Shawn Singh

-Adhered to compliance guidelines set by United Healthcare and CMS by identifying dissatisfaction by clients against providers, vendors, and their Insurance plan.

-Multitask with proficiency in operating CSP Facets, Maestro, ICUE, DMEVS, ETS, GPS, Genesys, One Note Microsoft Outlook, Microsoft Teams, Microsoft Excel, Microsoft Power Point, and Microsoft Word.

-Expert liaison between providers and patients in regards to claims, appeals, prior authorizations, appointments, and verifying network status.

- Experience with researching provider credentials and contract effective dates to remediate failure in identifying network status.

-Completed task/projects delegated by leadership to ensure client satisfaction with new healthcare plan modifications.

-Direct Advocate for member's with United Healthcare Medicare Advantage plans(Dual Complete) and Medicaid

• Responded to customer requests for Medicare products, services, and carrier information.
• Enrolled candidates into Medicare Advantage policies(MA and MAPD), stand alone prescription drug plans(PDP), Medicare Supplement, and ancillary policies.
• Part of a call center environment with a team of 100 or more customer service representatives.
• Licensed to sale Medicare policies in 24 states for Wellcare, Humana, United Healthcare, Anthem, Aetna. Mutual of Omaha, and Surebridge.
• Adhered to and remained in compliance to CMS guidelines while monitoring inbound and outbound call metrics.
• Directed policy holders to respective carrier and promoted sales for Wellcare, Humana, United Healthcare, Anthem, Aetna. Mutual of Omaha, and Surebridge.
• Proficient with MARx CMS Enterprise Portal, Delta Dialer, Humanify, Visa Pas, Salesforce, Tableau, Microsoft Excel, Powerpoint, Microsoft Teams, Zoom, Pidgeon, Outlook,

• Scheduled skilled nursing visits to customer locations .
• Coordinated possible payment options for patients with financial and insurance complications.
• Answer inbound calls and transferred caller to designated department.
• Coordinated with senior management and developed requested areas of care from patients such as wound and mental care,occupational, speech, and physical therapy.
• Resolved conflicts between patient and nurse or caretaker.
• Followed up with patient after skilled nurse visit and conduct patient surveys.
• Proficient with Allegheny, Citrix, EPIC, Kinnser, Microsoft Powerpoint, and Excel.