- Montgomery Street, San Francisco, CA 94105
- H: (555) 432-1000
- C:
- resumesample@example.com
- Date of Birth:
- India:
- :
- single:
Hands on Leadership Team Member who possesses an unstoppable hunger for knowledge and growth as well as strong aspirations to help a company achieve its goals.
- Driven by Constructive Criticism
- Adaptable to Changing Environment
- De-escalator and Communicator
- Supportive of Other
- Exceptional Detail
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- Success Oriented
- Excels Under Pressure
- Extreme Dependability
- Time Management
- Self-Directed
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Senior Insurance Verification Specialist, 07/2019 - Current
Refresh Mental Health – Salem, MA,
- Worked diligently for 6 months prior which had led me into this promotion so quickly.
- Am a direct point of contact for the Insurance Verification Specialists.
- Complete understanding of Major Medical and Pharmacy Benefit verification process.
- Delegating work among representatives to ensure they keep focused - provided training when needed in small groups as well as one on one.
- Operating a phone line solely for escalated calls. Listened carefully to each caller's concern in order to accommodate them as best as possible.
- Conducted interviews with potential new hires; decided if each applicant was right for the position based off of their individual experience as well as drive.
- Collaborating with other departments within the pharmacy to resolve issues.
- Working with our team to determine each representative's individual strengths in order for us to execute referrals most efficiently.
- Created multiple reference guides in hopes to help new representatives learn how to things I also struggled with when I was a new hire.
- Monitoring representative's productivity via Power BI and ensuring everyone is staying on task with little to no distractions.
- Encouraging representatives to branch out of their comfort zone and learn new things in order to help them grow.
Insurance Verification Specialist, 10/2018 - 07/2019
Aids Healthcare Foundation – Houston, TX,
- Responsible for collecting both medical and prescription insurance information for each Patient and confirming their unique coverage level for the Special Handling Team.
- Mastered the process of obtaining Prior Authorizations for all Pharmacy Benefit Management plans - following up with Doctor's offices to ensure all of our mutual Patients are made priority.
- Complete understanding of ScriptMed, Emdeon Pharmacy, Zitter, Covermymeds, Sharepoint, Navinet, Availity, Sharepoint and all Microsoft Office applications.
- Familiarized myself with Blue Card rules for Highmark Major Medical verification.
- Outbound calls to insurance plans to determine cause and resolution for common test claim rejections or obtaining an override that cannot be done by our internal system.
- Exceeding initial expectations and meeting deadlines of all tasks given by direct supervisor. Developed the ability to complete mass quantities of assignments quickly without losing any quality of my work.
- Ability to de-escalate calls on my own without ever needing to transfer someone to a senior or supervisor despite being asked on several occasions.
- Explained that I wanted more responsibility than was expected of me. Worked directly with my supervisor to ensure I was utilizing my full potential.
Benefits Specialist, 08/2017 - 10/2018
Sewell Corporation – San Antonio, TX,
- Answering questions and concerns relating to employer provided health insurance benefits.
- Became a reliable contact source for any new employees to reach out to with FAQ.
- Practiced white glove customer service skills with each of our clients in volumes of 50+ inbound calls per day.
- Explaining plan layout and description to clients who may be completely unfamiliar with insurance terminology.
- Made it a goal to have the member left with no questions by the end of each and every call.
- Processing Qualified Life Events within the time frame allowable by the specific plan for a client by individual request.
- Being one main benefits center for multiple clients meant that it was essential to recognize and understand specific rules and quirks each client had.
- Was able to compare and contrast the different plans offered by each employer with ease.
- Was added to a dedicated team of representatives who both processed appeals and was granted access to respond to questions submitted by the client on our website's message center.
- Responsible for auditing multiple recorded phone calls each month for grading purposes - this was how we reviewed each customer service representative's progress with the company.
Receptionist, 10/2016 - 08/2017
Spitzer Acura – City, STATE,
- Prepared and organized all purchase orders for parts and service.
- Solely in charge of ordering all general stock items needed for all departments.
- Managing and updating the new/used vehicle inventory.
- Became proficient in Quickbooks and Reynolds and Reynolds software.
- Cash handling with general public for down payments on new deals.
- Outbound calls made daily to offer surveys for any customer with a recent service visit.
- Assisted with routing all inbound phone calls to the correct department requested.
- Able to work with little to no supervision without losing track of daily objectives.
High School Diploma: , Expected in 2015
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Chartiers Houston Jr./Sr. High School - Houston, Pennsylvania ,
GPA:
- GPA: 4.0 Highest Honors
- Academic Improvement Award ($200)
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