Customer Service Medical

Debra L. Roy

**** ********* **. ***.*

Cincinnati, Ohio 45244

Phone:513-***-****)

Email- *********@*****.***

Qualifications Summary:

• Organized, efficient and highly-competent Enrollment Specialist professional.

• Diverse business experience in : Repeat Processing, Operations and High Volume Call Center

• Mentoring/Training

• High Level Customer Support

• Audits

• Able to multi-task and juggle competing priorities to ensure organizational success.

• Results-driven customer service professional able to resolve issues in timely manner.

• Natural encourager who works well in team environment.

• Able to quickly learn new task, techniques & information to reduce implementation curve on

Professional History:

United Health Group Inc. Cincinnati, OH (UMR) 1998-2020

(Part of the UHC Staff Reduction -February 2020)

• Provide comprehensive discrepancies, analyze transactional data to assure the highest level of

• Quality for both internal and external customers and members.

• Provide phone support during peak enrollment periods while maintaining timely and accurate processing for reports and customer needs.

• Maintain quality goal of 97% monthly.

• Enrollment mentor and trainer to term members in CPS System and Phone Training.

• Enrollment Representative for 65 groups including internet and electronic group. Managed an Additional 9 groups for approximately 6 months to help during team member shortage.

• Assist teammates with their 5 days report and open enrollment audits whenever available,

• Including after regularly scheduled hours.

Cobra Specialist: 04/2005-07/2008

• Administer Cobra with adherence to federal guideline /regulations

• Ensure client & participant inquires and /or complaints. Resolved quick, and equitable and courteous.

• Managed the collection and remittance of payment.

• *Cobra Department – Relocated to UMR Wausau Site *

Business Administer -Medical claims department -02/2000-04/2005

• Responsible for accurately processing all customer medical, disability and hospital claims

• .Handle all claims, related correspondence & customer service calls

• Strive to meet and exceed customer expectations

Mailroom Distribution Center – 10/1998-01/2000

• Responsible for receiving, sorting, scanning, prepping and delivery of the mail.

Reference

Lisa Sweeten -513-***-****

Shawna Yochum-513-***-****

Krista Ooten -513-***-****

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