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provider service advocate ii medicare part b resume example with 16 years of experience

Jessica Claire
  • , , 609 Johnson Ave., 49204, Tulsa, OK 100 Montgomery St. 10th Floor
  • H: (555) 432-1000
  • C:
  • resumesample@example.com
  • Date of Birth:
  • India:
  • :
  • single:
Summary

Motivational Supervisor with 15 years of experience monitoring, coordinating and allocating efforts of medium to large groups of employees to achieve organizational goals. Proven track record of development and implementation of practical continuous improvement processes. Skilled at managing employee's performance including appraisals, support, training and discipline.

Skills

  • Personal service background
  • Decision-making skills
  • Time management
  • Ability to take initiative
  • Microsoft Office proficiency
  • Organized and detail-oriented
  • Schedule management
  • Resource advocacy
  • Training skills
  • HIPAA guidelines
  • Computer skills
  • Microsoft Office Proficiency
  • Reliable and trustworthy
  • Active listening
  • Quality control optimization
  • Training delivery
  • Training coordination
  • Employee motivation
  • Scheduling proficiency
  • Reporting skills
  • Productivity benchmarks
  • CRM and office management software
  • Teambuilding
Experience
Provider Service Advocate II Medicare Part B , 08/2016 - Current
Novitas-Solutions, Inc. City, STATE,

· Verified Mentor

· Mentor tenured team members with insight on how to improve calls per hour

· Review Provider Service Advocate(s) calls to provide feedback with possible errors

· Help Team Collins-Bryant with rebuttals of failed calls

· Assist team members with callbacks, follow-up tracker, and returned issues

· Access multiple systems to research customer problems and record inquiry type

· Provide accurate and timely responses to telephone inquiries regarding Medicare claims

· Research CMS and company websites to provide knowledge and education to customers

· Access the IVR and Internet Portal systems as needed to help educate customers on self-service options that are available to them

· Utilize (MCS) Multi-Carrier System Daily and HIMR

· Exceed and maintain quality, production, and adherence standards

· Work Higlas Issues and Financial Correspondences for customers

· Implemented a weekly “Did you know” for Team Collins-Bryant to assist with high frequency errors

Senior Advisor Medicare Part B, 12/2019 - 06/2020
Novitas-Solutions, Inc City, STATE,
  • Perform research and solve problems.
  • Assist Provider Service Advocate(s) and Provider Service Advocate(s) II via telephone to ensure accurate answers are being provided.
  • Handle Supervisor inquiries from Medicare Part B Providers.
  • Facilitate weekly team training per CMS guidelines.
  • Manage timely completion of callbacks, call back letters, and follow-up tracker.
  • Handle complex inquires which required escalations to claims, Medicare appeals processing, provider enrollment, and debt recovery.
  • Review Provider Service Advocate(s) calls to provide feedback.
  • Review quality errors and assist with rebuttals as needed Work: Provider Service Advocate II Medicare Part B.
  • Coordinated implementation of new technological tools to improve data gathering and trend tracking.
Healthcare Finance Advisor, 07/2006 - 11/2014
University Of Phoenix City, STATE,
  • Provide accurate, timely, courteous, and personable customer service to healthcare/nursing student(s) and management as needed.
  • Served as Subject Matter Expert (SME) of Title IV funding guidelines and process.
  • Performed audit and resolved edits as needed to financial aid account.
  • Identify potential aberrances, including, fraud and abuse of title IV funding.
  • Identify, research, and analyze training opportunities to ensure.
  • Financial Advisors maintain knowledge of title IV policies and procedures.
  • Performs financial and business related research and analysis of forecasts records and trends of financial aid regulations to senior management.
  • Responsible for conducting and documenting financial aid reports and analysis.
  • Communicated effectively with prospective and/or current healthcare/nursing students via telephone, email, and/or in person with average daily talk time of 3 hours.
  • Coordinates training and seminars with other departments and locations.
  • Create and conduct presentations regarding analysis and trends.
  • Knowledge of forecasting upcoming financial trends regarding bad debt and future earnings.
  • Utilized critical thinking, strategic agility, creativity, and problem solving skills to address and resolve student issues to ensure a positive student experience.
  • Responsible for daily campus financial and account receivable management.
Customer Service Supervisor/Inventory Specialist, 06/2003 - 05/2006
Dynadirect.com, Inc City, STATE,
  • Supervised a Call Center for inbound Sales.
  • Responded to inquiries via phone and email, providing solutions to customers in a prompt, courteous, and effective manner.
  • Maintained accurate and current inventory records.
  • Responsible for customers invoicing.
  • Assisted Customer’s with returns of unwanted, defective or damaged products.
  • Managed clients such as, UPS, FedEx, DHL, USPS, Roadway and several other shipping companies to process damage claims.
  • Maintained a 30+ page daily report to provide Customers with status of all open orders and processed credit card credits via Amazon.
Education and Training
Bachelor of Science: Business Management, Expected in 06/2012
-
University of Phoenix - Jacksonville, FL,
GPA:
Status -
: Communication, Expected in
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MS Gulf Coast Community College - Gautier, MS,
GPA:
Status -

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Resume Overview

School Attended

  • University of Phoenix
  • MS Gulf Coast Community College

Job Titles Held:

  • Provider Service Advocate II Medicare Part B
  • Senior Advisor Medicare Part B
  • Healthcare Finance Advisor
  • Customer Service Supervisor/Inventory Specialist

Degrees

  • Bachelor of Science
  • Some College (No Degree)

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