Dependable Insurance industry worker equipped for fast-paced work and changing daily needs. Serves customers effectively with attention to detail and hardworking approach. Seeks out opportunities to go beyond basics, improve processes, and increase customer satisfaction. With nearly 20 years experience, looking to further a career into a Supervisor or Trainer position. Authorized to work in the US for any employer.
Skills
Team Leadership
Goals and Performance
Decision-Making Abilities
Conflict Resolution
Processes and Procedures
Search Engine Optimization
Training and mentoring
Group and individual instruction
Remote Learning
Materials Preparation
Project implementation
Customer service and assistance
Client Engagement
Organization and Time management
Computer proficiency
Work History
Account Specialist, 01/2018 - Current Experian – Ca 90501, CA,
Collecting debts from Insurance carriers with use of appeal either verbal or written.
Pulling and reviewing medical records, claims. and EOBs from EHR's or carrier portals.
Work 20-25 accounts per day.
Assist in hiring process, review resumes, interview applicants, and determine if applicant is good candidate for position.
Training and shadowing new hires.
Assist Supervisor preparing spreadsheets for team, providing weekly collections for client, preparing client meeting data and providing information for meeting.
Point person for project preparing accounts for review.
Developed and maintained courteous and effective working relationships.
Identified issues, analyzed information and provided solutions to problems.
Successfully maintain clean, valid driver's license and access to reliable transportation.
Used Microsoft Word and other software tools to create documents and other communications
Participated in team-building activities to enhance working relationships
Developed team communications and information for meetings
Used coordination and planning skills to achieve results according to schedule
Carried out day-day-day duties accurately and efficiently
Developed and maintained courteous and effective working relationships
Prepared variety of different written communications, reports and documents to ensure smooth operations
Administrator III, 12/2013 - 11/2017 Presbyterian Medical Services – Albuquerque, NM,
Prepared subject issues for meetings with client.
Prepare synopses of appeal cases for Federal Hearing Officer.
Using provided information to determine most appropriate step for appeal to move.
Working with other members of team to break down more difficult appeals and resolve best action to be taken.
Quality review , training and shadowing.
Worker 50 accounts per day.
Team Leadership.
Used Microsoft Word and other software tools to create documents and other communications
Supervised work of contracted employees to keep on task for timely completion
Identified issues, analyzed information and provided solutions to problems
Devoted special emphasis to punctuality and worked to maintain outstanding attendance record, consistently arriving to work ready to start immediately
Worked flexible hours; night, weekend, and holiday shifts
Quickly learned new skills and applied them to daily tasks, improving efficiency and productivity
Created spreadsheets using Microsoft Excel for daily, weekly and monthly reporting
Used critical thinking to break down problems, evaluate solutions and make decisions
Claims Pre-processor, 10/2001 - 12/2013 Claims Processor TMG HEALTH – City, STATE,
Data Entry
Entered up 10 500 accounts per day.
Claims adjudication.
Received and reviewed incoming documents and materials
Researched and resolved discrepancies to maintain accuracy
Maintained customer satisfaction with forward-thinking strategies focused on addressing customer needs and resolving concerns
Used company troubleshooting resolution tree to evaluate technical problems and find appropriate solutions
Answered customer telephone calls promptly to avoid on-hold wait times
Recommended products to customers, thoroughly explaining details
Evaluated account and service histories to identify trends, using data to mitigate future issues
Responded to customer requests for products, services and company information
Answered constant flow of customer calls with minimal wait times
Consulted with outside parties to resolve discrepancies and create effective solutions
Offered advice and assistance to customers, paying attention to special needs or wants
Education
Associate: Healthcare Management, Expected in 2018 - Penn Foster College - Scranton, PA GPA:
HIGH SCHOOL DIPLOMA: , Expected in 1991 - Wyoming Valley West High School - Plymouth, PA GPA:
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