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Skills

  • Team management
  • Billing issue management
  • Supervision
  • Claims escalation prevention
  • Category equipment
  • Public speaking and presentations
  • Regulatory compliance
  • Client consultation on health benefits
  • Project organization
  • Benefits interpretation

Work Experiences

  • Tailored health insurance plans to 9 specific clients, resulting in a 5% increase in sales.
  • Assisted in the setup of a new tool.
  • Contributed to 62% cost savings.
  • Achieved success in the HubSpot market.
  • Collaborated with cross-functional teams.
  • Achieved a 20% improvement in claim resolution times.
  • Achieved 18% growth in local membership.
  • Assisted policyholders with personalized solutions.
  • Checked insurance coverage over the phone and online to ensure proper benefit reimbursement and estimate patients' financial obligations.
  • Collaborated with engineering to design a workflow.

Summaries

  • Clear understanding of stakeholder engagement and risk assessment as well as client relations training.
  • Exceptional juggler of multiple competing responsibilities at the same time.
  • Attained a 17% client satisfaction rate.
  • Boosted client retention and policy renewals.
  • Achieved a 31% reduction in patient claim errors.
  • Health Insurance Representative is a multi-talented Health Insurance Representative who is consistently rewarded for planning and operational improvements.
  • Accountable Insurance Representative with strong client management and plan promotion skills.
  • Professional with Asana and Tableau skills who is proactive and friendly.
  • Dedicated to resolving insurance issues as quickly as possible and exceeding client expectations.
  • Achieved 63% operational improvement.

Accomplishments

  • Implemented an electronic claims submission process that reduced paper claims by 62% and improved verification speeds by 75%.
  • Developed a streamlined claims review process that reduced processing times by 18% and improved client satisfaction rankings by 38%.
  • Reviewed and contested denied claims with insurance carriers, achieving a 48% overturn rate, resulting in over $11 in recovered funds.
  • Consistently exceeded performance benchmarks for call response times and resolution metrics, maintaining a client satisfaction score of 36%.
  • Delivered public presentations on health insurance benefits, improving the community's understanding and boosting new sign-ups by 64%.
  • Used Microsoft Excel to develop inventory tracking spreadsheets.
  • Documented and resolved standard which led to system.
  • Audited 8 healthcare claims per day, identifying over $17 in erroneous charges and preventing potential loss.
  • Devised and implemented a client retention strategy that re-engaged 53% of clients with lapsed health insurance policies, increasing renewals by 82% in 2022.
  • Led a billing issue resolution initiative that reduced unresolved claims by 58%, decreasing outstanding payments by $12 within two years.

Affiliations

  • National Association of Social Workers
  • American Society of Safety Professionals
  • Managed Care Information Center (MCIC) Member
  • National Committee for Quality Assurance (NCQA) Certification
  • Certified Professional in Healthcare Quality (CPHQ)
  • National Association of Health Underwriters (NAHU)
  • Medical Group Management Association (MGMA)
  • American Marketing Association
  • Institute of Medicine Membership
  • Association of Insurance Compliance Professionals (AICP)

Certifications

  • Certified Healthcare Customer Service Representative (CHCSR) - Beacon Labs
  • Certified Healthcare Access Manager (CHAM) - standard
  • Microsoft Certified Systems Engineer (MCSE)
  • Certified Financial Counselor (CFC) – Financial Counseling Association of America (FCAA)
  • Certified Healthcare Reimbursement Specialist (CHRS) - Beacon Labs
  • First Aid/CPR Certified
  • Medicare Compliance Certificate – Meridian
  • Healthcare Dispute Resolution Course – Raleigh
  • CompTIA Security+
  • Customer Relationship Management (CRM) Certification - Power BI

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