Starr Thomas Young
Customer Service Representative
Chesapeake,VA
Summary
Ambitious Collections Representative with more than 5 years of experience in debt collection and collections processing. Successful in following up on past due accounts and recouping unpaid balances. Outstanding negotiator skillful in creating manageable repayment plans to reduce debt.
Overview
4
4
years of professional experience
2
2
years of post-secondary education
Work History
Group Rater
Guidewell Florida Blue
Jacksonville, FL
09.2017 - 05.2018
- Generate new large group proposals and renewal alternates for the state within allocated timeframes
- Provides support to large group sales' setup unit with administrative activities related to retention of group business for all product lines
- Manages daily inventory submitted to the Large Group Rating Mailbox
- Send generated proposals to internal and external sales partners via email
- Moderate to heavy keying required.
Customer Service Representative
Guidewell Florida Blue
Jacksonville, FL
09.2016 - 05.2017
- Excellent interpersonal and teamwork skills, Responsible for applying business rules for verification of Group coverage and member enrollment to include automated enrollment, Blues Enroll, and paper enrollment to ensure
- Ability to process manual reconciliation spreadsheet(s) and Automated Enrollment files to ensure accuracy prior to submission to the system
- Creates invoices, posting for manual adjustments, and reconciling premium income, totaling $482M monthly (averages $4M/$5M monthly per Service Advocate) in order to minimize financial risk for the organization
- May force balance accounts when systems are not able to provide correct amounts, generating refunds and/or collections to Group Administrators and transferring money from group divisions for reconciliation
- Serves as a contact for internal and external customers to resolve enrollment, membership and billing issues across multiple products and systems, including all health products
- Oversees the planning, execution, and prioritization of their assigned book of business (300-400 groups per Service Advocate)
Customer Service Representative
Aetna
Jacksonville, FL
09.2014 - 09.2016
- Answers questions and resolves issues based on phone calls/letters from members, providers, and plan sponsors
- Processes claim referrals, new claim handoffs, nurse reviews, complaints (member/provider), grievance and appeals (member/provider) via target system
- Educates providers on our self-service options; Assists providers with credentialing and re- credentialing issues
- Assists in compiling claim data for customer audits.
- Determines medical necessity, applicable coverage provisions and verifies member plan eligibility relating to incoming correspondence and internal referrals
- Handles incoming requests for appeals and pre-authorizations not handled by Clinical Claim management.
- Performs review of member claim history to ensure accurate tracking of benefit maximums and/or coinsurance/deductible
- Uses applicable system tools and resources to produce quality letters and spreadsheets in response to inquiries received.
Education
Master - Arts of Teaching
Liberty University Online
Lynchburg, VA 08.2021 - Current
Bachelor of Arts - Interdisciplinary Studies
Liberty University
Lynchburg, VA 01.2018 - 05.2020
Skills
Adaptability
Report preparation
Service recommendations
Documentation and reporting
Written and oral communication
Call center operations
Timeline
Master - Arts of Teaching
Liberty University Online
08.2021 - Current
Bachelor of Arts - Interdisciplinary Studies
Liberty University
01.2018 - 05.2020
Group Rater
Guidewell Florida Blue
09.2017 - 05.2018
Customer Service Representative
Guidewell Florida Blue
09.2016 - 05.2017
Customer Service Representative
Aetna
09.2014 - 09.2016