Commercial Insurance Team Member
Resume:
JAMES HAYWARD
E
*************@*****.***
P
A
**** ********** **, *********, **
OBJECTIVE
KEY SKILLS
To become an integral team member in an organization that values loyalty and commitment, through utilization of my extensive knowledge and understanding of Medicare and commercial insurance policies to assist in effective medical decision making.
PROJECT MANAGEMENT
SCHEDULING
MEDICAL CLAIMS MGMT
MEDICARE HEALTH BENEFITS
COMMERCIAL INSURANCE HEALTH BENEFITS
SIX (6) PROGRAMMING LANGUAGES
PROGRAMMING LANGUAGES
COBOL
FORTRAN
ASSEMBLER
BASIC
PASCAL
MS DOS
EDUCATION
Associate of Science Information Systems
Brevard Community College
Rockledge, FL
Ranked top 10% of class
Coursework was focused on computer programming, business management, and technical writing.
EXPERIENCE
November 2018 – August 2023
Medicare Customer Care Specialist
Health First Health Systems ● Rockledge, FL
Subject Matter Expert (SME) of medical benefit coverages and eligibility responses to patients and medical offices.
Employee of the Month for August 2023 for entirety of Health First Health Systems.
Performed at 95% resolution for approx. 75 calls per day as a secondary line of escalation- working to maintain company goals of resolution on first call/contact.
November 2007 – August 2018
Regional Customer Service Manager
Percepta, LLC ● Melbourne, FL
Attained white belt status leading charge to improvements in documenting telephonic interactions with customers of one of the largest vehicle manufacturers in the world regarding repairs, warranty work, extended warranties, and vehicle issues.
September 1996 – September 2005
Retail Sales Manager
Circuit City ● Melbourne, FL
Integral Technology Manager through business wind down operations in the bankruptcy and liquidation of local stores within territory.
Succeeded in territory-wide compilation of SWOT analysis of competitors, their products, and marketing strategies to understand the competitive marketplace and sales advantages.
TECHNICAL & SOFT SKILLS
Medicare, Amisys, AWD, Microsoft Word (expert), Microsoft Excel (expert), Microsoft Outlook (expert), Evicore, Caremanager, time management skills, positive learning processes.
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