Experienced, remote working, Consumer Service Associate bringing 15+ years of applying exceptional customer service and non-clinical support to varying types of medical teams. Nearly three years of experience with Anthem Blue Cross Blue Sheild in the Member Services department utilizing outstanding conflict mediation, and communication skills to address diverse needs, mainly claims/benefits inquiries. Responsive and resilient team player with adaptable and resourceful mindset. Highly motivated to apply my passion for success, my analytical excellence, and my experience to serve the goals and missions of your team.
Work History
10/2018 to Current
Consumer Service Representative IIAmerican Senior Communities – Salem, IN,
Provided concierge style customer service to include addressing complex claims inquiries.
Answered up to 60 incoming calls/chats per day in a busy, fast-paced work from home call center environment with little support needed.
Addressed incoming member inquiries regarding prior authorization, claims, benefits, and enrollment concerns.
Forwarded documentation (appeals, claims, hipaa authorizations, etc.) to the appropriate departments.
Updated customer accounts and system database with latest details to support accuracy and efficiency in future interactions.
Defused and deescalated escalating member concerns with exceptional conflict resolution skills.
Provided support to fellow employees as needed.
Followed up with members/facilities to address lingering concerns.
Assisted management with member call backs.
Coordinated timely responses to online customer communication and researched complex issues.
02/2015 to 09/2018
Medical Records CoordinatorKindred Hospice – City, STATE,
Maintained accuracy, completeness and security of medical records and health information including HPI
Accurately transferred paper records to the EMR system
Coordinated veterans pinning ceremonies and honor salutes
Processed record requests for subpoenas, insurance companies, patients, and their families
Monitored, tracked and conveyed important patient information to healthcare staff to help optimize treatment planning and care delivery
Developed and nurtured lasting customer relationships by projecting professional corporate image and responding quickly to issues
Protected privacy and delivered comfort to preserve dignity of patients and family members
Organized clinical documentation, treatment plans, and referrals
Mentored new hires, resulting in stronger staff development and increased productivity
Resolved conflicts and negotiated mutually beneficial agreements between parties
05/2014 to 12/2014
Geriatric Medical AssistantRiverside Medical Group – City, STATE,
Ensured confidentiality of patient information and data
Gathered statistical information on patient admissions, discharges, births, deaths and treatments administered for physician review
Reviewed charts and flagged incomplete or inaccurate information
Managed office logistics by scheduling appointments, maintaining files and collecting payments
Recorded medical history and vital signs of children, adults, and seniors
Assisted physicians with in office medical procedures for children, adults, and seniors
Implemented care and efficiency improvements to support and enhance office operations
Responded to correspondence from insurance companies to verify patient's coverage
E-prescribed medications under the supervision of a physician
Enhanced patient outcomes by providing knowledgeable education on procedures, medications and other physician instructions to new hires
06/2012 to 05/2014
Geriatric Medical AssistantAdvanced Adult Daycare – City, STATE,
Maintained accuracy, completeness and security of medical records and health information
Accurately pulled patient records for upcoming appointments and procedures
Obtained patient vital signs and maintained records of clinical findings
Worked with supervisors and team members to understand supply needs and bring levels within desired tolerances
Collaborated with team members to help expand marketing channels
Provided ADL assistance as needed
Collaborated with medical and administrative personnel to maintain patient-focused, engaging and compassionate environment
Responded to patient emergencies
Trained new hires on department procedures and policies to maximize department effectiveness
Provided detailed instruction and role modeling for acceptable social and work-related behaviors
Education
Expected in 2018
Master of Arts: History Southern New Hampshire University - Manchester, NH, GPA:
Graduated cum laude
Graduated with 3.9 GPA
Coursework in American History, Historiography, and African History
Expected in 2016
Bachelor of Arts: History Excelsior College - Albany, NY, GPA:
Graduated cum laude
Majored in History
Coursework in American History, Public History, and African History
Expected in 2012
Medical Office Technology Certificate: Medical Office Technology Drake School of Business - Newark, NJ, GPA:
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