Experience

Holista

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

• Authorization Representative

  • Nov 2018 - Present

  Explain insurance benefits and eligibility requirements to providersReview and determine authorization requests from providers for physical, occupational and speech therapyAnswer email and voicemail queries from providers Verify and document member insurance eligibility and benefitsAssist web portal users by answering troubleshooting calls and emails Host webinars to educate and promote use the of web portal

• Authorization Representative

  • Nov 2018 - Present

  Explain insurance benefits and eligibility requirements to providersReview and determine authorization requests from providers for physical, occupational and speech therapyAnswer email and voicemail queries from providers Verify and document member insurance eligibility and benefitsAssist web portal users by answering troubleshooting calls and emails Host webinars to educate and promote use the of web portal



SKYGEN

• United States
• Hospitals and Health Care
• 300 - 400 Employee

• Senior Electronic Outreach Coordinator

  • May 2017 - Jun 2022

  Create and deliver educational webinars and documentation in order to promote the use of the Provider Web PortalMaintain focus on cybersecurity and continuous improvement security protocolPartner with Electronic Outreach Manager and external departments to trouble shoot portal and any escalated issuesCreate and carry out test plans for all associated internal modules and external web portals.Own and manage large scale projects and provide regular status updates and reports on project progressWork with internal departments to produce training references and materialsProvide feedback, training and mentoring to department staffRecognize and suggest potential system and process enhancements that could be made to increase effectiveness or efficiencyResolve complex requests or escalated issues pertaining to portals, provider data and workflowsWork with clients to collect requirements, build and maintain web portalsCollaborate with internal departments to produce, maintain, and deliver provider training and references materialsActs as a liaison between providers and clients to resolve escalated claim issues for client owned provider networksAssign, prioritize and work and/or delegate OnTime tickets received from internal and external clientsRun weekly reports and research data using SQL

• Electronic Outreach Coordinator

  • Oct 2014 - May 2017

  Create training guides & reference materials for portal users & clients​​​​Plan and implement go-lives for new clients & system upgrades​​​​Deliver webinars to educate & promote the use of web portals​​​​Identify, track & work with Wonderbox to correct portal errors​​​​Assist callers with portal questions and issues​​​​Train, mentor and provide feedback to new and existing employees​​​​Determine and document processes and procedures for department workflows​​​​Serve as subject matter expert across all segments of the company​​​​Work with clients and internal departments to implement new programs​​​​Suggest, develop and act as stakeholder for system enhancements​​​​Promote the benefits of an electronic relationship through outreachPrioritize and work OnTime tickets received from internal and external clients as assigned

• Customer Care Representative

  • Nov 2012 - Oct 2014

  Provided benefit information to dental/ocular members and providers Communicated authorization and claim determination statuses Assisted providers with Provider Web Portal questions Completed provider and member follow ups in a timely manner Answered calls according to company and client guidelinesTrained and mentored new employees



We Energies

• Utilities
• 700 & Above Employee

• Billing Analyst (OA III)

  • Jun 2000 - Mar 2011

  - Analyzed residential and business accounts for bill accuracy​​- Explained complex rebilling corrections to residential and commercial customers​​- Worked with property managers to correct sales tax exemptions- Performed monthly billing of over 400 steam energy customers- Resolved joint metering situations between owners and tenants​​- Managed daily preparation of Group Bills​​- Assisted in training and mentoring of new employees

• Telecollector

  • Dec 1997 - Jun 2000

  12/97-6/02 ​Telecollector​​ ​- Arranged payment plans on delinquent accounts​​​​​- Answering general billing inquiries​​​​​- Mentoring new Telecollectors​​​​​- Handling moving orders, storm and outage calls​​​​​- Placing outbound calls to delinquent customers​​​ 1/99-5/00 Training Assistant (special job assignment)​​ - Prepared materials for training classes- Wrote training material ​​​​​- Created tests and role-play scenarios ​​​​​- Developed mentoring program for new employees​​​​​​- Presented training modules to students