Open To Work
Nakamba Simuwelu
Little Elm,TX
Work Preference
Summary
Dedicated to guiding individuals through the healthcare system, providing support, education, and resources to help them make informed decisions about their health and well-being.
Overview
7
7
years of professional experience
Work History
Customer Service Advocate
UnitedHealthcare
11.2022 - Current
- Respond to and resolve customer service inquiries and issues on the first call by identifying the topic and type of assistance needed (benefits, eligibility, claims, financial spending accounts, correspondence).
- Guide and educate customers about consumer-driven healthcare topics to select the best benefit plan options, maximize the value of their health plan benefits, and choose quality care providers.
- Contact care providers on behalf of customers to assist with appointment scheduling or connections with internal specialists.
- Ask appropriate questions and listen actively to identify specific questions or issues while documenting required information in computer systems.
Insurance Verification Specialist
Biologics by McKesson
12.2020 - 11.2022
- Verified patients' insurance coverage to ensure necessary procedures were covered by their providers.
- Entered data and updated patients' benefits information in the organization's insurance system, ensuring accuracy.
- Communicated with healthcare providers to ensure proper billing and reimbursement processes.
- Educated patients on their insurance coverage benefits to facilitate informed decision-making.
Customer Service Advocate
Foremost Family Health Centers
12.2018 - 01.2020
- Promptly received 100% of all telephone calls and visitors.
- Adapted to using all features of the telephone system and voicemail for staff communication.
- Communicated through radio and phone with clinical and dental departments to ensure each patient was greeted by clinical support staff.
- Scheduled appointments according to scheduling guidelines.
- Coordinated patients' appointments according to providers' requests through Athena tickler.
Education
Associate in applied sciences -
Collin County Community College
Plano, TXCMA - Medication Aide
Alliance Career Institute
Dallas, Tx 05.2010 - 07.2010
CNA - Certificate Nurse Aide
Alliance Career Institute
Dallas, Tx 06.2009 - 07.2009
High School Diploma -
Pearce High School
Richardson, TXSkills
- Technical knowledge of CSP
- Documentation
- 1 year plus claims/customer service experience
- Clear and effective communication
- Attention to detail
- Experience with Microsoft word, Excel, Outlook
- Time management
Timeline
Customer Service Advocate
UnitedHealthcare
11.2022 - Current
Insurance Verification Specialist
Biologics by McKesson
12.2020 - 11.2022
Customer Service Advocate
Foremost Family Health Centers
12.2018 - 01.2020
CMA - Medication Aide
Alliance Career Institute
05.2010 - 07.2010
CNA - Certificate Nurse Aide
Alliance Career Institute
06.2009 - 07.2009
Associate in applied sciences -
Collin County Community College
High School Diploma -
Pearce High School