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Customer Care Insurance

Location:
Glen Allen, VA
Posted:
September 30, 2020

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Resume:

Angela Pearce 804-***-**** adgjls@r.postjobfree.com

Dynamic and energetic professional in the legal sector. Default litigation operations analyst garnered with over 18 years legal field and credit acumen looking to leverage experience and qualifications in pursuit of a change in career direction.

Problem Resolution E-Filing/Document Management Quality

Session Training Project Management Support Billing/Collection

Process Management Relationship Management Communications

Legal Research

EXPERIENCE:

Home Care Delivered – Glen Allen VA 08/2017 - Present

Insurance Verification Specialist (01/2018 – Present)

Responsible for reviewing patients’ case and insurance coverage

Establish contact with the ordering physician’s office or customer service department to resolve issues concerning missing vital information from patients scanned requisition

Ensure timely processing of benefit information and seek assistance from management when necessary.

Work cordially in a team and participate in meetings, sharing ideas and information.

Ensure files are available for daily verification of insurance benefits

Contact clinical staff for patient’s clinical information if it is needed

Prior Authorization Specialist (08/2017 – 01/2018)

Collaborated with other departments to assist in obtaining pre-authorizations in a cross functional manner

Reviewed accuracy and completeness of information requested to ensure that all supporting documents were present

Received requests for pre-authorizations to ensure they were properly and closely monitored

Processed referrals and submitted medical records to insurance carriers expedite prior authorization processes

Created patients’ records and accounts and ensure that pre-authorization information was properly updated

Secured patients’ demographics and medical information by using great discretion and ensuring that all procedures were in sync with HIPPA compliance

Dealt with VA Medicaid issues

Prepared prior Authorization (Magellan, Optima (CCC+ and Family care), Aetna (of VA and Better Health PA)

Closed out prior authorizations that were denied

Called various insurance companies to verify client member ID

Ordered Pro site update information

Navigated MediDoc site to prepare orders

Navigated various Insurance sites to obtain information

Samuel I. White, PC – Richmond VA 6/2017 – 07/2017

Paralegal

Experience with Microsoft Word, Excel, and Outlook

Excellent verbal and written communication skill

Accuracy and attention to detail

Ability to organize and prioritize multiple tasks simultaneously

Professional attitude and demeanor

Obtained experience with litigation tasks, including faxing, filing, and typing

Became familiar with the bankruptcy court system and rules of civil procedure

I used Chapter 7,11;13,16

SunTrust Bank – Richmond VA 03/2005 - 04/2016

Paralegal

Reviewed and responded to inbound inquiries received from external attorney firms and various line of business

Identified qualifying right of offsets against direct deposit accounts to increase recoveries

Served as QA/QC processes and ensure the accuracy of monthly summary reports and supplier inventory reconciliations

Validated judgment lien information to Loss Mitigation database.

Communicated with loss mitigation professionals when needed

Conduced teleconference calls with attorney partners prior to trial and pre-settlement conferences to identify settlement opportunities and workout strategies

Prepared lien releases, judgment releases on Real Estate and non-Real Estate loans and ensure host system was documented Validate Affidavits for sign offs

Approved settlements, workout plans and payment arrangements on default accounts externally assigned for litigation

Responsible for the order and review of ComForce Reports for balance and lien validation

Managed attorney account recalls and appropriately redirected loans internally and externally

Delivered substantive reports and presentations to members of management.

I used Chapter 7,11;13,16

Lexus Nexus, loss mitigation. foreclosure

EDUCATION:

Washington University Law School

Master of Legal Studies/Litigation -Virtual Part-time (expected graduation 12/2020)

Colorado Technical University

Masters Business Administration and Systems Management/Technology Graduation 02/2014

Bachelor of Science - Business Administration Management/Technology

J. Sergeant Reynolds Community College

Paralegal Certification June 2017

TECHNICAL SKILLS:

Computer Skills: Microsoft Office, (Word, Excel and Power-point, Visio), X-Net, PACER, SCAS, Adobe Acrobat, ACAPS, SCAS, PVE, Accurint, Consumer Lending. Alltel, OCRF, KRCP, Apple, Access, MS Outlook,

Safari CMS, RMS, OBIQ, EDesk, X-net, SunTrust Classes Reg B, E, D, and C, Wire Transfers Domestic and Foreign, Account Receivable/Payable/ Reconciliation, Actimize, TSYS, customer care

CERTIFICATIONS:

Business Fundamentals, Business Concepts, Business Management, Project Planning, Notary Commission for the State of Virginia

ACCOMPLISHMENTS:

Attended Mortgage Bankers Association Training

Successfully completed the Educational program sponsored by the MBA two- week curriculums training program on building a model platform for SunTrust Mortgage

Recognized for Outstanding Performance. Recognized for outstanding performance during the “position to win” challenge.

Critical Project Management. Served on several key projects from 2009-2011

Yellow Belt Certification. Awarded in 2011



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