Summary
Overview
Work History
Education
Skills
Timeline
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Olivia Hall

Hampton,VA

Summary

Dependable and detail-oriented professional adept at quickly identifying and resolving operational issues, implementing processes and providing exemplary customer service. Possesses excellent organizational, problem-solving, and communication skills.

Overview

19
19
years of professional experience

Work History

Consumer Service Operations Professional 2

Humana
09.2023 - Current
  • Consistently exceeds performance benchmarks, processing a high volume of claims accurately within designated timeframes.
  • Conducts thorough reviews of claims, identifying errors or missing information before resubmitting corrections for approval.
  • Serve as a reliable resource for colleagues, sharing expertise on industry trends, changes in practices, or updates as needed.
  • Demonstrates adaptability during software transitions, quickly learning new systems to maintain productivity levels throughout implementation periods.
  • Maintained strict confidentiality of sensitive patient information, adhering to HIPAA guidelines and other applicable regulations in all aspects of the role.

Customer Care SME Specialist

WPS
08.2017 - 08.2023
  • Maintained organized claim files, ensuring easy access to pertinent information for efficient processing.
  • Complied with regulations and guidelines related to claims processing to maintain quality and adherence to standards.
  • Proactively obtained and analyzed internal and external claims data to determine specific problem areas.
  • Contributed to team success by consistently meeting or exceeding individual performance goals and metrics.
  • Reduced claim processing errors by conducting thorough policy reviews and maintaining up-to-date knowledge of industry regulations.
  • Promotes seamless claim process by educating providers on billing protocols.

Authorization and Appointing Customer Service Representative

Kelly Temp Services (Health Net Federal Services)
06.2016 - 08.2017
  • Displayed exemplary customer service in a fast-paced customer service environment.
  • Handled sensitive patient information with confidentiality, adhering to HIPAA regulations at all times.
  • Successfully served as a liaison between patients and physicians by monitoring assigned physician's practice and timeline.
  • Contacted Veteran's providers to arrange medical and surgical appointments.
  • Uploaded Veteran's profile and validated Medical Provider Demographic by Specialty.
  • Improved accuracy in patient coding by conducting thorough chart reviews and applying appropriate ICD-10 codes.

Department Sales Associate

Kmart
04.2015 - 01.2017
  • Offered personalized recommendations based on customer preferences, increasing average transaction value per sale.
  • Participated in inventory management tasks, ensuring accurate stock levels for seamless store operations.
  • Assisted customers in making informed decisions, leading to higher satisfaction rates.
  • Supported marketing initiatives through strategic placement of promotional materials on the sales floor.
  • Processed transactions quickly and accurately, demonstrating professionalism at the cash register.
  • Built customer loyalty and retention by delivering excellent shopping experiences.

Youth Empowerment Counselor

Greater Emmanuel Church of God
01.2009 - 01.2017
  • Successfully planned, developed, and implemented appropriate initiatives concerning Group Building, Mission, And Outreach.
  • Adapted counseling techniques to best suit individual needs of each client.
  • Recruited and trained volunteers.
  • Kept records of participation and managed the budget.
  • Communicated closely with other counselors to devise programs and activities based on developmental and academic levels.
  • Conducted assessments to determine progress and performance and report findings to relevant authorities.

Internship-Substance Abuse Counselor

Essential Seeds of Change, LLC
02.2016 - 12.2016
  • Processed patient in-take & assessments for court referred clients aged 13-19 addressing anger management and substance abuse.
  • Assisted with conducting life skills groups or education workshops.
  • Maintained accurate documentation of client progress, facilitating informed decision-making within the treatment team.
  • Supported and assessed clients struggling with addiction or relationship issues and devised strategies based on client needs.
  • Developed individual intervention strategies for Recovery Plans.

Sr. Account Service Rep/Escalation Team

Sprint
01.2005 - 04.2016
  • Consistently resolved escalated billing/service inquiries using problem solving and conflict resolution techniques.
  • Coached agents in delivering exceptional customer service in a fast-paced call center environment.
  • Streamlined workflows for better consistency in addressing customer concerns, enhancing overall experience.
  • Conducted detailed case reviews to pinpoint areas of improvement in team performance, driving continuous growth and development.
  • Showcased excellent multitasking abilities while managing multiple high-priority escalations simultaneously without sacrificing quality or attention to detail.
  • Contributed to a positive work environment by providing support and guidance to fellow team members.

Education

Master of Science in Criminal Justice -

Saint Leo University
12.2012

Bachelor of Science in Criminal Justice -

Old Dominion University
12.2009

Skills

  • Customer Service & Engagement
  • Insurance claims processing
  • Medical Billing/Coding
  • Medical/Insurance Claims
  • Medical terms and procedure knowledge
  • Organizational abilities
  • Patient confidentiality
  • Private Insurance Policies

Timeline

Consumer Service Operations Professional 2

Humana
09.2023 - Current

Customer Care SME Specialist

WPS
08.2017 - 08.2023

Authorization and Appointing Customer Service Representative

Kelly Temp Services (Health Net Federal Services)
06.2016 - 08.2017

Internship-Substance Abuse Counselor

Essential Seeds of Change, LLC
02.2016 - 12.2016

Department Sales Associate

Kmart
04.2015 - 01.2017

Youth Empowerment Counselor

Greater Emmanuel Church of God
01.2009 - 01.2017

Sr. Account Service Rep/Escalation Team

Sprint
01.2005 - 04.2016

Master of Science in Criminal Justice -

Saint Leo University

Bachelor of Science in Criminal Justice -

Old Dominion University

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Olivia Hall