Highly communicative individual identifies issues and make the best decisions regarding course of treatment. Disciplined with expertise in data confidentiality and client education and promoting experience working with culturally diverse families.
Overview
12
years of professional experience
1
Certification
Work History
BMI Federal Credit Union
Member Service Specialist
06.2022 - Current
Job overview
Responded to over 80 customer calls and emails per day to answer questions about products and services.
Investigated and resolved account issues by offering applicable options to customers.
Reviewed reports and individual transactions which appeared suspicious to uncover possible fraudulent activity.
United Healthcare
Insurance Agent
01.2021 - 06.2022
Job overview
Maintained high standards of customer service by building relationships with clients.
Reported policy changes and company conditions affecting customer satisfaction.
Tracked progress of all outstanding insurance claims.
Calculated quotes and educated potential clients on insurance options.
Scanned, received and sent faxes to appropriate departments, including insurance claims, co-pay assistance information and patient documentation.
Verified insurance coverage by telephone and online to guarantee proper reimbursement of benefits and estimate patients' financial responsibilities.
USI Affinity
Insurance Coordinator
11.2014 - 08.2016
Job overview
Filed and tracked insurance claims and communicated claims status to patients.
Prepared insurance claims for submission to clearinghouses or insurance companies.
Reviewed accounts receivable reports, insurance contracts and weekly and monthly financial reports.
Posted payments to accounts and maintained records.
Observed strict procedures to protect sensitive patient information, including medical records and payment data.
Teleperformance
Fulfillment Specialist
11.2012 - 07.2014
Job overview
Helped employees with day-to-day work and complex problems by applying motivational and analytical strategies.
Trained team members on performance metrics and consumer behavior identification.
Read, analyzed and interpreted complex procedures and regulations while drafting general correspondence to facilitate administrative processes.
Resolved associate, tool and service delivery issues revealed by statistical reports.
Job And Family Services
Case Worker
01.2012 - 01.2013
Job overview
Worked with clients to improve life choices and maximize benefits of programs.
Explained medical care options to help families make informed healthcare decisions.
Interviewed clients, families or groups to assess situations, limitations and issues and implement services to address needs.
Conducted interviews with participants to assess eligibility.
Education
Franklin University
Columbus, OH
Bachelor of Science from Criminal Justice Administration
04.2023
University Overview
Cum Laude
Columbus State Community College
Columbus, OH
Associate of Science from Criminal Justice Adult Supervision
08.2021
University Overview
Dean's List 2021
Summa Cum Laude
Skills
Policy Feature Explanations
Insurance Coverage Verification
Records Maintenance
Client Interviews
Critical Thinking
Administrative Functions
Verbal and Written Communication
Time Management
HIPAA Compliance
Fraud and Anomaly Analysis
Dispute Resolution
Risk Level Determination
Certification
Licensed Life and Health Insurance
Licensed Property and Casualty
Emergency Management Institute: F.E.M.A Effective Communication
Availability
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Available
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friday
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Timeline
Member Service Specialist
BMI Federal Credit Union
06.2022 - Current
Insurance Agent
United Healthcare
01.2021 - 06.2022
Insurance Coordinator
USI Affinity
11.2014 - 08.2016
Fulfillment Specialist
Teleperformance
11.2012 - 07.2014
Case Worker
Job And Family Services
01.2012 - 01.2013
Franklin University
Bachelor of Science from Criminal Justice Administration
Columbus State Community College
Associate of Science from Criminal Justice Adult Supervision