TaChara Rogers
Snellville,GA
Summary
Detailed oriented client focused critical thinker with over 16 years of providing excellent client management within the Healthcare Insurance field providing risk adjustment and quality. Fostering positive relationships with internal and external clients by building meaningful relationships, commitment to team, individual goals. Analyzing risk, troubleshooting problems, maintaining member relations, retention of client accounts, conflict resolution. Documenting data into client’s account of outcome of inquiries. Identifying risk for improvement within client accounts and implementing change to improve the process while maintaining client relations across departments. Ability to handle a high volume of inbound and outbound calls. Speak clearly and persuasively in both positive and negative situations. Resolving escalations, client concerns for both internal and external clients while building and maintaining a trusting relationship. Strong collaborator and individual worker. Compliant with HIPAA and all government regulations.
Overview
16
16
years of professional experience
Work History
Individual Client Account Specialist II
Humana, Inc.
02.2011 - 05.2023
- Critical Inquiry team member resolving escalation DOI complaints, Risk adjustment, point of contact for review/research/respond adhering to deadlines
- Manage projects through life cycle while communicating updates to management
- Process monthly bill cycles
- Collect and analyze data of required documentation to ensure contract and payment information is accurate
- Run reports
- Audit client billing accounts, assess accounts for risk and make necessary adjustments
- Streamline client resolution response
- Utilize cross functional teams to resolve issues
- Setup ACH and credit card bill cycles and process payments
- Generate invoices, create monthly audits
- Implement new training to internal clients of new system functionality and processes as well as external clients of system functionality
- Coordinate meetings with different departments to ensure expectations and business objectives will be met
- Special projects include data mapping, survey review collection of data year over year analysis.
- Provided customer service to clients and responded to inquiries promptly.
- Monitored changes in client accounts and updated records accordingly.
- Prepared reports on account activity and performance metrics for management review.
- Generated invoices for clients and tracked payments against outstanding balances.
- Managed the renewal process of existing client contracts, negotiating terms as necessary.
- Ensured compliance with company policies and procedures regarding client accounts.
- Maintained accurate records of all interactions with clients in the CRM system.
Group Account Specialist
Humana, Inc.
06.2007 - 02.2011
- Receive, balance, and post premium payments for companies dental and vision insurance plan
- Manage Group Enrollment and Terminations
- Build and maintain relationships with benefit coordinators
- Account Management of over 100 Groups
- Audit Group Accounts
- Reconciliation of Group payments
- Resolve premium discrepancies before posting payments
- Identify requirements and resources
- Responsible for maintaining all cash current within a 30-day Period and post for month end.
- Received, prioritized and responded to multiple points of customer communication.
- Established customer rapport to quickly mitigate problems while complying with established support processes and procedures.
- Handled spirited customer conversations and alleviated disputes using appropriate communication skills and conflict resolution techniques.
- Established accounts for new customers and updated existing accounts with current demographic and order information.
- Recommended and implemented solutions based on issue analysis and business implications.
- Reviewed financial status and evaluated discrepancies by assessing account information and activities.
Education
Edward Shands High School
Skills
- Critical thinker, Excellent communication skills both verbal and written, Customer focused, Attention to detail, Conflict resolution, Client retention, Effective time management, Multitask
- Microsoft Outlook, Excel, Microsoft Word, UMB, Paypal, AS400 , SalesForce, Data Entry, CRM
- Customer Engagement
- Billing Resolutions
Timeline
Individual Client Account Specialist II
Humana, Inc.
02.2011 - 05.2023
Group Account Specialist
Humana, Inc.
06.2007 - 02.2011
Edward Shands High School
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