Dedicated Customer Service professional with knowledge of service delivery and proven multitasking abilities. Committed to maintaining professional relationships to increase profitability and drive business results.
Overview
2026
2026
years of professional experience
Work History
Member Services/ Provider Service Specialist
Sonder Health Plans
06 2023 - 05.2025
Efficiently and courteously respond to telephone inquiries from subscribers regarding benefit verification, claims issues, and eligibility.
Interpret plan coverage for subscribers and providers to determine correct level of benefit coverage.
Efficiently make requested changes ( temporary address changes, member ID card requests).
Provide claim filing instructions when needed to subscribers and providers.
Perform daily clerical duties, including sending faxes, making copies, and assisting in other areas.
Ensure safe care to patients, staff and visitors, adhere to all Sonder policies, procedures, and standards within budgetary specifications including time management, supply management, productivity and quality of service.
Assist members with but not limited to (benefits, PCP lookup, appointment setting, scheduling transportation, and documenting Grievance and/or appeals).
Auto Initial Loss Reporting Representative
State Farm
03 2022 - 05 2023
Deliver a remarkable customer experience throughout the reporting and handling of lower complexity claims, identifying and ensuring prompt routing of claims to other functional areas.
Receive and process claim information, and communicate with internal and external customers via phone and other communication channels.
Handle claims meeting Express criteria, engage team leads as needed, and route claims to other segments.
Utilize the applicable job aids, expertise, and tools to process and document lower-complexity claims.
Gather information and explain coverage and claim processes on liability, PIP/MPC, UMPD, physical damage coverages, and initiate auto processing for payments as appropriate.
Account Recievable Specialist
Erbe Usa
10 2017 - 02 2022
Perform functions related to the collection of customer accounts in a conscientious and professional manner.
Initiate past due inquiries, follow up on commitments, process monthly statements and coordinate collection efforts with sales representatives; advise director on difficult or uncollectible accounts.
Monitor overall accounts receivable balances.
Prepare monthly aging trend analysis including explanations and current status of delinquent accounts.
Initiate customer refunds where applicable (overpayments and returns).
Review codes and processes daily receipts, including posting and preparing daily bank deposits.
Coordinate year-end financial statement audit in aspects related to accounts receivable.
Customer Care Representative
Cox Media Group
10 2016 - 07 2017
Respond to internal and external customer questions via telephone and written correspondence.
Operate a PC/image station to obtain and extract information; document information, activities and changes inthe database.
Research and analyze data to address operational challenges and customer service issues.
Under immediate supervision, receive and place follow-up telephone calls/emails to answer customer questions that are routine in nature.
Use computerized systems for tracking, information gathering and troubleshooting.
GRIEVANCE AND APPEALS REPRESENTATIVE at Humana Health Plans Inc./CarePlus Health PlansGRIEVANCE AND APPEALS REPRESENTATIVE at Humana Health Plans Inc./CarePlus Health Plans
Vice President, Provider Network Operations at Jefferson Health Plans (formerly Health Partners Plans)Vice President, Provider Network Operations at Jefferson Health Plans (formerly Health Partners Plans)