Negad Nawawy
Tampa
Summary
Detail-oriented Health Service Representative with a strong background in health care administration and operational services. Proficient in handling member and provider inquiries, verifying insurance details, and facilitating effective communication between healthcare providers and members. Skilled in navigating electronic health records systems and maintaining meticulous records. Committed to delivering proper care coordination, adhering to regulatory guidelines, and enhancing the overall healthcare experience for members.
Overview
6
6
years of professional experience
Work History
Community Health Service Representative
Sunshine Health Plan
01.2023 - Current
- Conducted 10+ health risk screenings per week to identify health needs.
- Engaged with community members to raise awareness about health services and programs.
- Provided information and resources to promote health education within the community.
- Connected members to appropriate healthcare services and resources.
- Gathered and documented health data to identify trends and areas for improvement.
- Worked closely with healthcare providers to ensure quality care for Sunshine Health members.
- Educated members about billing, payment processing and support policies and procedures.
- Identified and resolved problems through root cause analysis and research.
Home Loan Specialist (Contract)
PennyMac
01.2022 - 04.2022
- Compiled closing disclosure packages for drafting and presentation accuracy.
- Upheld complete confidentiality of all submitted information according to release guidelines.
- Prepared documents for underwriting by verifying client income, credit reports and other information.
- Reviewed loan files and updated to match current standards.
- Audited variety of critical financial documents for completeness and accuracy, noting and resolving deficiencies and errors.
Service Advisor
Wesley Chapel Honda
01.2021 - 12.2021
- Identify, confirm and offer resolution to customer concerns.
- Communicate with customer what needs to be done, how much it will cost and when service will be complete.
- Provide estimates that are accurate and support upfront pricing guarantee.
- Communicate with technicians to gain clear understanding of services required and/or performed.
- Delivered excellent customer service, resulting in consistent 100% customer satisfaction rating.
Claim Specialist
MetLife
06.2019 - 09.2020
- Reviewed 150+ claimant cases per week and verified insurance coverage information.
- Communicated verification and authorization status updates with disability department to facilitate decision-making for patient admissions and insurance coverage.
- Managed assigned caseload of minimally complex claims.
- Respond to inquiries, handle outbound calls needed, handle customer escalations.
- Develops and maintains strong working relationships with internal and external customers.
Customer Service Representative
MetLife
06.2018 - 06.2019
- Preparing confidential files to be scanned into research queue.
- Indexing scanned files and placing them under proper document and subdocument type.
- Reduced process gaps while training new hires on products, software, operation all best practices and protocols.
- Examined reports, accounts and evidence to determine integrity and accuracy of information.
- Evaluated accuracy and quality of data entered into agency management system.
Education
Bachelor of Arts - Business Analytics & Information Systems
University of South Florida
Tampa, FL08.2017
Skills
- MS Office
- Analytical Problem-Solving
- Healthcare Operations
- Insurance Coverage Verification
- Account Management
- Documentation Abilities
- Policy Interpretation
- Regulatory Compliance
- Member Advocacy
- Logical Decision Making
Timeline
Community Health Service Representative
Sunshine Health Plan
01.2023 - Current
Home Loan Specialist (Contract)
PennyMac
01.2022 - 04.2022
Service Advisor
Wesley Chapel Honda
01.2021 - 12.2021
Claim Specialist
MetLife
06.2019 - 09.2020
Customer Service Representative
MetLife
06.2018 - 06.2019
Bachelor of Arts - Business Analytics & Information Systems
University of South Florida
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