Professional Summary
Self-starter with excellent interpersonal, organization, execution and problem-solving skills that is seeking opportunities to apply experience and expertise to a position in a company to achieve professional management goals through exceptional service and integrity.
Core Competencies and Skills
Project Management Problem-Solving Customer Service
Research and Analysis Excellent Written and Oral Communication Health Insurance
Relationship Building Medical/Insurance Coding and Billing
Relevant Experience
United Healthcare, Greensboro, North Carolina
Health Advisor March 2009—Present
• Serves as member associate by performing outbound calls and working with business partners to resolve issues; also responsible for following up with members to provide status of completed resolutions.
• Advise members on how to maximize their healthcare; responsibilities include educating members on in network and premium medical providers, generic drug utilization, and methods to optimize consumer driven health plans, in addition to helping members understand their insurance benefits, educating on plan options and answering inquiries regarding the enrollment process.
• Additional responsibilities include providing members relevant information to make informed decisions, promote personalized campaigns based on unique member needs; and also engages other experts if needed to provide additional information and assistance to resolve member’s issues.
• Experience includes knowledge of member’s products to optimize service experience and training to handle benefits such as medical, flexible spending accounts/health reimbursement accounts, and pharmacy products to provide an instant visibility and understanding on the relation of key products and increase ability to resolve members’ questions in an effective manner.
• Experience managing the following inquiries: verification of member eligibility and coverage, research drug coverage, inquire about quantity limits on prescriptions, provide mail order benefits, assist with pharmacy locations, and provide status of processed claims.
Bank of America, Greensboro, North Carolina June 1995—June 2008
Extensive Research 2008
• Researched complex issues to solve problems on consumer lines of credits; also responsible for account maintenance to ensure customer delight and satisfaction.
Provisional Credit 2004—2008
• Distributed daily workflow, provided research and analysis in relation...
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