Customer Service Relations

BRONISLAVA AGARUNOVA

* ****** ***** ***** 718-***-****

Staten Island, NY 10308 Email: **********@****.***

OBJECTIVE:

A highly accomplished, dynamic and skilled professional candidate with in-depth knowledge of handling administrative tasks and customer relations .

Seeking a position as operation specialist to improve my knowledge and skills with a growing organization that will utilize my experience and permit growth.

EXPERIENCE:

Centers Plan for Healthy Living

Staten Island NY

Reimbursement Specialist

03/27/17-Present

Outbound calls to enrolled/disenrolled members regarding a reimbursement request that was made through a member or a provider

Working with Limosys and checking to see if a mbr was picked up by transportation company and based on this information checking if member is eligible for a reimbursement

Working with Medicaid and Medicare members

Working with reimbursement for Transportation, DME and etc.

Update all member on the status of a reimbursement

Providing support and advocacy for current members and prospects with CPHL programs MLTC, FIDA, MAPD

Document call interaction and develop activity report and activity notes into Case Trakker and into the Smart Sheet

Coordinate with members to ensure positive experience with the Plan

HEALTHFIRST 06/08/15-03/25/2017

New York, NY

Member Services Representative

High volume of calls

Checking eligibility on Epaces and Biztalk

Setting up transportation for Senior Health Partners and Medicaid members

Assist each client with sending out a new id cards changing PCP and other issues that may occur

Assist client with the complaints that they may have about the Doctors or the medical bills that they have received

Provide with excellent customer service English/Russian speaking members

WEST 5th MEDICAL

BROOKLYN, NY 01/11 - 03/15

Administrative DME

Processing orders for Durable Medical Equipment in compliance with insurance guidelines

Checking insurance eligibility, obtaining authorization for services rendered to patients

Assisting customer service and following up on the patient’s orders

Promptly resolving any issues either patients or insurance companies may experience with authorizations and orders

Communicating with patients in professional manner when answering questions, disseminating information, taking orders and addressing complaints.

Knowledge of HCPS Codes, and Diagnosis codes

Maintaining and updating the patients’ database using computerized systems

AFFINITY HEALTH PLAN

BROOKLYN, NY 01/10-12/10

Marketing Representative

Assisted each client with benefit enrollment and registered clients for insurance benefits such as Medicaid/Family Health Plus/Child Health Plus through Affinity Health Plan.

Review clients information in order to determine whether they are eligible for benefits.

Scheduled Benefit meetings with clients in an office or at their home.

Worked with disenrollment list if a client needed insurance.

Confer with customers by telephone or in person in order to provide information about services, to take orders or cancel accounts, or to obtain details of complaints.

Followed up with existing clients to maintain professional relationships.

MARINE PARK RADIOLOGY 02/05-12/07

BROOKLYN, NY

Collection/ Insurance Verification

Handling patients’ inquires, complaints and billing questions;

Assisted doctor in medical procedures

Verified patient’s insurance and collected payment if necessary

Monitoring and maintaining patients charts;

Requested authorization for MRI and CT

Answering multi-line phone;

Relating well to people from deferent cultures.

Organizing and filing patient records.

EDUCATION

Williamstown University

Master of Science in Human Resource and Business Management

SKILLS:

Bilingual (Russian/English)

Excellent communication skills, both verbal and written

Fluent in Russian

Strong organizational and management skills

Goal oriented and capable of handling multiple tasks and working under stress

Capable of typing 80 wpm accurately

Possessing excellent phone etiquette and interpersonal skills

Possessing strong analytical skills

REFENCES : Available upon request

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