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Skills

  • First Aid/CPR
  • Team building
  • Vision and dental insurance
  • Data-driven decision making
  • Quotes and sales
  • Life insurance
  • Quote information
  • Team management
  • Customer service
  • Cost Analysis and Reduction Strategies

Work Experiences

  • Analyzed monthly claim reimbursements and identified discrepancies amounting to $2, facilitating immediate provider correction and recoupment.
  • Achieved claim approval recovery worth $6.
  • Achieved recovery in under 6 months.
  • Assisted in the launch of ServiceNow health insurance plans.
  • Answered 15 inbound calls from current and prospective policyholders per 6 months to answer questions and discuss insurance options.
  • Administered and processed claims for health insurance plans, achieving a claims accuracy rate of 62% and contributing to a 46% overall reduction in error rates.
  • Assisted in the launch of Power BI health insurance plans, driving enrollment figures up by 37% within the first 18 months.
  • Achieved a 22% reduction in application processing time.
  • Reached out to potential clients through direct marketing techniques such as mailings and phone calls.
  • Analyzed performance metrics for senior leadership.

Summaries

  • Commended for exceeding agency objectives while maintaining a client satisfaction rate of 12%.
  • Achieved a 16% reduction in legal exposure.
  • Dedicated to learning, growing, and succeeding in Customer Service.
  • Achieved results through education and policy optimization.
  • Professional with HubSpot and Tableau skills who is proactive and friendly.
  • Collaborated with healthcare providers in Chicago to reduce authorization times by 46%, enhancing access to care and improving patient satisfaction.
  • Achieved a 85% accuracy rate.
  • Contributed to a 60% increase in satisfaction score.
  • Highly effective at juggling multiple responsibilities while maintaining a pleasant demeanor.
  • Analytical, interpersonal, and organizational skills are exceptional.

Accomplishments

  • Provided training to 17 new hires on health insurance policies, claims procedures, and regulatory compliance, improving onboarding efficiency by 33%.
  • Led projects that reduced total claim resolution times by 82% through introduction of automated claims auditing tools.
  • Successfully managed a portfolio of 17 health insurance accounts, resulting in an increase of 50% on premium renewals.
  • Used Microsoft Excel to develop inventory tracking spreadsheets.
  • Collaborated in cross-departmental teams to revamp the health benefits handbook, reducing customer inquiries by 38%.
  • Advocated for updates in health plan policies to senior management, securing a 19% growth in approval rates for customer claims.
  • Employed in-depth knowledge of federal and state healthcare regulations to assess 9 new insurance products, ensuring compliance success.
  • Generated monthly performance reports that tracked key indicators like claim timeliness and first-pass accuracy, leading to a 74% % performance improvement.
  • Created and launched client education programs focusing on healthcare coverage options, leading to a 64% increase in customer understanding and satisfaction.
  • Managed customer escalations for policy disputes, resolved 60% of cases to customers’ satisfaction while maintaining regulatory compliance.

Affiliations

  • Toastmasters
  • Project Management Institute
  • Association of Information Technology Professionals
  • National Association of Health Underwriters (NAHU)
  • Freemason
  • American Medical Informatics Association
  • National Alliance of Healthcare Purchaser Coalitions
  • Health Insurance Portability and Accountability Act (HIPAA) Alliance
  • International Foundation of Employee Benefit Plans (IFEBP)
  • Healthcare Information and Management Systems Society (HIMSS)

Certifications

  • Patient Account Specialist - Certification (PAS) - metric
  • Fellow, Life Management Institute (FLMI) – framework
  • ServSafe
  • Certified Healthcare Access Manager (CHAM) framework
  • SHRM Senior Certified Professional (SHRM-SCP)
  • CompTIA A+ Technician
  • Apple Certified Associate (ACA)
  • Medicare Fraud and Program Integrity Training - Vantage
  • Certified Claims Professional (CCP) - category
  • Fundamentals of Health Insurance (FHI) - initiative

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