Clinical Customer Advisor Resume Orlando, FL - Hire IT People

SUMMARY:

Highly motivated and accomplished insurance specialist with a solid track record of performance in insurance reviews. Key strengths include ability to meet and exceed targets, a knack for managing on - time projects and the ability to maintain productivity levels
Advanced knowledge of insured and self-funded healthcare products
Effective analytic skills aimed at providing judicious claims settlements
Deep understanding of maintaining meaningful relationships with clients and insurance companies
Strong knowledge of communicating insurance claims education to clients
In depth knowledge of medical terminology aimed at providing accurate information to clients and insurance companies

TECHNICAL SKILLS:

WORK EXPERIENCE:

Confidential, Orlando, FL

Clinical Customer Advisor

Responsibilities:

Resolves routine, general questions and problems submitted by customers via phone with limited variety following established guidelines and standard scripts and procedures. Utilizes all available information to choose the best solution and resolve customer concerns. Directs complex questions and problems to more senior staff level.
Uses a computer application to log and track inquiries, as well as, to check the status of items that require follow-up or involvement of other parties. Documents customer interactions, records details, complaints, comments and actions taken.
Coordinates with other functional areas as necessary. Refers unresolved customer grievances as designated by the departments for further investigation.
Contacts customers to respond to inquiries or to notify them of investigation results and planned adjustments.
Handles inquiries on one or more product lines.

Confidential, Rockledge, FL

Licensed health insurance agents

Responsibilities:

Answered incoming calls from customers looking to buy insurance and customers with questions .
Maintained personal contact with each policy holder of every group policy sold .
Personally, sent out premium reminders to customers that were in danger of falling behind in their payments.
Made outbound calls to introduce prospects to the company ' s health insurance offerings .
Helped take customer service calls when the customer service department was overwhelmed .
Put together packages of introductory material for new clients.

Team lead

Confidential

Responsibilities:

Motivated team of call center operators on both inbound and outbound calls .
Supervised inbound team to make certain they answered questions knowledgeably and thoroughly .
Supervised outbound team to ensure they followed computer - generated lead order and exhibited courtesy always .

Confidential

Work At home

Responsibilities:

Inbound calls
Payment processing
Document cases on salesforces.
Process cases on quickbases.
Password resets for customers
Guide customers through different process.
I manage and service customer accounts up-sell and cross-sell various products and services.
Build rapport with customers by greeting them in a courteous, friendly, and professional manner using procedures.
Use decision-support computer software programs to respond to common customer work/ service order inquiries and requests.

Customer Services - Insurances Specialist / Resolutions Specialist

Confidential, Orlando, Florida

Responsibilities:

Primarily responsible for resolving Third Party Rejects (TPRs)
Responsible for reviewing the Third-Party Rejections, gathering information, making corrections, and resubmitting.
Responsible for making telephone calls as necessary.
Responsible for following all guidelines and procedures for resolving third party insurance rejects
Must be able to read and understand Confidential prescription data entry guidelines and procedures; applies and maintains appropriate licensure/registration, as required by state regulations.
Must have the ability to interprets medical abbreviations (SIG codes)
Answering inbound calls and voicemails from customers.
Work at home
Customer service

Medical Billing Clerk

Confidential, Orlando, FL

Responsibilities:

Responsible for the maintenance of the patient's documents and their addresses.
Maintained the patient's information, reports, income reports and statistics with balancing the daily schedule.
Processed patient's billing, statements, reimbursement claims, post transaction and data.
Deals with the queries and respond to them by telephone or by writing.
Responsible for the reports distribution, telephone and generation of the bills.
Responsible for the maintenance of the records of the patients, billing instructions etc.
Maintained the special bill's lists, customers account, etc.
Also, responsible for the answering the customer’s queries, complaints and problems.