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Experienced Healthcare Insurance Specialist successful at managing high caseloads in fast-paced environments. Organized, driven and adaptable with excellent planning and problem-solving abilities. Offering four years of experience and willingness to take on any challenge.
- Coverage assessments
- Settlement determinations
|
- Documentation Review
- Claims Adjustments
|
Claims Specialist, 03/2020 to Current
American Modern Insurance Group – Valley Forge, PA,
- Maintained confidentiality of patient finances, records and health statuses.
- Coordinated with contracting department to resolve payer issues.
- Communicated verification and authorization status updates with Utilization and Management department to facilitate decision-making for patient admissions and insurance coverage.
Server Part Time, 01/2020 to Current
Watermark Retirement Communities – Herriman, UT,
- Arranged tables for customers, following established preparation procedures to provide guests with excellent experiences and foster repeat business.
- Collaborated with kitchen team to support order preparation, manage efficient deliveries and minimize customer service issues by verifying meals.
- Created orders, documented special requests and followed up with kitchen personnel to foster top-quality service and minimize complaints.
Title Clerk, 11/2019 to 02/2020
Holiday Inn Club Vacations – Brownsville, VT,
- Organized and prepared tax and title documents to transfer ownership of property.
- Posted titling transactions and monitored corresponding schedules, using Excel.
- Prepared tax and title documents to submit all legal transfer work to DMV.
Banquet Server, 06/2018 to 08/2019
Grand Casino – Foxtrot Marketing, MN,
- Maintained customer satisfaction with timely table check-ins to assess food and beverage needs.
- Executed synchronized meal service simultaneously serving multiple guests with speed and efficiency.
- Collected credit card, cash and gift certificate payments and dispensed change for cash transactions.
Inside Sales Representative, 06/2016 to 05/2017
Resideo Technologies, Inc. – Indianapolis, IN,
- Showcased product features to customers and discussed technical details to overcome objections and lock in sales.
- Collected information on sales and service issues to provide effective resolutions.
- Surpassed sales targets by 70%.
Retention Specialist, 01/2016 to 06/2016
Cano Health – Palm Bay, FL,
- Reviewed successes and failures to learn from previous mistakes.
- Adhered to appropriate legal scripting when required.
- Coordinated implementation of people-related services, policies and programs through departmental staff.
Hospice Coordinator, 03/2015 to 01/2016
Deckers Outdoor Corporation – Albertville, MN,
- Communicated with patients, ensuring that medical information was kept private.
- Developed and updated policies and procedures, maintaining compliance with statutory, regulatory and local, state and federal guidelines relating to HIPAA, benefits administration and general liability.
- Discussed medical histories with patients in effort to provide most effective medical advice.
Health Insurance Consultant, 10/2013 to 03/2015
21St Century Oncology – Lompoc, CA,
- Verified insurance coverage by telephone and online to guarantee proper reimbursement of benefits and estimate patients' financial responsibilities.
- Performed needs analysis to obtain information required to make appropriate health insurance product recommendations.
- Remained impartial in order to advise clients based on circumstances.
Legal Administrative Assistant, 04/2011 to 08/2014
W. Benjamin McClain Jr., Attorney At Law LLC – City, STATE,
- Maintained organized office and case-specific paper and digital files for easy tracking and retrieval.
- Managed accounts and client records of clients, observing confidentiality and extreme discretion.
- Generated pleadings and other legal documents for review by attorneys and paralegals.
Senior Inbound Customer Service Specialist, 03/2011 to 02/2012
Gannett – City, STATE,
- Greeted customers and listened closely to problems described to determine solutions.
- Resolved customer service issues using company processes and policies and provided updates to customers.
- Maintained up-to-date knowledge of product and service changes.
Billing Specialist, 09/2005 to 09/2008
TeleTech Holdings – City, STATE,
- Generated and submitted invoices based upon established accounts receivable schedules and terms.
- Contacted clients with past due accounts to formulate payment plans and discuss restructuring options.
- Handled high volume of in-bound calls pertaining to reconciliation of delinquent accounts.
Associate of Science: Legal Studies, Expected in 05/2012
Brown Mackie College - Greenville, SC,
GPA:
- Graduated with 3.8 GPA
- Graduated magna cum laude
- Member of National Technical Honors Society
- Coverage assessments
- Settlement determinations
- Documentation Review
- Claims Adjustments
Claims Specialist, 03/2020 to Current
Morley Companies – Greenville, SC
- Maintained confidentiality of patient finances, records and health statuses.
- Coordinated with contracting department to resolve payer issues.
- Communicated verification and authorization status updates with Utilization and Management department to facilitate decision-making for patient admissions and insurance coverage.
Server Part Time, 01/2020 to Current
Cheddar's Scratch Kitchen Darden Restaurants – Greenville, SC
- Arranged tables for customers, following established preparation procedures to provide guests with excellent experiences and foster repeat business.
- Collaborated with kitchen team to support order preparation, manage efficient deliveries and minimize customer service issues by verifying meals.
- Created orders, documented special requests and followed up with kitchen personnel to foster top-quality service and minimize complaints.
Title Clerk, 11/2019 to 02/2020
Find Great People – Greer, SC
- Organized and prepared tax and title documents to transfer ownership of property.
- Posted titling transactions and monitored corresponding schedules, using Excel.
- Prepared tax and title documents to submit all legal transfer work to DMV.
Banquet Server, 06/2018 to 08/2019
Express Professionals – Greenville, SC
- Maintained customer satisfaction with timely table check-ins to assess food and beverage needs.
- Executed synchronized meal service simultaneously serving multiple guests with speed and efficiency.
- Collected credit card, cash and gift certificate payments and dispensed change for cash transactions.
Inside Sales Representative, 06/2016 to 05/2017
Spectrum – Simpsonville, SC
- Showcased product features to customers and discussed technical details to overcome objections and lock in sales.
- Collected information on sales and service issues to provide effective resolutions.
- Surpassed sales targets by 70%.
Retention Specialist, 01/2016 to 06/2016
Concentrix – Greenville, SC
- Reviewed successes and failures to learn from previous mistakes.
- Adhered to appropriate legal scripting when required.
- Coordinated implementation of people-related services, policies and programs through departmental staff.
Hospice Coordinator, 03/2015 to 01/2016
Allcare Medical – Greenville, SC
- Communicated with patients, ensuring that medical information was kept private.
- Developed and updated policies and procedures, maintaining compliance with statutory, regulatory and local, state and federal guidelines relating to HIPAA, benefits administration and general liability.
- Discussed medical histories with patients in effort to provide most effective medical advice.
Health Insurance Consultant, 10/2013 to 03/2015
CONCENTRIX – Greenville, SC
- Verified insurance coverage by telephone and online to guarantee proper reimbursement of benefits and estimate patients' financial responsibilities.
- Performed needs analysis to obtain information required to make appropriate health insurance product recommendations.
- Remained impartial in order to advise clients based on circumstances.
Legal Administrative Assistant, 04/2011 to 08/2014
W. Benjamin McClain Jr., Attorney At Law LLC – Greenville, SC
- Maintained organized office and case-specific paper and digital files for easy tracking and retrieval.
- Managed accounts and client records of clients, observing confidentiality and extreme discretion.
- Generated pleadings and other legal documents for review by attorneys and paralegals.
Senior Inbound Customer Service Specialist, 03/2011 to 02/2012
Gannett – Greenville, SC
- Greeted customers and listened closely to problems described to determine solutions.
- Resolved customer service issues using company processes and policies and provided updates to customers.
- Maintained up-to-date knowledge of product and service changes.
Billing Specialist, 09/2005 to 09/2008
TeleTech Holdings – Greenville, SC
- Generated and submitted invoices based upon established accounts receivable schedules and terms.
- Contacted clients with past due accounts to formulate payment plans and discuss restructuring options.
- Handled high volume of in-bound calls pertaining to reconciliation of delinquent accounts.
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