Wilmoshia Opare-addo
Hermitage,TN
Summary
Hardworking and passionate individual with strong organizational skills eager to secure a full time position in the healthcare administration industry and continue to make an impact on members and providers. Tech-savvy and smart professional equipped with experience in medical environments and top-notch administrative skills. Works great with colleagues and maintains strong patient relations. Excels at following procedures and independently handling common questions and concerns.
Overview
9
9
years of professional experience
Work History
Referral Specialist
myNEXUS/Anthem
06.2021 - 03.2024
- Reviewed insurance claim forms or related documents regarding home health authorizations from members and providers
- Provided excellent customer care by responding to requests, assisting with claim approvals
- Explained the referral process to members and providers and assisted with portal support access and updates
- Cross-trained in PDS process; able to assist with home health authorization denials after reviewed by clinical nurses
- Managed account data and verified information with clients and providers
- Utilized various healthcare IT systems to schedule appointments and communicate with medical professionals and patients.
Insurance Services Administrator
DXC Technologies
01.2020 - 06.2021
- Directed incoming calls to internal personnel and departments, routing to best-qualified department
- Shared knowledge and expertise with co-workers to foster awareness and increase staff productivity
- Reviewed and adjusted customer coverage levels to address, identify and resolve customer conflicts
- Maintained strong knowledge of basic medical terminology to better understand services and procedures
- Posted payments to accounts and maintained records
Service Advisor
AppleOne
10.2018 - 01.2020
- Handled customer issues with confidence, using complex problem solving to provide effective resolution
- Pleasantly greeted customers and asked open-ended questions to better determine needs
- Documented problems and corrective actions to maintain records
- Maintained high customer satisfaction standards to meet or exceed targets
- Cross-trained and provided backup support for organizational leadership
Customer Service Representative
CVS Caremark
10.2016 - 08.2018
- Provided primary customer support to internal and external customers
- Responded to customer requests for products, services and company information
- Clarified customer issues and determined root cause of problems to resolve product or service complaints
- Recommended products to customers, thoroughly explaining details
- Maintained clean and orderly checkout areas by mopping floors, emptying trash cans and wiping down surfaces
Customer Service Representative
CSI Companies
03.2016 - 09.2016
- Communicated professionally with colleagues, freelancers and clients
- Promptly responded to inquiries and requests from higher management
- Collaborated with staff members to enhance customer service experience and exceed team goals through effective client satisfaction rates
- Maintained up-to-date knowledge of product and service changes
Customer Service Representative
WellCare Insurance
09.2015 - 02.2016
- Responded proactively and positively to rapid change
- Provided excellent customer care by responding to requests, assisting with product selection and handling ordering functions
- Educated customers about billing, payment processing and support policies and procedures
- Followed up with customers about resolved issues to maintain high standards of customer service
Education
Healthcare Management - Healthcare Management
04-2022
Skills
- Innovative
- Organization
- Microsoft Office Tools
- Collaborative
- Customer Service
- Adaptable
- Punctual
- Leadership & management
- Interpersonal & communication
Timeline
Referral Specialist - myNEXUS/Anthem
06.2021 - 03.2024
Insurance Services Administrator - DXC Technologies
01.2020 - 06.2021
Service Advisor - AppleOne
10.2018 - 01.2020
Customer Service Representative - CVS Caremark
10.2016 - 08.2018
Customer Service Representative - CSI Companies
03.2016 - 09.2016
Customer Service Representative - WellCare Insurance
09.2015 - 02.2016
Nashville State Community College - Healthcare Management , Healthcare Management
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