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Commercial Insurance Team Member

Location:
Melbourne, FL
Posted:
October 25, 2024

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Resume:

JAMES HAYWARD

E

*************@*****.***

P

321-***-****

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.



Contact this candidate