Experience

United Urology Group

• Hospitals and Health Care
• 100 - 200 Employee

• Patient Access Specialist

  • Oct 2021 - Present

  Urologist Urologist


NWFCU
• United Kingdom
• Consumer Services
• Member Services Specialist 2

  • Mar 2019 - Oct 2021


Santa Clara Family Health Plan

• United States
• Insurance
• 100 - 200 Employee

• Customer Service Representative

  • Feb 2018 - Jun 2018

  Staffs telephone call center and answers inbound calls; works directly with members and providers to accurately and completely answer inquires that involve services and benefits with SCFHP programs. Responds to member and provider questions, concerns, problems and requests in a timely, respectful, professional and culturally competent manner. Educates members and providers on scope of benefits and how to access services. Participates in the department and individual Quality Monitoring Program. Meets monthly and quarterly individual performance standards as outlined in the Quality Monitoring Program. Documents and codes all contacts and follow-up actions regarding activities in the database and in accordance with established guidelines. Follows established guidelines and resources to handle all contacts and to respond to callers. Identifies and escalates cases, as needed, Seek assistance, as needed, to respond to the caller. Appropriately documents and handles grievances and appeals in accordance with established policies and procedures. Follows established guidelines to ensure appropriate telephone coverage at all times during the business day. 8. Attends and actively participates in daily, weekly and monthly departmental meetings, in-services and training sessions. 9. Helps to identify member/provider issues and trends and reports relevant information to management. 10. Maintains an effective and efficient filing system to allow easy retrieval, refilling and tracking of related files and departmental resources. Maintains confidentiality, in accordance with regulations, of all member and provider documents, records, discussion and other information generated in connection with daily activities and to make no disclosure of such information except to persons authorized to receive it in the conduct of business. Show less



Apex Systems for Alliance Rx Walgreens Prime

• Patient Care Coordinator

  • Sep 2017 - Dec 2017

  In the inbound/outbound service center, I processed patient orders received via telephone fax or email. Which were assigned as separate work ques. I provided timely responses to patient and doctor inquires consistent with service/quality standards and established guidelines while advising them of pricing, availability, and shipping, I scheduled the shipment of medications to patients address of choice either work or home via FedEx or UPS. Most medications were refrigerated and perishable requiring special packaging and expedited shipping. I managed patient inquires and complaints and forwarded correspondence from the appropriate teams, departments, pharmacist and doctors to them by creating patient activities such as; follow -up calls, initiating discharge of services, change of medication, compliance issues due to not taking medication as prescribed, side effects, Adverse Drug Event Reports, notification of urgent orders, then, if necessary, I transferred patients directly to the pharmacist for counseling or any other reminders relating to the patient’s care. I completed other stages of the order process as assigned such as scanning prescriptions, image indexing, loading insurance information, running test claims and facilitating prior authorizations. Show less



Kaiser Permanente

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

• Dental Member Associate

  • Mar 2017 - May 2017

  As a team member I handled inbound calls from members in a high-volume call environment. I was responsible for scheduling, rescheduling, or cancelling dental appointments according to scripts and guidelines. I utilized provider scheduling protocols set forth by management and the dental care team. I updated demographic information and verified patient insurance. I advised patients of their co pay and or other applicable fees that applied to their office visits. I assisted patients by providing phone numbers facility addresses and directions. I redirected callers to other depts. and forwarded messages to dental offices following specific guidelines and procedures. Show less



Seterus Inc.

• Customer Service Representative

  • Jun 2016 - Oct 2016

  . Via inbound and outbound calls, I serviced home owners whose loans were 30 or more days delinquent. I assisted with setting up payment plans that fit their budget to bring loans current. I also offered more long-term solutions such as assistance programs and loan modifications to avoid foreclosure. When borrowers did not qualify for assistance. I advised and facilitated them giving the loan back to the bank so that it would not impact their credit as severely as foreclosure. . Via inbound and outbound calls, I serviced home owners whose loans were 30 or more days delinquent. I assisted with setting up payment plans that fit their budget to bring loans current. I also offered more long-term solutions such as assistance programs and loan modifications to avoid foreclosure. When borrowers did not qualify for assistance. I advised and facilitated them giving the loan back to the bank so that it would not impact their credit as severely as foreclosure.



UnitedHealth Group

• United States
• Hospitals and Health Care
• 1 - 100 Employee

• Customer Care Agent

  • Nov 2014 - Nov 2015

  I answered incoming calls from patients and providers, advising behavioral health benefits. Giving patient referrals to doctors in their plan. Going over copays and deductibles. I provided pre-authorizations if required by the benefit plan. I was required to immediately alert the care advocate team if a patient was at risk oh harming themselves or someone else. I reviewed existing claims and resubmitted them for processing if needed. I provided the electronic payer id as well as the mailing address for paper claims upon request. Show less



Comcast Cable

• CAE 2

  • Jun 2012 - Jul 2014

  I worked in a busy inbound call center engaging over 50 calls per day. I sold telephone internet and tv packages and well as home monitoring services thru the Xfinity brand. I managed multiple computer screens using proprietary software to ensure optimum order processing verifying client information and equipment to be installed. I was responsible for new acct set up credit checks and deposit collection if applicable. I processed payments, assisted with moving services to a new address. Client billing and assisted with minor technical problems. Show less



Alpine Access

• United States
• Outsourcing and Offshoring Consulting
• 500 - 600 Employee

• Customer Care Professional

  • Feb 2012 - Jun 2012

  In this work from home position I answered over 50 client calls per day. Successfully selling new memberships to AARP as well as renewals and resolving any concerns. I advised members of their benefits and how to access them. My efforts resulted in 20 or more renewals daily. I quickly resolved disputes and handled customer complaints in a professional manner to ensure customer satisfaction. I participated in online meetings with management weekly to go over any problems or concerns I may have had working from my home office. Show less



LaneStaffing for ACS

• Customer Service Representative

  • Mar 2011 - Aug 2011

  I handled 30 or more calls per day relating to billing, insurance, third party payments, adjustments, demographics and record maintenance for the city of Pasadena fire dept. ambulance services. I submitted claims to secondary insurers as required. Verifying ICD-10 codes were correct for processing. Posted payments to accounts and resolved balance discrepancies. I handled 30 or more calls per day relating to billing, insurance, third party payments, adjustments, demographics and record maintenance for the city of Pasadena fire dept. ambulance services. I submitted claims to secondary insurers as required. Verifying ICD-10 codes were correct for processing. Posted payments to accounts and resolved balance discrepancies.



Coldwell Banker Residential Brokerage, Keller Williams Realty

• Independent Realtor

  • Sep 2002 - Jun 2008

  During this license period I was affiliated with the following agencies: Coldwell Banker, ReMax, Keller Williams and Exit Right Realty. I Represented and assisted clients with residential sales and purchases of Maryland real estate. Negotiated contracts to reflect the best interest of clients. Arranged and attended home inspections. I also worked with the rental market. I built relationships and worked closely with loan officers who assisted my clients thru the loan approval process. Accompanied clients to settlement, guaranteeing a smooth transaction for all parties involved. Facilitated and coordinated community real estate education seminars and presentations for first-time home buyers. Efforts resulted in a 5% increase in first-time home buyer business. Show less



Verizon

• United States
• IT Services and IT Consulting
• 700 & Above Employee

• Sales Consultant

  • Jan 2008 - May 2008

  I assisted customers in an inbound call center selling phone TV and internet packages. I managed customer credits price adjustments and billing disputes. I was accountable for meeting production goals set forth by management. I assisted customers in an inbound call center selling phone TV and internet packages. I managed customer credits price adjustments and billing disputes. I was accountable for meeting production goals set forth by management.