Customer Service Insurance

Jabar Robinson

**** ****** ******* 609-***-****

Houston, TX 77067 *******@*****.***

PROFESSIONAL EXPERIENCE

United Healthcare (Call Center)

Member Services / Medicare and Medicaid division

12/2014 to Present

14141 Eastex Freeway

Sugarland, TX 77478

Customer Service Advocate

Responsible for answering incoming calls from customers while ensuring a high level of customer service and maximizing productivity in an inbound customer call center environment.

Assist consumers with resolution to questions or concerns regarding their Medicaid healthcare benefits coverage, prescriptions, benefit and eligibility, billing and payment issues, customer material requests, physician assignments, authorization for treatment and Explanation of Benefits (EOB).

Meeting monthly statistical metrics set forth by company (Quality, Adherence, AHT)

Communicate with other health related agencies and organizations as needed

Cross trained to provide back up support for other customer service representatives when needed.

Operate multiple systems to perform tasks.

Knowledge of insurance Terminology

Claims Inquiries

Authorizations

Appeals and grievances

Balance billing

Recently trained to assist Behavioral Health Members.

Memorial Herman Health Solutions (Call Center)

Customer Service Benefits Specialist

Medix Staffing Solutions, Houston, Tx

April 2013 – December 2014

Insurance verification

Capable of Handling high call volume (80 to 90 calls per day)

Outbound calls made to Members

Assists with claims processing and appeals

Employee Benefits

Medicare and Cobra Coverage’s

Medical billing

Pre-cert verification

Insurance sales along with quoting of benefits

Experienced in Fully Insured / Self Insured Plans

Knowledge of insurance Terminology

Claims processing

Authorizations

Appeals and grievances

Process dependent changes

Balance billing

Federal Health Insurance Marketplace

Team Lead Customer Service Representative (Call Center)

General Dynamics, Houston, TX

September 2011 – April 2013

Assisted Consumers in enrolling in the Health Insurance Marketplace.

Provided stellar customer service that met company and federal standards

Assisted Consumers in enrolling in an affordable health plan that met his/her family’s needs

Operated federal systems to verify consumer’s identity and income verification

Provided help and support as well as training to New Hires

Educated on Health insurance terminology / Federal and state laws.

A.E.C.E Trained and certified.

Cross Trained to Medicare and Medicaid Systems.

Knowledgeable about each plan offered in the federal marketplace from various insurance companies such as, Aetna, Cigna, Blue Cross, United HealthCare, etc.

R&W Total Solutions (Home healthcare Office) 09/2009 – 09/2014

2800 South Post Oak Blvd., Suite 220

Houston, TX 77057

Intern Promoted to Administrative assistant.

Professional role and responsibilities have expanded/intensified dramatically during the movement through several pay-step gradations within this particular job classification, and include, but are not necessarily limited to, the following:

Establish and actively records for a specialized cohort on an annual basis, and routinely perform associated “gap” analyses (vs. available program capacity) using Microsoft Excel spreadsheets.

Collect, review, input and maintain data related to patient records and compile/publish monthly site-based program utilization reports at both the sub-group and systemic levels (as appropriate).

Assist office personnel as well as cognizant staff, answer multiple line telephone, entered patient data into the system, scheduled patient follow up appointments and caregiver/ provider services.

Develop comprehensive annual staffing matrix (via Excel spreadsheet), and engage regional support staff in quarterly data reconciliation/remediation activities.

Provide data entry assistance on a regular basis, as well as for obligatory web-based data management applications

Function as front-desk receptionist and office assistant, when needed.

Best Buy Home Theater Installations 09/2008-09/2009

(Geek Squad Call Center)

7034 Highway 6 N, Houston, TX - 281-***-****

Responsibilities: Customer Support Specialist

Deliver and perform advanced/complex installation of home theater/satellite/multi-room audio products.

Provide technical advice and assistance to clients.

Answered non-stop inbound calls

Created work orders for repair and installations. / Produced sales with add on products.

Provided technical support for setup of home theater devices / sold warranty products

EDUCATION

High School Diploma 06/2010

Cypress Ridge High School

Houston Baptist University 2010 – Present

Medical Office Management

ADDITIONAL SKILLS

• Excellent communication and interpersonal skills

• Comfortable working long hours

• Adaptability to all kinds of environments

• Strong time management skills

REFERENCES

Available Upon Request

Contact this candidate