FAMILY ADVOCATE Professional Summary A motivated professional practical, analytical, operational skills resourceful problem solving. Communicative personable, learn adapt quickly. Hands on, follow directions, serve internal external customers poise professionalism. Skills Strong interpersonal skills MS Word, MS Excel, MS Powerpoint Outlook Benefit servicing systems: ICUE, Facet, ISET Customer service management expertise Citrix, medical benefit claim systems: KL library, LINX Case Management Medical Terminology Records (VLookup, Pivot Tables, etc) Team leadership Team liaison Self-motivated Extremely organized Client assessment analysis Risk management processes analysis Staff development Negotiation competency Active Listening skills Seasoned conflict resolution Courteous demeanor Employee relations specialist High customer service standards Troubleshooting skills Telecommunication knowledge Work History Company Name Family Advocate // City State // May 2014 Current Provide excellent customer service responding customer interactions via telephone, email, internet, professional, courteous, accurate manner recording brief overview communication. Resolves customer inquiries concerns first call resolution; assist members needs regarding benefits, eligibility, claims, financial spending accounts, health reimbursement accounts, correspondence. Answers customer's questions help guide educate selecting best benefit plan options, maximize value health plan benefits helping understand select quality care providers. Intervene care providers (doctor's offices) behalf member assist appointment scheduling connections iternal specialist assistance. Encourages self-sufficiency assisting members navigating company websites, cell phone applications, tools. Take ownership call build rapport providing resolutions behalf member real time. Creates, generates, initiates request customer callbacks allow research follow-up customer. Research complex claims issues across multiple databases work support resources resolve customer issues addition collaborating departments resolve escalated issues. Provide benefits education status previously submitted pre-authorizations pre-determination requests. Exceeds performance goals established position areas of: efficiency, call quality, customer satisfaction, first call resolution attendance. Participates supports development implementation special projects. Research solve claims billing issues. Helps members eligibility benefits coverage questions. Interfaces insurance carriers, physicians, hospital healthcare providers. Company Name Patient Care Advocate // City State // January 2008 May 2014 Maintained confidentiality compliance standards times. Met patients families discuss care plan action future. Maximized preventative care utilization reduce hospital burden help eliminate readmissions. Provided subject matter expertise case management related procedures. Resolved issues billing communication problems could affect care. Increased utilization preventative care reduce readmission. Updated documentation reports detailing patient activities, care actions hospital determinations. Company Name Resident Director/Advisor // City State // May 2004 July 2007 Coached students useful life personal care skills. Performed several administrative duties, including room transfers, incident reports maintenance requests. Encouraged community atmosphere implementing educational social programs. Attended, participated contributed monthly staff meetings addressing resident needs. Mentored supervised groups 56 residents. Mediated provided professional conflict resolution timely fashion. Counseled peers career, academic personal concerns. Led example mature behavior consistent university regulations rules. Fostered students' commitment lifelong learning connecting course materials broader themes current events. Demonstrated continued commitment undergraduate teaching full participation college community. Education Master Chiropractic Life University // City State // 2013 Bachelor Science Psychology East Stroudsburg University PA // City State // 2007 Psychology Skills Administrative support: filing, researching Consulting Customer service, customer support, telephone Data entry: MS Excell, MS Office, Outlook, MS PowerPoint, MS Word Medical Billing coding: ICD-9, ICD-10 Office management: phone skills, phone, typing