A highly experienced individual seeking a position within the healthcare setting to exhibit my medical terminology knowledge, hands on experience, and versatility in the medical field.
Overview
19
19
years of professional experience
Work History
Provider Web Support Specialist
Provider Web Support Specialist
01.2012 - 01.2021
Assists providers with registering accounts online to obtain claim information, EOBs, member benefits and copay information
Properly diagnose problems and guides users through problem resolution
Provided account management to all new and incoming providers
Provided technical support and instruction to all staff members
Troubleshoot issues and problems by coordinating maintenance within CWS and related equipment and software
Support clients by focusing on their application and technical web related issues
Help clients by troubleshooting problems and finding resolutions
Assisted with product testing on behalf of XL Health
Assisted other team members with resolutions requirements
Provider/Member Service Specialist
XL HEALTH CORPORATION
01.2010 - 01.2012
Solely provided claim status to members and providers
Retrieved deductible and co-pay information for new patients
Mailed HIPAA certification, updating enrollment and termination information
Provided benefits for par and non-par providers
Responded to claims and health services requests to set up PNOF's for Claims, RAF's and TAR's for all lines of business
Assisted the finance department with returned EOP's and checks by researching new mailing addresses for providers and updating systems
Provided an elevated customer experience to generate a loyal clientele
Addressed an average of 80 customer inquiries and complaints each week
Followed up with customers on unresolved issues
Reported policy changes and company conditions affecting customer satisfaction
Disease Management Coordinator
NATIONWIDE BETTER HEALTH
01.2002 - 01.2010
Handled multifaceted clerical tasks as administrative support to the Disease Management Nursing team
Coordinated telephone interviews with patients and entered their information into a patient database to be assessed by the nursing team
Communicated effectively with multiple departments
Worked with facility personal to establish care strategies for chronic diseases that are prevalent in the community
Planned and developed, as well as implement and direct, a program that provides services for disease management
Coordinated a database of statistics and narratives for tracking progress and efficacy of treatments and program outcomes
Oversaw educational literature for patients and for staff
Developed and led outreach to the community through lectures, health fairs, and other public events
Provided direct patient care within the parameters of the program you have developed
Educated and trained staff in new methods of approach for chronic disease management
Education
Some college courses -
COMMUNITY COLLEGE OF BALTIMORE COUNTY
Essex, Maryland
High School Diploma - Business Administration
Southern Senior High School
Baltimore, MD
06.2001
Skills
Website Maintenance
Web Analytics
Quality Assurance Testing
Web Accessibility
Web development
Customer Service
Problem-Solving
Attention to Detail
Problem-solving abilities
Microsoft Windows and Office
Multitasking
Excellent Communication
Organizational Skills
Network support
Effective Communication
Remote Technical Support
Help Desk Support
Customer Support
Timeline
Provider Web Support Specialist
Provider Web Support Specialist
01.2012 - 01.2021
Provider/Member Service Specialist
XL HEALTH CORPORATION
01.2010 - 01.2012
Disease Management Coordinator
NATIONWIDE BETTER HEALTH
01.2002 - 01.2010
Some college courses -
COMMUNITY COLLEGE OF BALTIMORE COUNTY
High School Diploma - Business Administration
Southern Senior High School
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