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Customer Service Insurance

Philadelphia, Pennsylvania, 19126, United States
$40K annually
January 10, 2018

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I am a people-oriented health and human services professional with 20 years of experience in customer service delivery. Qualifications include comprehensive knowledge of federal /state healthcare and social services regulations, excellent services-management abilities. Strong communication skills administrative experience and ability to work well in self-managed and team based environments.


- Delivery of high quality Customer Service and problem/conflict resolution

- Ability to handle the pace in a high volume customer service call center

- Needs assessment Interviewing

- Call and Caseload management/ administration

- Medical Terminology

- Medicare/Medicaid regulations


Licensed Accident & Health Associate Humana Member Services 2013 Present Blue Bell PA

As a Liscensed Customer Service Associate I am answering calls in a high volume call center, providing benefit and policy information to Humana Health Insurance subscribers on both Affordable Care Act Plans and private insurance plans. I provide explanations of denied claims and provide claims grievance and appeals process instructions to insured and process premium payments. I utilize my customer service and people skills to handle irate callers and reach a positive outcome for both the company and the customer. Income Maintenance Caseworker Commonwealth of Pennsylvania Department of Welfare

2005 2012

Philadelphia, PA

As an Income Maintenance Case Worker I held full responsibility for a caseload of citizens needing access to public assistance programs. I performed caseload management activities of, including processing applications and performing service on individual cases for cash, food stamps, and medical assistance benefit programs. I handled primary tasks, including intake interviewing and eligibility determination. I utilized my knowledge of federal income guidelines and social service regulations on a daily basis. I honed customer service skills through the daily job functions.

ER Receptionist Abington Memorial Hospital 2004 2005 Abington, PA

As ER Receptionist I served in a high volume position as the point of exit for the trauma center. My duties included handling cash and process credit card payments for ER visits, and verifying and processing insurance information. I was responsible for needs-assessment and interviewing of all uninsured patients, to determine eligibility for financial assistance.

Patient Registration Associate Drexel University College of Medicine 2003 2004 Philadelphia, PA

As a Patient Registration Associate I was responsible for greeting patients and scheduling appointments, in a busy multi-specialty office. I handled the task of arranging specialty testing for the following specialties: Gastroenterology, Rheumatology, Nephrology, Infectious Disease and Pulmonary Medicines. Assisted in the billing of various health insurers utilizing my knowledge of third party information.


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