Experience

UniqueHR

• United States
• Human Resources Services
• 1 - 100 Employee

• Benefits Coordinator

  • Dec 2022 - Present

  Administration of employee benefits with regards to Health and Welfare plans. Provide special guidance, assistance and information regarding benefit plans currently in operation. Administer group health care plan and coordinate with management, insurance providers, clients, and broker as necessary to meet company goals and regulatory requirements. Data entry of new employee benefits, terminations, and changes in the computer database and with the insurance carrier. Process refunds to client and employee when applicable. Process employee terminations and changes in the computer database. Assist with monthly billing reconciliation as needed. Provide logistics and administrative support to the Benefits manager. Keep Benefits manager informed of changes, client issues/requests which are out of the ordinary or may affect customer service goals and/or business operations. Conduct presentations to new and prospective clients of available Health and Welfare plans in person or via Zoom meetings. Show less



Plexos Group, LLC

• United States
• Government Administration
• 1 - 100 Employee

• Case Manager

  • Apr 2021 - Sep 2022

  Provide comprehensive case management services to persons impacted by COVID-19 per program funding guidelines and in accordance with agency standards and other federal, state, and local regulatory requirements. Determine eligibility via intake interviews and review and authentication of supporting documents. Maintain logs for tracking purposes. Review discrepancies of received data. Accurately complete and submit all case notes, files, and records in a timely manner and maintain detailed and organized files. Respond to inquiries regarding program eligibility in a courteous, compassionate, and timely manner. Conduct outreach via telephone and email to payees (property managers/property owners) and utility companies identified as having received ineligible funds for recoupment purposes. Show less



Randstad USA

• United States
• Staffing and Recruiting
• 700 & Above Employee

• Program Coordinator

  • May 2019 - Dec 2020

  Perform tasks necessary to promote member compliance by scheduling mandatory assessments via an electronic scheduling system. Maintain logs for tracking purposes. Maintenance of service coordinator’s calendar of scheduled visits. Screen members for eligibility and benefits. Submit documentation to the state (HHS) regarding assessment delays. Respond to all communications from members, service coordinators, management, and team members. Perform tasks necessary to promote member compliance by scheduling mandatory assessments via an electronic scheduling system. Maintain logs for tracking purposes. Maintenance of service coordinator’s calendar of scheduled visits. Screen members for eligibility and benefits. Submit documentation to the state (HHS) regarding assessment delays. Respond to all communications from members, service coordinators, management, and team members.



Results Company

• Business Consulting and Services
• 1 - 100 Employee

• Customer Service Representative

  • Oct 2018 - Dec 2018

  Obtain and enter demographic and billing data of prospective enrollees. Obtain responses from prospects to complete insurance applications. Explain required scripting (terms and conditions, attestations). Obtain required verbal signatures to complete applications. Upload completed applications for submission to CMS. Maintain a positive and professional demeanor in escalated situations. Obtain and enter demographic and billing data of prospective enrollees. Obtain responses from prospects to complete insurance applications. Explain required scripting (terms and conditions, attestations). Obtain required verbal signatures to complete applications. Upload completed applications for submission to CMS. Maintain a positive and professional demeanor in escalated situations.



Alorica

• United States
• Outsourcing/Offshoring
• 700 & Above Employee

• Patient Care Advocate

  • Nov 2017 - Jun 2018

  Fill/refill/renew medication prescriptions. Educate members and providers of insurance plans, benefits, and eligibility. Complete cost comparisons for retail and mail prescription refills. Perform cashiering functions through the collection of required copayments, deductibles, and coinsurance payments. Educate members of rejected claims. Submit requests for prior authorizations and tier exceptions. Ensure the protection of private and confidential health information in accordance with established HIPAA guidelines. Maintain a positive and professional manner in escalated situations. Show less



CHRISTUS SPOHN HOSPITAL

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

• Patient Access Representative

  • Mar 2016 - Nov 2017

  Employ effective communication to obtain accurate patient demographic and insurance information for billing purposes. Promote excellent customer service in every interaction. Perform insurance eligibility and verification screens to ensure accurate reimbursement. Collect required copayments. Ensure the protection of confidential health information in accordance with established HIPAA guidelines. Ensure patient understanding of consent forms and obtain signatures on all required forms. Exercise empathy when appropriate. Show less



First Data Corporation

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

• Quality Analyst

  • Aug 2005 - Nov 2015

  Monitor agent live and recorded calls to ensure product knowledge and customer satisfaction through one-stop resolution. Identify trends and provide additional training and coaching to address the needs of the call center. Maintain and report accurate details of agent results for tracking purposes. Grade calls in accordance with established quality guidelines. Communicate with all levels of staff and client management team via telephone, chat, and email in a timely manner. Identify and report negative impacts to average call handle time, call structure, and procedures. Submit product enhancement recommendations for publication to agent guidelines. Serve as subject matter expert. Maintain an elevated level of flexibility in a team environment. Maintain calendar of scheduled meetings with agents, team management, and clients. Facilitate virtual call review sessions with quality analysts, clients, and the management team. Maintain and present monthly review sessions of customer satisfaction surveys and negative call trends. Show less



Southwestern Bell Telephone

• United States
• Telecommunications
• 1 - 100 Employee

• Customer Service Representative

  • Apr 2000 - Jul 2005

  Manage incoming billing and service inquiries in a fast-paced call center. Utilize fact finding skills to identify the customer’s issue and offer services and equipment as needed. Respond to inquiries regarding service orders, billing, and equipment requests. Complete sales of services and equipment related to internet, telephone, satellite, and cell phones. Schedule service installation dates. Maintain customer account history and confidentiality while focusing on customer retention. Adhere to established policies and procedures. Show less



Corpus Christi Medical Center

• United States
• Hospitals and Health Care
• 100 - 200 Employee

• Registration Clerk

  • Feb 1995 - Apr 2000

  Utilize effective communication to obtain patient demographic and insurance information for billing purposes while promoting excellent customer service in every interaction. Upload data to the patient’s medical record to ensure accurate reimbursement for services. Schedule appointments and register patients for clinic and emergency room visits, outpatient testing, outpatient surgery, and inpatient hospital stays. Perform insurance verification and eligibility screening. Educate patients regarding in and out of network benefits and financial obligations. Collect patient copayments, deductibles, and coinsurance payments. Show less



Asbestos Control Team

• Office Manager

  • Sep 1990 - Aug 1994

  Manage all reception duties and written correspondence. Type and submit required bid request forms and supporting documents in a timely manner. Conduct weekly payroll and monthly accounts receivable and accounts payable tasks. Organize and maintain contract files. Maintain paper and computerized filing systems. Facilitate completion of all new hire documents. Maintain personnel files. Maintain inventory and purchasing of supplies. Manage all reception duties and written correspondence. Type and submit required bid request forms and supporting documents in a timely manner. Conduct weekly payroll and monthly accounts receivable and accounts payable tasks. Organize and maintain contract files. Maintain paper and computerized filing systems. Facilitate completion of all new hire documents. Maintain personnel files. Maintain inventory and purchasing of supplies.