Insurance verification specialists – United Health Care
Authorized to work in the US for any employer
Insurance verification specialists
November 2015 to October 2017
Answer incoming phone calls from health care providers (i.e. physician offices, clinics) and identify the type
of assistance the provider needs (i.e. benefit and eligibility, billing and payments, authorizations for treatment(Psychological Testing) familiar with CPT codes, putting authorizations on file for Medicaid,
Medicare, andCommercial accounts. Applying Quickcert/Clinical authorizations for Inpatient, Residential,
Intensive Outpatient, Detox and Partial Hospitalization.
•Focus on resolving issues on the first call; navigate through the appropriate computer system(s) to identify
the current status of the issue and provide appropriate response to caller
•Deliver all information and questions in a positive, conversational and compassionate manner to facilitate
developing a relationship with the provider, while providing the best customer service experience possible
•Complete the documentation necessary to track provider issues and facilitate the reporting of overall trends
Demonstrated ability to listen skillfully collects relevant information, determine immediate requests and identify the current and future needs of the member
•Proficient problem solving approach to quickly assess current state and formulate recommendations
•Flexibility to customize approach to meet all types of member communication styles and personalities
•Proficient conflict skills to include ability to resolve issues in a stressful situation and demonstrating personal
August 2013 to August 2015
Role model Superior Customer Service.
– Listen and show sensitivity to Customers concerns and handle issues in a professional and effective manner.
– Assist in maintaining company sanitation standards.
– Monitor and manage potential shrink.
– Ensures Standard Operating Procedure compliance in the service department.
– Monitor, enforce and role model company dress-code standards.
– Perform all duties of Checker and Customer Service Assistant as well as assist with Business Center
transactions as needed.
– Monitor front-end activity to expedite Customer throughput by directing Customer traffic.
– Review and approve financial transactions at cash register and Business Center (i.e., overrides, refunds,
– Provide ongoing communication with store staff and management regarding daily events and concerns that
– Listen and show sensitivity to Partners’ concerns and handle issues in professional manner.
– Encourage and champion front-end selling activities.
– Recognize Partners and celebrate success.
– Convey appropriate sense of urgency in dealing with Partner and Customer issues
– Oversee the ordering of products to ensure 100% in-stock conditions and inventory control.
June 2011 to November 2011
– Created new processes and systems for increasing customer service satisfaction.
– Cross-trained and provided back-up for other customer service representatives when needed.
– Computed accurate sales prices for purchase transactions.
High school diploma
Microsoft word, Microsoft office, Microsoft PowerPoint, Linx, Cdb, & Microsoft access