MISHAEL ALLEN
Montgomery
Summary
Results-driven healthcare administrator with expertise in managing prior authorization processes and ensuring compliance. Proven ability to enhance operational efficiency through effective team collaboration and adaptability to changing requirements. Strong communicator with problem-solving skills, adept at navigating complex healthcare systems. Customer service specialist skilled in prioritizing tasks and addressing escalated support issues in fast-paced environments.
Overview
1
1
year of professional experience
Work History
Customer Service Representative
Firstsource Solutions
Montgomery
11.2025 - 01.2026
- Resolved customer complaints promptly, ensuring effective solutions and high satisfaction levels.
- Handled multiple tasks in a fast-paced environment while delivering exceptional service.
- Delivered knowledgeable and friendly service during conflict resolution, enhancing customer satisfaction.
- Provided accurate information regarding products and services, effectively addressing customer inquiries.
- Demonstrated calm professionalism in stressful situations, effectively diffusing tension.
- Maintained accurate records of customer interactions and transactions, supporting quality assurance efforts.
Enrollment Specialist
Ehealth
Montgomery
09.2025 - 11.2025
- Educated clients on eligibility requirements, enrollment options, and available benefits.
- Handled high call volumes, ensuring exceptional customer support and client retention.
- Resolved escalated calls by effectively addressing complex issues and ensuring client satisfaction.
- Enhanced first-call resolution rates through comprehensive issue analysis and problem-solving techniques.
- Built client trust by addressing concerns and offering tailored resolutions, enhancing overall satisfaction.
- Efficiently resolved inquiries using CRM systems to boost customer satisfaction levels.
- Assisted customers with informed purchasing decisions by sharing expert product knowledge.
- Coordinated with team members to streamline communication processes, improving response times.
Medical Claims Processor
Everise
Montgomery
06.2025 - 08.2025
- Processed high volumes of medical claims accurately under tight deadlines, ensuring prompt payments.
- Audited processed claims for compliance with company policies and regulations, ensuring accuracy and adherence.
- Resolved discrepancies in claims through thorough investigations and effective communication with healthcare providers.
- Verified patient insurance coverage for medical claims, enhancing accuracy in submission and reducing errors.
- Evaluated medical claims for completeness and researched missing data for accurate processing.
- Processed claims by paying or denying based on established criteria, ensuring compliance with regulatory standards.
- Maintained up-to-date knowledge of HIPAA regulations, medical terminology, and claims processing principles.
- Monitored and updated claims status in processing systems to enhance operational efficiency.
Claims & Prior Authorization Representative
Foundever
12.2024 - 05.2025
- Processed prior authorization requests efficiently, ensuring compliance with insurance guidelines.
- Verified eligibility and compliance with authorization requirements for service providers.
- Processed large volumes of claims efficiently in fast-paced work environment.
- Ensured compliance with industry regulations by following established procedures in claims handling.
- Provided exceptional customer service, addressing inquiries from both patients and healthcare providers promptly and professionally.
- Gathered necessary documentation from healthcare providers to secure timely approvals.
- Utilized electronic health record systems to track and manage authorization statuses effectively.
- Analyzed denials and implemented corrective actions to reduce delays in patient care.
- Maintained accurate records of authorizations, facilitating reporting and audits.
Education
High School Diploma -
Wetumpka High School
Wetumpka, AL05-2018
Skills
- Insurance verification and authorizations
- Patient scheduling and follow-up
- Medical claims processing
- Electronic health records management
- Benefit coverage analysis
- HIPAA compliance
- Call center operations
- Payment processing and client service
- Effective communication skills
- Conflict resolution and mediation
- Problem solving and critical thinking
- Attention to detail and quality assurance
- Punctuality and reliability
- CRM system proficiency
- Microsoft Office expertise
- Spreadsheet management
- Multi-line phone operation
- Team collaboration and development
- Onboarding assistance and training
- Adaptability and flexibility in tasks
Timeline
Customer Service Representative
Firstsource Solutions
11.2025 - 01.2026
Enrollment Specialist
Ehealth
09.2025 - 11.2025
Medical Claims Processor
Everise
06.2025 - 08.2025
Claims & Prior Authorization Representative
Foundever
12.2024 - 05.2025
High School Diploma -
Wetumpka High School