JOHN MCGINLEY

**** ****** ******

Philadelphia, PA 19152

Home# 215-***-****

Cell# 215-***-****

Email: ad327j@r.postjobfree.com

OBJECTIVE:

To obtain a challenging position within an organization providing opportunity to enhance my skills and abilities, while significantly assisting in achieving organizational goals.

EMPLOYMENT EXPERIENCE:

AETNA BETTER HEALTH

Prior Authorizations Representative

1/2016 to Present

Primary responsibility is assisting providers with the submission of prior authorization requests for medical services requiring authorization by the organization’s medical director prior to services rendered. This includes entering emergency requests with providers by telephone or those sent by fax.

Member Services Representative

1/2015 to 1/2016

Primary responsibility is assisting members and providers in resolution of issues concerning enrollment, benefits, claims and pharmacy via telephone through the QNXT, HEDIS, VOS and Peoplesafe systems. This includes providing education of the benefit contract as set forth by the county assistance office of the state of Pennsylvania.

WALNUT STREET THEATRE

Telephone Service Representative

7/2012 to 4/2013 – 12/2013 – 1/2015

Primary duties include contacting established theatre patrons via telephone to inform of upcoming shows and offer packages that can make the theatre experience more affordable.

APEX SYSTEMS

Order Entry Analyst

4/2013 to 11/2013

Position was contracted with Comcast. Duties include assisting with conversion of teleworker accounts, requesting site surveys for both BCI and Teleworker customers, and ensuring the portal time frames are updated daily. These duties were completed using the following systems: Workbench, DST, CSG, Teleworker Portal, BCI portal and Grand Slam.

INDEPENDENCE BLUE CROSS

Senior Member Services Representative

7/2007 – 6/2012

Primary responsibility is assisting customers, such as individuals, group administrators and brokers, in resolution of issues concerning enrollment, premium billing, website support, benefit coverage and medical claims via telephone. This includes advising how the members could get the maximum financial benefit from their medical contract.

P.A. DEPARTMENT OF LABOR AND INDUSTRY

Intermittent Intake Interviewer

11/2001 to 4/2007

Responsible for building unemployment claims via telephone with people seeking unemployment compensation. Duties include entering claimant and employer information into the database, advising claimants of unemployment claims and procedures and sending relevant information to unemployment examiners for the purpose of eligibility determination.

EDUCATION: COMPUTER LEARNING CENTER

Computer Science: Associate Degree

Completion Date: 8/1997

TEMPLE UNIVERSITY

BA in Business Administration

Major: Accounting

Completion Date: 12/1991

REFERENCES: Furnished Upon Request

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