Stephanie Bluhm
Summary
Highly motivated professional with great customer service skills, phlebotomist training, and an in-depth knowledge of health insurance. Bachelor's Degree in Kinesiology, minor in Psychology from Western Washington University. Experienced in communications, decision making, leadership and working with others.
Overview
10
10
years of professional experience
1
1
Certification
Work History
Appeals Specialist II
PREMERA BLUE CROSS OF WASHINGTON
10.2017 - 03.2024
- Reviewed and investigated member-submitted appeals related to adverse determinations made by Premera Blue Cross
- Determined if exceptions should be made to allow members' requests, or if an internal process must be corrected
- Prevented influxes in appeals by alerting internal departments to correct errors that have triggered member appeals
- Educated members in detail when original denials or adverse determinations were correct and answered additional questions via phone or email
- Knowledgeable in health insurance processes
- Innovated new procedures to improve productivity
- Communicated relevant case information to leadership to improve planning for caseloads
Customer Service Representative
PREMERA BLUE CROSS OF WASHINGTON
10.2017 - 12.2019
- Clarified matters of eligibility, claims, and benefits to both members and providers by researching various resources
- Relayed information to members in laymen's terms and provided further detailed information when needed
- Identified and corrected misinformation by collaborating with the appropriate department
- Maintained professional tone when communicating with members
- Prioritized listening to members' concerns during calls to efficiently assist in matters of benefits
- Monitored and followed-up on complex cases that could not be resolved during the initial phone call.
Lead Aquatics Concierge
PRO SPORTS CLUB
07.2016 - 10.2017
- Increased customer satisfaction when pairing clients with compatible instructors, thereby, boosting The ProClub Aquatics Department's revenue by 1% each month from March 2017 to August 2017
- Resolved conflicts with members by taking ownership of the situation, problem-solving, as well as following up with clients
- Assisted management by editing and reformatting our Staff Manual to clearly convey information to employees.
Aquatics Fitness Instructor
PRO SPORTS CLUB
09.2014 - 10.2017
- Provided triathletes in the Bel-Red area with training; consisting of challenging workouts and technique-focused drills
- Identified and assessed clients' abilities in order to provide effective, challenging lessons.
Personal Trainer
PRO SPORTS CLUB
08.2014 - 10.2015
- Created fitness programs tailored to each client based on their goals and abilities
- Methodically recorded body metrics and strength improvements to track clients' progress.
Education
Kinesiology, B.S. -
Western Washington University
06.2014
High School Diploma -
Auburn Mountainview High School
Auburn, WA06.2009
Skills
- PATIENT-ORIENTED
- COMMUNICATION
- COMPUTER SKILLS
Treats all patients with dignity, respect, and empathy
Proficient in clearly communicating complex health insurance information via email and phone calls Promptly alerting teammates and leadership after identifying trends related to appeals
Proficient with Microsoft Office Suite, including Word and Outlook, as well as Adobe Acrobat Utilizes Tableau to monitor caseloads
- LEADERSHIP
- TEAM WORK
- WORK ETHIC
Team Captain for the WWU Women's' Rowing Team, leading the team 11th consecutive appearance at the NCAA Nationals
Collaborated with multiple departments to identify and improve processes related to health insurance
Consistently exceeded workplace expectations and quotas Corrected internal issues to leaderships attention, which resulted in improved member experience
Trained Applications
- Microsoft Word
- Adobe Acrobat
- Tableau
- Excel
Accomplishments
- Awarded “All-American” by a council of D2 coach for women's rowing
- Two-time NCAA Rowing Champion
Certification
- Phlebotomy Technician Certification from the National Certification Organization (NHCO)
- Pending Medical Assistant-Phlebotomy Certification (MA-P) with the Washington State Department of Health
Timeline
Appeals Specialist II
PREMERA BLUE CROSS OF WASHINGTON
10.2017 - 03.2024
Customer Service Representative
PREMERA BLUE CROSS OF WASHINGTON
10.2017 - 12.2019
Lead Aquatics Concierge
PRO SPORTS CLUB
07.2016 - 10.2017
Aquatics Fitness Instructor
PRO SPORTS CLUB
09.2014 - 10.2017
Personal Trainer
PRO SPORTS CLUB
08.2014 - 10.2015
Kinesiology, B.S. -
Western Washington University
High School Diploma -
Auburn Mountainview High School