Rachael Burke
Chattanooga,TN
Summary
Highly organized and detail-oriented professional with strong work ethic and dedication to achieving goals. Skilled at developing and maintaining documentation systems, managing calendars and preparing reports. Knowledgeable in project management principles, business processes and customer service best practices.
Overview
17
17
years of professional experience
1
1
Certification
Work History
Northwest Regional Coordinator
OrthoFi
09.2021 - Current
- Responsible for reporting on the Northwest region to the Ortho Success Manager.
- Reports include but are not limited to call trends, attrition, recidivism rates, onboarding of new Orthodontic practices, customer service, retention, claims, eligibility.
- Chosen as part of the Training and Implementation Associate program to assist with training and implementation of new Orthodontic practices that onboard with OrthoFi.
Practice Advocate
OrthoFi
06.2021 - 09.2021
- Responsible for customer service, troubleshooting practice issues, eligibility questions, claims, remittance, exam adjustment within the Orthodontic treatment realm
- Promoted to Northwest Regional Coordinator.
Escalation Supervisor
Cigna
04.2020 - 05.2021
- Trained in Choice Fund call management, Cigna EE accounts, Proclaim, Medicare, ARI, CCX/Evicore, MBI, EPro, VipR, CED, CPF, OneView, Provider Maintenance, Trucare, ICMS, Evicore portal, ASHlink, ART tool, COB SharePoint, QECP SharePoint, ECP SharePoint
- Responsible for customer service, escalations, Durable Medical Equipment calls, benefits, Advanced Radiology calls, appeals, claim explanation, refund requests, Cigna EE calls and escalations, metrics, coaching, as well as working with the Escalation Team email box
- Served in a Mentor position while with ECT as well
- Worked daily with Medicare members as well as escalated coordination of benefit opportunities as a result of primacy confusion.
Customer Service Advocate/Dedicated Ancillary Team
Cigna
09.2018 - 04.2020
- Trained in Choice Fund call management and Cigna EE accounts
- Responsible for customer service, escalations, CareCentrix calls, benefits, Advanced Radiology calls, appeals, claim explanation
- Assigned to the CareCentrix Escalation Team Inbox as of 04/01/2019
- Instrumental in the change of vendors for Enteral Formula supplies from Apria as of May 2019 due to repeated escalations
- As of 11/01/2019, moved to CareCentrix Escalation Lead
- Responsible for weekly conference calls with CareCentrix and monthly senior management conference calls with CareCentrix.
Claims Coordinator
US XPRESS, INC
09.2014 - 04.2017
- Responsible for inbound claims calls from the drivers that have been involved in vehicle accidents
- Coordination of the cleanup, Fire/Rescue arrival, the Police arrival, if an External Adjuster is needed, when or if the Coroner is needed, when the tower is needed and the estimated time of arrival, and the damages to the truck or trailer
- Responsible for inbound Workers compensation calls when the drivers are injured after hours, as well as the coordination of emergency care when needed and notify the next of kin
- Cargo calls when there are overages, shortages, or damages to the cargo as per the customers
- Responsible for assisting drivers when they would run out of driving hours, and if needed, assist to find a safe haven
- Coordination of the mandated DOT regulated Drug/Alcohol tests when serious accidents occur and drivers are cited at the scene.
Experienced Driver Recruiter
US XPRESS, INC
12.2013 - 09.2014
- Responsible for recruiting experienced drivers with a Class A CDL license, worked with the drivers to ensure 100 % accuracy on their applications, pre-qualify based on DOT requirements and company standards, schedule orientations, work with background to verify employment
- Responsible for DAC and MVR reporting for each driver
- Inbound calls from drivers looking for OTR and dedicated accounts, based on driver need.
Outbound Insurance Team Lead
HomeServe USA
07.2011 - 10.2012
- Responsible for assisting in the creation of sales goals, attendance goals, coaching’s, side by sides, daily/weekly/monthly reporting
- Proficiency in Microsoft Word, CTIOS, Ensura maintenance
- Responsible for the proofing and maintenance of scripting for separate campaigns, creating and administering training for new partners and campaigns for the team
- Selected to train and educate the Inbound Insurance teams, both Miami and Chattanooga, to take Outbound calls on a need basis
- Responsible for the floor support and continued education of the Inbound teams while taking Outbound Sales calls
- Managing of a 24-28 person team on a daily basis
- Awarded the Support Employee of the Month for August 2011.
Outbound Sales Representative
HomeServe USA
01.2011 - 07.2011
- Call Center environment, responsible for sales goals, maintaining attendance to make any sales goals given
- Held Top Seller for Outbound Department for both the months of April 2011 and May 2011
- Awarded Stack Ranking for the month of April 2011 as well
- Tested and completed the Property and Casualty licensure for the Outbound team
- Was first Outbound Sales representative to successfully become an Outbound Property and Casualty Insurance Representative.
Customer Service Representative
T-Mobile
05.2007 - 01.2011
- Call Center Environment, responsible for commitment to schedule, call resolution time, timely resolution, knowledge, technical troubleshooting for devices, customer service, sales, returns, exchanges, advanced billing, T-Mobile @home service specialist, Business Care specialist, meeting and exceeding monthly goals
- Ranked within the top 100 representatives in call center, Ranked within the top 20 representatives for CRT, Nominated for PEAK achievement in 2008.
Education
Bachelor of Arts - History
University of Tennessee At Chattanooga
Chattanooga, TN12.2008
Skills
- Staff Supervision
- Financial Management
- Business Administration
- Administrative Leadership
- Project Management
- Contract Management
Certification
Currently licensed in Tennessee for Property, Casualty, Life, Accident, and Health.
Organizations
2003, Current, Alpha Xi Delta, Volunteering with Girls Inc.
Timeline
Northwest Regional Coordinator
OrthoFi
09.2021 - Current
Practice Advocate
OrthoFi
06.2021 - 09.2021
Escalation Supervisor
Cigna
04.2020 - 05.2021
Customer Service Advocate/Dedicated Ancillary Team
Cigna
09.2018 - 04.2020
Claims Coordinator
US XPRESS, INC
09.2014 - 04.2017
Experienced Driver Recruiter
US XPRESS, INC
12.2013 - 09.2014
Outbound Insurance Team Lead
HomeServe USA
07.2011 - 10.2012
Outbound Sales Representative
HomeServe USA
01.2011 - 07.2011
Customer Service Representative
T-Mobile
05.2007 - 01.2011
Bachelor of Arts - History
University of Tennessee At Chattanooga
Similar Profiles
Sheila CamaraSheila Camara
Claims Coordinator – Remittance at OrthoFiClaims Coordinator – Remittance at OrthoFi
Jennifer RummellJennifer Rummell
Claims Coordinator 2 at OrthoFiClaims Coordinator 2 at OrthoFi
Kimberlee MulkayKimberlee Mulkay
Customer Success Manager / Previous Sales Rep at OrthoFiCustomer Success Manager / Previous Sales Rep at OrthoFi
Abbie MadewellAbbie Madewell
Tour Guide at Ruby FallsTour Guide at Ruby Falls
Courtney DouglassCourtney Douglass
Food Delivery Driver at Self-employed Via Door Dash and Uber EatsFood Delivery Driver at Self-employed Via Door Dash and Uber Eats