Verlene Broadnax

Responsible for customer interactions directly by assisting participants, beneficiaries, and agents via phone and email with a focus on empathy, active listening, and urgent one call resolution. Handled inquiries regarding retirement benefits, loan balances, and assisted with demographic changes. Identify client needs, clarify information, while performing verification process for each caller.

Provided operational support by submitting transactional service requests, research issues, and coordinate with support functions to ensure timely resolution for the client.

Manage inbound calls for assistance involving web or technical support with individual accounts. Collaborate with stakeholders to improve the customers experience. Managed incoming high volume calls while maintaining service and quality goals.

• Manage high volume inbound calls by answering member/provider inquiries with prompt, courteous, and accurate responses.
• Address concerns regarding billing, or claims by extensive research through available resources to provide a timely follow up.
• Identify, and expedite priority issues to the appropriate authority. Effectively communicate benefits to members/providers.
• Utilize multiple systems to navigate, and process member or provider requests in a timely fashion. Follow up with customers by documenting all information according to standard operating procedures.
• Increase efficiency within the department with one call resolution.
• Maintain HIPAA confidentiality guidelines of all information sources.
• Assist in training/shadowing of new employees. Consistently surpass the accuracy and productivity goals of the organization.
• Utilization Management Review

• Respond to telephone or written inquiries from members/providers and internal departments.
• Administer post service claims work by processing requests for review. Initiate cases for prior authorization review.
• Verify benefit eligibility for facility based treatment.
• Assigns authorization for inpatient admission, outpatient precertification, and prior authorization for post service requests.
• Conducts thorough research, and follow up utilizing analytical tools.
• Refers cases requiring clinical review to the nurse case manager.
• Serve as a liaison between medical management, and internal departments.
• Develops and maintains positive customer relations, and coordinates with various functions within the company to ensure customer requests, and questions are handled appropriately and in a timely manner.

• Managed high volume inbound calls. Responded to patient inquiries regarding hospital billing, payments, and discrepancies.
• Monitored past due accounts to set up payment arrangements, or determine eligibility for financial assistance.
• Processed payments. Verified and updated demographic information.
• Reconciled adjustments for overpayments, or billing errors, while making necessary corrections.
• Assisted insurance agents with research, and follow up. Provided thorough documentation on all accounts.
• Prepared outgoing correspondence. Assisted with shadowing trainees.
• Developed and maintained positive customer relations and coordinated with various functions within the company to ensure customer requests or questions were handled appropriately, and in a timely manner.

• Handled high volume of incoming calls regarding billing, equipment, or service issues.
• Analyzed billing for services, and fees through utilizing navigation tools.
• Performed technical troubleshooting of customer equipment, while educating customer on services.
• Supported technicians or salespersons by scheduling service calls and installations while maintaining work orders.
• Applied retention skills by introducing new products and services.
• Processed payments. Addressed, and resolved complaints.
• Clearly communicated product features and benefits, helping customers make informed decisions about their purchases.
• Utilized strong problem-solving skills to quickly identify and address customer issues.

• Provided support to the CEO by conducting all administrative functions for the Academy, and Church.
• Served as the primary point of contact regarding all services.
• Developed enrichment programs for children, and adults.
• Created a school curriculum for low income, and at risk children, allowing students to average 2 grades above their grade level.
• Established operational procedures for staff/facilities.
• Managed federal, and state funding by reconciliation of all financials.
• Furnished quarterly and year end financials while undertaking program focused budgets.
• Negotiated acquisitions for supplies, equipment, and vendors.
• Operated as a consultant for faith-based schools in Indianapolis, by streamlining business processes for building a private educational institution.

• Handled high volume incoming calls regarding new service, equipment issues, and contract disputes, ensuring timely resolutions.
• Answered inquiries with demonstrated knowledge of office products and services.
• Coordinated with field techs and sales department on overdue accounts to facilitate prompt follow-up and resolution.
• Ensured smooth operations by streamlining processes and workflows.