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.
Core Values
Driven by Constructive Criticism
Adaptable to Changing Environment
De-escalator and Communicator
Supportive of Other
Exceptional Detail
Success Oriented
Excels Under Pressure
Extreme Dependability
Time Management
Self-Directed
Professional Experience
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.
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.
Education
High School Diploma: , Expected in 2015 - Chartiers Houston Jr./Sr. High School - Houston, Pennsylvania , GPA:
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