
- Microsoft Office
- Microsoft Outlook
- Logistics
- Yardi
- UCC law
- ADP
- Computer Networking
- DRG coding
- Team management
- HIPAA
- Real estate law
- Multi-line phone systems
- Fair Housing regulations
- Microsoft Access
- Interviewing
- Computer networking
- Strategic planning
- Time management
- Citrix
- Presentation skills
- Zendesk
- Microsoft Word
- Medical terminology
- Microsoft Powerpoint
- Clerical experience
- Customer service
- Conflict management
- Negotiation
- Loan endorsement
- Google Suite
- Benefits administration
- Accounting
- Accounts payable
- Intake
- Writing skills
- Communication skills
- Management
- Sales administration
- Paylocity
- Help desk
- Fraud detection
- Organizational skills
- Qualitative research interviewing
- Help Desk
- Proficient with LiveVox
- Property leasing
- Case management
- Filing
- Contracts
- Employee Orientation
- Litigation
- E-commerce
- Dermatology
- Quality control
- Credit analysis
- Data entry
Certification
Life Insurance License
Links
and
Additional Information
Authorized to work in the US for any employer
Timeline
Medicare Sales Representative
eHealth
07.2024 - 04.2025
Customer Service Representative
AppleOne
03.2024 - 07.2024
Benefits Verification Specialist
TalentBridge
09.2023 - 03.2024
Claims Manger (Remote)
Apex Systems - Contract
10.2022 - 08.2023
Hr CRC Specialist (Remote)
Apex Systems
01.2022 - 10.2022
Benefits Counselor (Remote)
Loop Recruiting
07.2021 - 12.2021
Independent Contractor Driver
Metro Lift/Yellow Cab
10.2019 - 06.2021
Remote - Fraud Analyst II
Jack Henry & Associates INC.
06.2017 - 12.2019
Customer Service Representative
A1 Personnel
09.2016 - 06.2017
FHA Insuring Specialist
Stewart Lending Services
02.2015 - 10.2015
Enrollment Specialist
Centauri Health Solutions
- Current
High school diploma -
Cleveland Heights High School