Focused and dedicated professional motivated to provide superior customer service. Would like to demonstrate my abilities and knowledge that I have gained through my experience and be a valuable asset within your organization.
Began as Customer Svc Manager and assisted in the implementation and building of new department to assist with membership. Trained new employees on ACA plans, guidelines and procedures in order to provide best possible customer experience. Worked in team environment to review and submit 109 new plans to the DOI for effective date of 1/1/14.
Jan 2014 I was promoted to Benefits and Vendor Rel. Mgr and assisted with ensuring our many vendors were providing optimal service. I worked with many vendors which included Insure Monkey, UniteHereHealth, Catamaran and Eldorado.
Jan 2015 I moved laterally into the position of Provider Relations Claims Manager. I continued in this position until NHC announced it would be closing its doors at the end of 2015 and my position was eliminated. I worked very closely with the medical management team and the various providers. I met with a number of providers whenever there were any issues or confusion regarding the contract reimbursements or delay in payments. I performed many functions within NHC. I did any function that was necessary to assist in the member experience. I not only met with the providers and vendors but there were many times I met with members to assist in understanding. By the time I left NHC there were approximately 160 plans. I also spoke at Broker Meetings in order to educate about the plans in order for our broker partners to be able to effectively inform the public about NHC and assist potential members about their various choices on the marketplace.
Computer Literacy: Javelina, AS-400, V-3, RIMS, Mainframe, Word, Outlook, Some Excel
ICD-9, CPT, ASA, HCPC Knowledge
Advanced Customer Service Skills
Strong research & resolution skills
Strong verbal and written communication skills
Familiar with COB and Cobra policies
Strong Typing and 10 key by touch
Resumes, and other information uploaded or provided by the user, are considered User Content governed by our Terms & Conditions. As such, it is not owned by us, and it is the user who retains ownership over such content.
Companies Worked For:
Job Titles Held: