Customer Service Health Care

Rachel A. Wilcher

**** ****** **** ******* ******* Beach Mi 49253 734-***-**** ***********@*****.***

I utilize my dynamic interpersonal skills, ability to forge solid, long term relationships with members

and providers on a daily basis, to resolve customer difficulties in an expedient and tactful manner. I

possess a strong commitment to working within a team environment and partnering with leadership to

introduce and launch corporate goals and directives.

Qualifications

More than 15 years experience in various capacities in the field of health care.

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Working within a team environment of a high volume call center with walk in clients to advise

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members of their medical benefits, and to trouble-shoot claims issues. Maintain compliance

with HIPPA guidelines, and honor member’s personal information with complete confidentiality.

Conversant in HMO, PPO, POS and Medicare and Medicaid health insurance terminology,

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HIPPA, and health care policies and procedures.

Strong attention to detail, organized, with highly developed verbal and written communication

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skills, ability to follow through with tracking of outstanding issues and to resolve claims issues

for members in a timely manner.

Professional servicing skills and active partnering with leadership to assist in the successful

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transition from MCare to Blue Care Network, (parent company Blue Cross Blue Shield of

Michigan).

Coordinating patient flow, preliminary testing for patients and assist doctors with pre- and post-

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operative Lasik patients, including triaging for emergencies.

Provide administrative support and back up for management to maintain work and patient flow

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and implementation of best practices to build strong, relationships with members and increase

client satisfaction.

Technical Skills

Certifications

Superior Customer Service seminar, experience in Word, Excel, Access, Unified Connect phone

system, Amisys, and Outlook.

Rachel A. Wilcher

9575 Devils Lake Highway Manitou Beach Mi 49253 734-***-**** ***********@*****.***

Professional Experience

Title Dates

MCare, BlueCare Network (Blue Cross Blue Shield of MI) 2005-Present

• Customer Service Representative - For a health care provider in Michigan, with a full Service

call center and walk in service. I present a professional appearance, and positive attitude while

handling all aspects of a high profile health care membership. Communications to members,

regarding their enrollment and benefit changes including explanation for termination of

benefits.

Bennett Optometry (formerly H.W. Bennett & Associates, Inc.) 1999-2004

• Assistant Manager - For a full Service Optometrist office.

Provided support for implementation of best practices with cross-functional teams to maintain

patient work flow, including absence tracking, scheduling, phone support, payroll and new

hires training processes. Assisted with Lasik co-management, quality control and adherence to

HIPPA regulations.

• Insurance Coordinator - Over site of insurance billing, explaining benefits to patients at

discharge, trouble shooting insurance problems. Implemented application of appropriate fees

and submissions for reimbursement. Communicating changes with benefits,

• Optometric Technician – Assist doctors with pre- and post-operative Lasik patients, triage for

emergencies, record patient background history and conduct preliminary testing on patients.

Foote Hospital – Jackson, Michigan 1997-1999

• Unit Clerk – Responsibilities include, providing back up support to nursing staff and physicians.

Assistance to Administration as needed, including ordering lab tests transcribing physician

orders, processing admissions and discharges.

Saint Joseph Mercy Hospital – Ann Arbor, Michigan 1988 - 1996

• Unit Clerk – Responsibilities include, providing back up support to nursing staff and physicians.

Assisting Administration as needed, including ordering lab testing, transcribing physician

orders, processing admissions and discharges.

Education and Volunteer Experience

High School Diploma – Lincoln Consolidated Schools 1987

Graduated with Honors.

Community Service – collaborated with teams to organize school and community events to benefit

the local school system.

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