Michelle Corso
Clover,SC
Summary
Compassionate and driven professional with a commitment to making a positive impact in the insurance and healthcare industry. A passion for mentoring and conducting peer reviews have not only enhanced the skills of coworkers but also fostered a culture of adherence to policies and procedures. Keen eye for detail and a dedication to efficiency. Ability to analyze reimbursement trends and collaborate with field teams as a trusted regional expert. Detail-oriented team player with strong organizational skills. Ability to handle multiple projects simultaneously with a high degree of accuracy. Analytical mindset with expertise in Underwriting. Gifted in evaluating risk and loss potential and developing information for new and renewal policies. Team-oriented with success in building relationships with brokers and sales agents to achieve business goals.
Overview
24
24
years of professional experience
Work History
Insurance Specialist (Temp)
AbbVie
08.2023 - Current
- Maintained high standards of customer service by building relationships with Patients, Healthcare workers and Health Insurance Companies.
- Processed eligibility and benefits verification and authorization requests.
- Maintained confidentiality of patient records and health statuses.
- Responded to customer calls swiftly to resolve issues and answer questions.
- Monitored changes in the insurance industry to stay compliant with relevant laws and regulations.
- Built relationships with clients using active listening and issue resolution to provide excellent service.
- Prepared and reviewed insurance applications to verify compliance with regulations
Case Manager
AmerisourceBergen
11.2020 - 09.2023
- Handling Appeals and Denials for successful resolution, ensuring maximum reimbursement and reduction in financial losses.
- Verification and coordination of benefits to maximize coverage and minimize out-of-pocket expenses for patients. Exercise judgment within defined standard operating procedures to determine appropriate action
- Providing comprehensive support for medical billing, coding, and claims processing.
- Conducting Peer Reviews and mentoring Associates to ensure adherence to policies and procedures and enhance their skills,
- resulting in improved productivity and efficiency.
- Collaboration with Field Team, Field Reimbursement Managers, and Sales Representatives
- Providing exceptional customer service, analyzing and reporting reimbursement trends/delays, and processes necessary
- Correspondence to identify opportunities for improvement and ensure timely resolution of issues.
- Triaging and coordinating Pharmacy services and wholesale order processing, ensuring timely and accurate delivery of medications and supplies.
- Responding to program inquiries and assessing patients for Copay, QuickStart, and Patient Assistance Programs.
- Conducting advanced research to explore alternate coverage options.
- Processing Enrollment Forms.
Field Service Representative
Redbox Corporation
05.2019 - 11.2020
- Travel to 20-25 assigned kiosks each day, collect products and restock as needed
- Keep a weekly record of products distributed
- Follow a specifically designed merchandising route
- Provide quality customer service
- Demonstrate multitasking and problem-solving skills
- Followed safety procedures and conducted training on driving skills
Financial Underwriter
Coventry Healthcare/ Aetna
08.2006 - 02.2014
- Worked with Small and Large Market Businesses
- Collaborate with President of Underwriting, and senior management to forecast and accurately document the book of business risk, overall profit/loss, and related financial reporting
- Develop group premium rates for prospective and renewal business of 2-50 and 51-99 life accounts
- Evaluate actuarial data via model testing to ensure products are priced appropriately
- Assist in presenting information to external clients
- Support sales and marketing teams and provided assistance with underwriting methodologies
- Conducted weekly meetings with account managers and sales representatives to provide an overview of cases for each territory
- Responsible for tracking, and running monthly checkbook to manage profit
- Completed Government Programs Medicare University Course
- Utilized knowledge of insurance principles, policies and procedures to make decisions on risk assessment.
Issue Underwriter
MetLife
04.2000 - 05.2006
- Made approval and denial recommendations by determining accurate risk levels.
- Reviewed applications for Life, Dental, and Disability insurance coverage and to determine risks.
- Operate as sales liaison by communicating outcome of rates, medical requirements, and plan exceptions to sales associates, brokers, and clients
- Supported review and acceptance or denial of new or renewal business.
- Documented underwriting decisions and provided evidence of compliance with applicable regulations.
- Ensure accuracy and quality regarding all aspects of business processes
- Reviewed applications for insurance coverage and reports from loss control specialists to determine risks.
- Built strong relationships with brokers and clients for constructive communications.
Education
High School Diploma -
Ellicottville Central School
Ellicottville06.1990
Skills
- Analytical Skills
- Critical Thinking
- Small Group Underwriting: Life, Dental, Disability, Health
- Decision-Making Capabilities
- Microsoft Excel Proficiency
- Verbal and Written Communication
- Risk Pool Management
- Financial Analysis Proficiency
- Microsoft Word
- Microsoft Access
Timeline
Insurance Specialist (Temp)
AbbVie
08.2023 - Current
Case Manager
AmerisourceBergen
11.2020 - 09.2023
Field Service Representative
Redbox Corporation
05.2019 - 11.2020
Financial Underwriter
Coventry Healthcare/ Aetna
08.2006 - 02.2014
Issue Underwriter
MetLife
04.2000 - 05.2006
High School Diploma -
Ellicottville Central School