Experience

City of Shoreline

• United States
• Government Administration
• 100 - 200 Employee

• Intern Office Support to Adminstrative Assistant

  • Jan 2012 - Present



Aetna, a CVS Health Company

• United States
• Wellness and Fitness Services
• 700 & Above Employee

• Member Services Representative

  • Feb 2005 - Sep 2009

  Work with members, providers and plan sponsors to answer and research issues and questions regarding payment of benefits, areas of plan coverage and billing discrepancies. Continually enhance customer satisfaction and retention through strong customer service and interpersonal skills. • Handle telephone and written correspondence from varied sources. • Explain customer/member specific plan benefits along with member's responsibilities in accordance with contracted arrangements. ! Experience with third party patient referral and billing systems such as ICD-9, CPT and HCPCS. • Review complex, sensitive, and/or specialized claims in accordance with claim processing guidelines. • Review claims cost payments in order to respond to all requests for reconsideration or appeal. • Work with doctors offices, hospital and care facilities in solving member issues. • Make outbound calls for client follow-up as needed. • Educate members on the website and other self-service tools. • Document, review, and manage all pending contacts and claim follow-ups daily, focusing on earliest release possible. • Manage complex claim research scenarios. • Document and track all member contacts, events, and outcomes via appropriate systems. • Access information from a variety of systems and references. Show less



Verity Credit Union

• United States
• Banking
• 1 - 100 Employee

• Membership Services

  • Sep 2000 - Dec 2004

  Extensive contact with members by phone and mail. Handle most teller operations via the phone, including account transfers, loan payments, member inquiries, issuing and ordering checks and taking consumer loan applications. Counsel members on savings and savings alternatives, interest rates and services offered at the Credit Union. Extensive contact with members by phone and mail. Handle most teller operations via the phone, including account transfers, loan payments, member inquiries, issuing and ordering checks and taking consumer loan applications. Counsel members on savings and savings alternatives, interest rates and services offered at the Credit Union.