Experience

MetLife

• United States
• Insurance
• 700 & Above Employee

• Account Representative II

  • Mar 2018 - Present

• Claims Manager

  • Feb 2017 - Feb 2018

  Greater Chicago Area Independently assess, analyze and render appropriate claim decisions pursuant to certificates. Communicate clearly and concisely to influence return to work, discuss terms of the certificate, and the basis for payment/non-payment. Communicate with a variety of constituents (for example, claimants, doctors, nurses, employers, and attorneys) to gather information relevant to assessing, analyzing and rendering decisions based on the provisions of the policy and their own… Show more Independently assess, analyze and render appropriate claim decisions pursuant to certificates. Communicate clearly and concisely to influence return to work, discuss terms of the certificate, and the basis for payment/non-payment. Communicate with a variety of constituents (for example, claimants, doctors, nurses, employers, and attorneys) to gather information relevant to assessing, analyzing and rendering decisions based on the provisions of the policy and their own discretion. As the sole owner of the STD claim, determine return to work potential and strategy, identify a likely claim progression based on the facts of the claim and take action on their own assessment of the claim.



Dreyer Medical Clinic

• Medical Practices
• 200 - 300 Employee

• Disability Representative

  • Oct 2016 - Feb 2017

  Responsible for completing and submitting disability, FMLA, state registration, and release forms for patients that have applied. I take calls from patients in regards to status of forms and answer general medical records questions. Responsible for ensuring efficient customer service, by explaining our processes to patients and completing forms correctly, while in a timely manner. I maintain confidentiality and follow HIPAA guidelines, while working with the release of health information. I am… Show more Responsible for completing and submitting disability, FMLA, state registration, and release forms for patients that have applied. I take calls from patients in regards to status of forms and answer general medical records questions. Responsible for ensuring efficient customer service, by explaining our processes to patients and completing forms correctly, while in a timely manner. I maintain confidentiality and follow HIPAA guidelines, while working with the release of health information. I am also responsible for taking any payment for any forms that are needing to be processed by Advocate Dreyer Physicians.

• Patient Registrar

  • Aug 2015 - Oct 2016

  Responsible for ensuring efficient customer service and performing a variety of front desk related tasks. I process new and return patient registrations, update demographic and insurance data of established patients, verify insurance benefits and eligibility for timely reimbursement, answer calls, arrive patients in the scheduling computer system, and obtain signatures on all required documents. Work also includes handling cash, receiving multiple types of payments producing receipts, and… Show more Responsible for ensuring efficient customer service and performing a variety of front desk related tasks. I process new and return patient registrations, update demographic and insurance data of established patients, verify insurance benefits and eligibility for timely reimbursement, answer calls, arrive patients in the scheduling computer system, and obtain signatures on all required documents. Work also includes handling cash, receiving multiple types of payments producing receipts, and balancing monies at the end of the day.

• Patient Service Representative

  • May 2015 - Aug 2015

  Responsible for taking phone calls from patients in regards to appointments and concerns. Routed calls and took messages for doctors and nurses. I also took part in advancing prescription refill requests to doctors for approval.



Health Care Service Corporation

• United States
• Hospitals and Health Care
• 700 & Above Employee

• Processor

  • Nov 2014 - Feb 2015

  Responsible for making changes on members’ accounts with the new Health Care Reform Act in place. Responsible for investigation, communication, and generating correspondence in order to obtain necessary information to complete the changes. As a processor, I also supported other areas within the organization when needed. Subject to divisional standards of quality and productivity.



Sam's Club

• United States
• Retail
• 300 - 400 Employee

• Business Developer

  • Mar 2014 - Nov 2014

  Montgomery, IL Responsible for actively seeking companies and organizations to partner with for exclusive Sam's Club membership offers. Responsible for marketing the new store location/grand opening while working closely with businesses. I serve as a contact for any business in the relative area that may wish to be a part of the Partner Membership Program. I also work with local community events to introduce the new store to the community and gain membership.



Omnicare, a CVS Health company

• United States
• Pharmaceutical Manufacturing
• 700 & Above Employee

• Cash Applications/ Administrative Accounting Clerk

  • Feb 2008 - Jul 2013

  Naperville, IL - Read EOB’S and apply payments/credits/debits to patient accounts - Review write-offs and late filing reductions - Review Medicare recoupments - Research inquires requested by other departments - Complete refund check requests