Robin Kilmurray
Iola,KS
Summary
Dedicated Sr Enrollment Representative with a proven track record in client relationship building and effective communication. Expertise in navigating complex eligibility requirements and providing exceptional customer service.
Overview
15
15
years of professional experience
Work History
Sr Enrollment/Eligibility Representative
United Healthcare
06.2011 - Current
- Assisted clients in understanding eligibility requirements for various programs
- Processed applications and verified documentation for accuracy and completeness
- Supported team in maintaining updated knowledge of program regulations and policies
- Communicated effectively with clients to resolve inquiries and provide guidance
- Participated in training sessions to enhance understanding of eligibility criteria
- Assisted clients with navigating complex eligibility requirements, ensuring accurate submissions.
- Ensured timely resolution of discrepancies by conducting thorough research and documentation.
- Effectively managed competing priorities while maintaining a focus on providing exceptional customer service.
- Trained new Eligibility Representatives on best practices, contributing to overall team efficiency and success.
- Provided knowledgeable guidance to clients regarding program rules, regulations, and updates.
- Utilized data-driven decision-making strategies to make informed recommendations on complex cases.
- Managed high-volume caseloads while maintaining strict adherence to privacy regulations and confidentiality protocols.
- Enhanced client satisfaction by efficiently processing eligibility applications and addressing inquiries.
- Reduced errors in eligibility determinations through meticulous attention to detail and rigorous quality control measures.
- Balanced responsibilities as an Eligibility Representative with ongoing education pursuits or additional roles within the organization, demonstrating strong time management skills and dedication to continued professional growth.
- Developed strong relationships with clients, fostering trust and confidence in the organization''s services.
- Resolved discrepancies with client applications to verify eligibility.
- Assisted clients with accurate eligibility form, application and document completion.
- Trained staff on current eligibility requirements and policies.
- Completed benefit investigations.
- Handling escalations from doctor's offices and from patients.
- Explaining medical billing processes to patients and internal agents.
- Analyzing claims and explaining the breakdowns to patients and agents.
- One year in specialty pharmacy patient care coordinator
- One year in billing
- 12 years in medical billing
Education
No Degree - Business
University of St Mary
Leavenworth, KSSkills
- Client relationship building
- Healthcare industry
- Policy interpretation
- Confidentiality
- Effective communication skills
- Documentation and paperwork
- Verbal communication
- Microsoft office
- Data entry
- Documentation and reporting
- Telephone etiquette
- Benefits administration
- Eligibility procedures
- Customer service
- Teamwork and collaboration
- Problem-solving
- Time management
- Attention to detail
- Problem-solving abilities
- Multitasking
- Excellent communication
- Critical thinking
- Flexibility
- Active listening
- Effective communication
- Adaptability and flexibility
- Decision-making
- Conflict resolution
- Professionalism
- Training skills
Timeline
Sr Enrollment/Eligibility Representative
United Healthcare
06.2011 - Current
No Degree - Business
University of St Mary