Summary
Overview
Work History
Skills
Awards
Timeline
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VIRGINIA JORDAN

Dryden,NY

Summary

Dedicated, personable, and professional business professional with a proven track record of success. Skilled in building strong relationships and maintaining diplomacy with peers and professionals across all levels. Adaptable and flexible, able to handle pressure with a sense of humor. Exceptional organizational, interpersonal communication, problem-solving, and team-building abilities. Self-motivated and capable of independently taking tasks from initiation to completion with precision.

Overview

24
24
years of professional experience

Work History

CUSTOMER SERVICE ADVOCATE

United Healthcare
11.2023 - Current
  • Provide excellent customer experience by quickly and accurately identifying and accessing individual customer needs and taking appropriate action steps to satisfy those needs; inquiries may include:
  • Manage incoming calls and chat inquiries for UHC Rewards Program
  • Identify and communicate technical troubleshooting steps for activity trackers in UHC App and on myuhc.com website
  • Answer questions on program earnings and points
  • Educate customers about program benefits and changes
  • Respond to customers in compassionate, polite, and courteous manner, especially in stressful situations when there is need to communicate information that members may not want to hear
  • Assist customers in navigating and other activity tracker apps
  • Consistently meet established productivity, schedule adherence, and quality standards
  • Promote superior experience by addressing customer concerns, demonstrating empathy, and resolving problems swiftly.
  • Deliver exceptional customer service to every customer by leveraging extensive knowledge of products and services and creating welcoming, positive experiences.
  • Enhance customer satisfaction by promptly addressing and resolving inquiries and issues.

STRATEGIC RELATIONSHIP MANAGER

Thee Amish Structures
03.2011 - 11.2023
  • Managed and operated local, family owned shed and outdoor structure business
  • Maintained focus on relationships with current and new customers by offering multiple forms of communication and providing unmatched customer service and products
  • Controlled costs to keep business operating within budget and increase profits.
  • Responsible for all fiscal aspects of business including accounts payables and receivables, inventory management, monthly and year-end closings
  • Responded to customer inquiries and resolved complaints to establish trust and increased satisfaction.
  • Achieved high levels of client satisfaction through meticulous attention to client needs and preferences.
  • Built and maintained relationships with new and existing clients while providing high level of expertise.
  • Provided exceptional customer service, resolving issues promptly and maintaining client trust throughout resolution process.

MEMBERSHIP CUSTOMER SERVICE REPRESENTATIVE

Group Health Inc. (GHI/Emblem Health)
04.2005 - 10.2008
  • Managed membership inquiries surrounding payment of claims, in-network providers, membership status, and other general questions for plans under various GHI offered benefits plans (Medical, dental, hospital, and supplemental)
  • Met and exceeded daily and monthly KPI driven goals surrounding quality of service and productivity
  • Continued learning of HIPAA compliance, Medical Terminology, ICD9 and CPT4 coding
  • Delivered exceptional customer service to every member by leveraging extensive knowledge of products and services and creating welcoming, positive experiences.
  • Investigated and resolved member inquiries and complaints quickly.
  • Managed high volume of calls daily, maintaining composure under pressure while providing exceptional service.
  • Demonstrated excellent multitasking abilities by simultaneously handling multiple tasks such as navigating systems, taking notes on calls, and answering inquiries from members.
  • Adhered to company policies and scripts to consistently achieve call-time and quality standards.
  • Consistently met or exceeded performance goals, contributing to overall success of the call center.

WORKERS' COMPENSATION MEDICAL BILLING SPECIALIST

The Hartford
10.2000 - 04.2005
  • Audited medical invoices to determine reimbursement based on Workers' Comp status and regulations
  • Analyze bills for proper assignment of detailed medical coding
  • Investigate and resolve any claim or billings issues
  • Assist claim handlers, providers, and claimants with new and on-going claims
  • Assisted with the creation of the Med Bill Processing Center Mentoring Program and helped train new team members
  • Continued learning of HIPAA compliance, Medical Terminology, ICD9 and CPT4 coding
  • Team Lead responsibilities when needed
  • Researched CPT and ICD-9 coding discrepancies for compliance and reimbursement accuracy.
  • Communicated effectively and extensively with other departments to resolve claims issues.
  • Precisely completed appropriate claims paperwork, documentation and system entry.

Skills

  • Customer Service
  • Data Entry
  • Medical Claims
  • Medical Coding
  • Medical Billing
  • HIPAA Compliance
  • Medical Terminology
  • Training
  • Management
  • Call center experience
  • Administrative support
  • Live chat support
  • Staff education and training

Awards

New York State Entrepreneur Recognition Award 2015.

This award was in recognition of my leadership in enhancing my local community's economy and demonstrating that self-employment is a viable option for individuals with disabilities.

The award was one of 6 given in the state and only one of 2 given in the Southern Tier of New York State.

Timeline

CUSTOMER SERVICE ADVOCATE

United Healthcare
11.2023 - Current

STRATEGIC RELATIONSHIP MANAGER

Thee Amish Structures
03.2011 - 11.2023

MEMBERSHIP CUSTOMER SERVICE REPRESENTATIVE

Group Health Inc. (GHI/Emblem Health)
04.2005 - 10.2008

WORKERS' COMPENSATION MEDICAL BILLING SPECIALIST

The Hartford
10.2000 - 04.2005

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VIRGINIA JORDAN