Wakeelah Holly
Cedar Hill,TX
Overview
11
11
years of professional experience
Work History
Advocate4Me Representative
United Healthcare, Inc
01.2022 - Current
- Answers inbound calls from United Healthcare members regarding their health insurance benefits, eligibility, claims, and other related inquiries.
- Explaining complex healthcare concepts, outlining plan options, and assisting customers in selecting appropriate care providers.
- Resolving issues investigating and addressing customer concerns related to billing errors, claim denials, benefit verification, and provider access.
- Accessing and utilizing multiple computer applications to retrieve customer information, verify eligibility, and process requests.
- Educating customers on their health plan features, utilization management tools, and how to maximize their benefits.
- Documenting customer interactions, updating account information, and ensuring data integrity within the system.
- Maintaining high standards of customer service by providing timely responses, actively listening to customer needs, and resolving issues efficiently.
Post Closing Shipping Specialist
Fairway Independent Mortgage Company
01.2021 - 01.2022
- Reviewed closed loan packages in accordance with the most recent Post Closing Checklist.
- Audited files for compliance with TILA-RESPA Integrated Disclosures.
- Audited all loan types (Conventional, FHA, USDA and VA) files for compliance with TILA-RESPA and Integrated Disclosures. Audited included but not limited to the following, loan information, loan amount, flood determination, hazard policy declaration page and escrow.
- Insured loans through online government insuring systems.
Customer Service Representative
WebTPA
01.2021 - 12.2021
- Utilized resources to assist customers in understanding components of their benefits including claims, accumulator usage and balances, and cost sharing.
- Educated members by delivering individualized programs based upon member's unique needs and preferences to help guide the members to a clear path to care.
- Handled customer service inquiries via telephone.
- Followed established company policies and procedures to ensure compliance with healthcare regulations.
Healthcare Concierge
Aetna
01.2018 - 12.2021
- Received Outbound/Inbound Calls-calls from members Aetna members.
- Utilized resources to assist customers in understanding components of the Aetna products including claims, accumulator usage/balances and cost sharing.
- Educated members by delivering individualized programs based upon preferences to help guide members along a clear path to care.
- Advised members of their copay, deductibles, out of pocket maximum, and yearly benefits plans.
- Coordinated efforts both internally, externally and across departments to successfully resolve service issues.
- Followed established company policies and procedures to ensure compliance with healthcare regulations.
Collector II
J.P. Morgan Chase
01.2018 - 12.2018
- Collected on past due mortgage accounts.
- Clearly and accurately explained all aspects of ARMS, Escrows, Escrow Analysis, Loan histories, payoffs and prepayment premiums.
- Accepted and processed transactions via PayConnexion(pay by phone).
- Handled moderately difficult skip trace assignments and appropriate solutions.
- Processed returned mail and quality check mailing address changes.
Customer Service Advocate
Humana
01.2015 - 12.2018
- Answered outbound/Inbound calls from Human members regarding their pharmacy benefits.
- Assisted members with placing medication orders, verifying prescription details, and coordinating with pharmacies to ensure timely delivery.
- Advised members of their copay, deductibles, out of pocket maximum, and yearly benefits plans.
- Investigated and resolved customer complaints or issues related to prescription orders, billing discrepancies, or medication access.
- Followed all HIPAA regulations and company policies regarding patient privacy and data security.
Timeline
Advocate4Me Representative
United Healthcare, Inc
01.2022 - Current
Post Closing Shipping Specialist
Fairway Independent Mortgage Company
01.2021 - 01.2022
Customer Service Representative
WebTPA
01.2021 - 12.2021
Healthcare Concierge
Aetna
01.2018 - 12.2021
Collector II
J.P. Morgan Chase
01.2018 - 12.2018
Customer Service Advocate
Humana
01.2015 - 12.2018