Philadelphia, Pa. ***** 215-***-**** ac3zy3@r.postjobfree.com

Arlene Allen

Summary

I am a motivated Customer Service Professional with over 10 years of experience within the health insurance industry. I have been recognized for my excellence in communication skills, customer service, and resource management. I am highly skilled in data entry and problem identification and resolution. I have a strong passion for developing others through active listening and effective training. I also work very well both independently and in collaboration with others to accomplish goals. Proficient in Microsoft Office, Compass System, and various proprietary systems

Experience

6/2016 to 8/2017

MedRisk, /Inc.

King of Prussia, Pa.

Billing Analyst

Research and resolve problems concerning complex billing, claim processing, case setup, and reimbursement issues

Communicate issues and trends found within Revenue operations, finance, Account Management, Provider Relations, and customer Service center and insurance carriers

Effectively document actions and results providing clear and concise written notes

Understand and adhere to all aspects of client specific workflow and appropriate processes, amends, reconsiderations, appeals, and denials on billing within established TAT’s

6/2015-1/2016

Philidor Rx Services, LLC

Horsham, Pa

Senior Customer Service Rep.

Maintained correct and comprehensive documentation of all patient interactions while executing an exceptional level of customer service. Information included: patient demographics, prescription insurance information, and payment using multiple computer- based applications

Managed difficult and emotional customer situations in an efficient manner to improve the overall customer service experience for patients and physicians alike

Demonstrated leadership within team for direct floor support to customer service specialists, prioritized workload and managed multiple time sensitive issues

Assisted supervisors by monitoring phone calls, identifying call quality, and providing formal feedback to ensure success of the team

4/2006-11/2014

AmeriHealth Administrators

Ft. Washington, Pa.

Customer Experience Coach

Coached department representatives to respond to external and internal telephone inquiries in an efficient and courteous manner according to department guidelines

Educated and assisted team members with information regarding insurance products, policies and procedure, and the responsibility of reporting trends that may impact the customers experience

Direct involvement in the training of new techniques that increased department efficiency by up to 25%. Responsible for the implementation of methods for new and existing representatives

Recognized for superior leadership skills, effective communication, and a willingness to adapt to an ever changing environment

Exceeded expectations for professional development through company sponsored courses

6/2005 – 4/2006

Express Scripts Inc.

Horsham, Pa.

Customer Service Associate

Coordinated and scheduled delivery services for patients with medications that required special handling due to temperature restrictions

Conducted member services while strictly adhering to compliance laws including HIPAA

Demonstrated compassion and professionalism while handling patient inquiries regarding claim issues, mail order services, and all questions related to pharmacy benefits

3/2003 - 11/2006

Concorde Inc.

Philadelphia, Pa.

Customer Service Associate

Recruited medical facilities and individuals to perform drug testing and physicals for multiple client bases. Negotiated with companies regarding services, fees, and credentials for providers in this market

Organized and maintained a large database for all new and existing providers and clients

Launched 100+ sites in southern region of United States to begin drug testing and DOT physical programs, resulting in an effective and efficient system

Trained client representatives in applications necessary to operate within the system, resulting in their ability to complete tasks independently

Education

DeVry University

Ft. Washington, Pa.

Bachelor Degree in Technical Management /Health Services

Community College of Philadelphia

Philadelphia, Pa.

Associates Degree in General Studies

Mc Carrie School of Health Technology

Philadelphia, Pa.

Associate, MLT, Lab Technician

References

References are available on request.

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