LiveCareer-Resume

Health Information Representative I resume example with 6+ years of experience

JC
Jessica Claire
Montgomery Street, San Francisco, CA 94105 (555) 432-1000, resumesample@example.com
Professional Summary

Effective Senior Customer Service Specialist with 10+ years of experience assisting customers using active listening and customer needs assessment to offer targeted solutions. Consistently friendly and professional when handling diverse customer needs in high-volume call center environments. Smoothly manage workflow and optimize team strengths to meet service quotas.

Skills
  • Customer Experience
  • Ability To Manage
  • Outbound and Inbound Calls
  • Verbal And Written Communication
  • Microsoft Office Suite
  • Technical Documents Comprehension
  • Professional Manner
  • Customer Service Support
  • Schedule Appointments
  • Human Resources
  • Excellent Interpersonal Skills
  • Audit
Work History
10/2022 to 12/2022 Health Information Representative I Iconma, L.L.C. | , , Albany, NY Work At Home
  • Developed appropriate and accurate written and oral responses to communicate scientific and health information to public.
  • Followed up with patients about medical and healthcare processes.
  • Resolved concerns with products or services to help with retention and drive sales.
  • Answered average of 70 calls addressing customer inquiries, solving problems and providing product information.
  • Offered internal and external customers first-rate customer service to maximize satisfaction and business success.
  • Collected customer feedback and made process changes to exceed customer satisfaction goals.
  • Provided initial contact between distinct Care Management programs and specific identified members.
  • Handled inbound/outbound enrollment and engagement calls with eligible members to provide information regarding medications.
  • Maintained customer satisfaction with forward-thinking strategies focused on addressing customer needs and resolving concerns.
  • Answered customer telephone calls promptly to avoid on-hold wait times.
11/2021 to 09/2022 Health Information Specialist Lead Sodexo Usa | , , Albany, NY
  • Sorted, scanned and indexed documents, developed workflows and processed workflow reports to keep clinical records maintained in accordance with guidelines.
  • Directed and assisted pulling and procurement of medical files according to established procedures.
  • Maintained relationships with medical providers, suppliers and reporters.
  • Monitored and tracked inventory, assigned work tasks and adjusted assignments based on priorities.
  • Trained and backed reception area, on-call and distribution runs to facilitate quality customer care.
  • Followed up with patients about medical and healthcare processes.
  • Retrieved medical data for physicians and patients.
06/2021 to 09/2021 Coordinated Care Specialist The Millennium Group | , , Work At Home
  • Facilities and Providers Reach out to obtain prior authorization for testing and OP, IN, procedures, and ER admission.
  • Input all patient data regarding claims and prior authorizations into Salesforce accurately.
  • Authorized surgical and medical requests by applicable plan guidelines.
  • Tracked referral submission before facilitation of prior authorization issuance.
  • Created and maintained spreadsheets detailing medical procedures and insurance denials and approvals.
  • Obtained and logged accurate patient insurance and demographic information for use by insurance providers and medical personnel.
  • Managed over 50 provider calls per day.
04/2019 to 03/2021 Customer Service I Centene (Fidelis Care) | , , Latham, NY
  • Cultivated customer loyalty, promoted repeat customers and improved sales
  • Used company troubleshooting resolution tree to evaluate technical problems while leveraging personal expertise to find appropriate solutions
  • Assisted customers with setting appointments, shipping and special order requests, and arranging merchandise pick-up at other locations
  • Consulted with outside parties to resolve discrepancies and create effective solutions
  • Provided primary customer support to internal and external customers in fast-paced environment
  • Presented insurance options to customers in order to close sales on new policies
  • Processed 50 invoices daily and mailed documentation to clients
  • Maintained customer satisfaction with forward-thinking strategies focused on addressing customer needs and resolving concerns
01/2017 to 02/2019 Operations Support Specialist Cox Automotive Inc. | , , East Greenbush, NY
  • Researched, Updated all required materials needed for Dealerships and Department of Motor Vehicle
  • Copied, logged, scanned supporting documentation
  • Answered average of 100 calls, emails and faxes per day, addressing dealership inquiries, solving problems and providing new memo information
  • Obtained documents, clearances, certificates and approvals from local, state and federal agencies
  • Verified data integrity and accuracy
  • Entered details such as payments, account information and call logs into computer system
  • Sorted and placed mail into mailboxes with accuracy and efficiency
  • Weighed letters and packages and calculated costs based on classification, weight, and destination
  • E-mailed Dealerships, Vendors and D.M.V with shipping updates
  • Handled high volume paperwork and collaborated with accounting department to resolve invoicing and shipping problems
10/2015 to 02/2017 Shipping and Receiving Manager Lord & Taylor | , , Albany, NY
  • Verified that all returns were being completed within 24-hour timeframe from receipt in fulfillment area
  • Unloaded incoming trucks and properly staged inventory
  • Prepared envelopes, packages, containers and pallets with correct merchandise counts
  • Reviewed daily queue report daily to ensure all orders were processed within shipping system
  • Promoted and maintained safe work environment ensuring compliance with company safety policies
  • Trained and developed new sales team associates in product knowledge, selling techniques and company procedures
  • Performed basic mathematical calculations to check weights and dimensions of shipments
  • Coordinated efficient storage areas to optimize materials movements and minimize labor hours
  • Negotiated with various freight companies and received annual contracts resulting in cost savings of 40%.
Education
Expected in 2021 Associate Of Science | Health Information Management Hudson Valley Community College, Troy, NY GPA:
Expected in 2007 Associate Of Science | Business Administration And Management Sullivan County Community College, Loch Sheldrake, NY GPA:
Skills
  • Customer Experience
  • Ability To Manage
  • Outbound and Inbound Calls
  • Verbal And Written Communication
  • Microsoft Office Suite
  • Technical Documents Comprehension
  • Professional Manner
  • Customer Service Support
  • Schedule Appointments
  • Human Resources
  • Excellent Interpersonal Skills
  • Audit
Work History
10/2022 to 12/2022 Health Information Representative I Elevance Health | ,
  • Developed appropriate and accurate written and oral responses to communicate scientific and health information to public.
  • Followed up with patients about medical and healthcare processes.
  • Resolved concerns with products or services to help with retention and drive sales.
  • Answered average of 70 calls addressing customer inquiries, solving problems and providing product information.
  • Offered internal and external customers first-rate customer service to maximize satisfaction and business success.
  • Collected customer feedback and made process changes to exceed customer satisfaction goals.
  • Provided initial contact between distinct Care Management programs and specific identified members.
  • Handled inbound/outbound enrollment and engagement calls with eligible members to provide information regarding medications.
  • Maintained customer satisfaction with forward-thinking strategies focused on addressing customer needs and resolving concerns.
  • Answered customer telephone calls promptly to avoid on-hold wait times.
11/2021 to 09/2022 Health Information Specialist Lead CIOX HEALTH, Health Information Managment | ,
  • Sorted, scanned and indexed documents, developed workflows and processed workflow reports to keep clinical records maintained in accordance with guidelines.
  • Directed and assisted pulling and procurement of medical files according to established procedures.
  • Maintained relationships with medical providers, suppliers and reporters.
  • Monitored and tracked inventory, assigned work tasks and adjusted assignments based on priorities.
  • Trained and backed reception area, on-call and distribution runs to facilitate quality customer care.
  • Followed up with patients about medical and healthcare processes.
  • Retrieved medical data for physicians and patients.
06/2021 to 09/2021 Coordinated Care Specialist EmblemHealth (CGCGROUP) | ,
  • Facilities and Providers Reach out to obtain prior authorization for testing and OP, IN, procedures, and ER admission.
  • Input all patient data regarding claims and prior authorizations into Salesforce accurately.
  • Authorized surgical and medical requests by applicable plan guidelines.
  • Tracked referral submission before facilitation of prior authorization issuance.
  • Created and maintained spreadsheets detailing medical procedures and insurance denials and approvals.
  • Obtained and logged accurate patient insurance and demographic information for use by insurance providers and medical personnel.
  • Managed over 50 provider calls per day.
04/2019 to 03/2021 Customer Service I Centene (Fidelis Care) | ,
  • Cultivated customer loyalty, promoted repeat customers and improved sales
  • Used company troubleshooting resolution tree to evaluate technical problems while leveraging personal expertise to find appropriate solutions
  • Assisted customers with setting appointments, shipping and special order requests, and arranging merchandise pick-up at other locations
  • Consulted with outside parties to resolve discrepancies and create effective solutions
  • Provided primary customer support to internal and external customers in fast-paced environment
  • Presented insurance options to customers in order to close sales on new policies
  • Processed 50 invoices daily and mailed documentation to clients
  • Maintained customer satisfaction with forward-thinking strategies focused on addressing customer needs and resolving concerns
01/2017 to 02/2019 Operations Support Specialist Cox Automotive Inc. | ,
  • Researched, Updated all required materials needed for Dealerships and Department of Motor Vehicle
  • Copied, logged, scanned supporting documentation
  • Answered average of 100 calls, emails and faxes per day, addressing dealership inquiries, solving problems and providing new memo information
  • Obtained documents, clearances, certificates and approvals from local, state and federal agencies
  • Verified data integrity and accuracy
  • Entered details such as payments, account information and call logs into computer system
  • Sorted and placed mail into mailboxes with accuracy and efficiency
  • Weighed letters and packages and calculated costs based on classification, weight, and destination
  • E-mailed Dealerships, Vendors and D.M.V with shipping updates
  • Handled high volume paperwork and collaborated with accounting department to resolve invoicing and shipping problems
10/2015 to 02/2017 Shipping and Receiving Manager Lord & Taylor | ,
  • Verified that all returns were being completed within 24-hour timeframe from receipt in fulfillment area
  • Unloaded incoming trucks and properly staged inventory
  • Prepared envelopes, packages, containers and pallets with correct merchandise counts
  • Reviewed daily queue report daily to ensure all orders were processed within shipping system
  • Promoted and maintained safe work environment ensuring compliance with company safety policies
  • Trained and developed new sales team associates in product knowledge, selling techniques and company procedures
  • Performed basic mathematical calculations to check weights and dimensions of shipments
  • Coordinated efficient storage areas to optimize materials movements and minimize labor hours
  • Negotiated with various freight companies and received annual contracts resulting in cost savings of 40%.

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Resume Overview

School Attended

  • Hudson Valley Community College
  • Sullivan County Community College

Job Titles Held:

  • Health Information Representative I
  • Health Information Specialist Lead
  • Coordinated Care Specialist
  • Customer Service I
  • Operations Support Specialist
  • Shipping and Receiving Manager

Degrees

  • Associate Of Science
  • Associate Of Science

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