Service Representative Training
Resume:
Amaya Spencer
(H) 719-***-**** adhz6x@r.postjobfree.com Colorado Springs, CO 80918
PROFESSIONAL SUMMARY
Quality-driven Health Plan Analyst versed in Medicare and Tricare health insurance, as well as pharmacy benefits through OptumRx. With almost 4 years of Training experience, I have proven to be a successful leader and problem solver. I worked closely with new team members to build confidence and skills they would need to be successful in their role with UHC. Continuously improved training in order to maximize effectiveness and performance of employees. I am prepared to bring 10 years of Health Insurance experience to challenging new role.
SKILLS
Public Speaking
Team Leadership
Data Entry
Team Liaison
Extremely Organized
Interpersonal and written communication
Process implementation
Staff development
Conflict resolution
Expertise in SharePoint, Microsoft, NDB, COSMOS, RxCCR, RxClaim, ServiceNow and more
Cultural Ambassador
Innovation Advocate
Lesson plan development
Course planning
Online instruction
Materials preparation
Documentation and reporting
Positive learning environment
Experience with instructional design
Creative learning strategies
Database administration
Expertise in claims processing
Knowledge of health insurance
WORK HISTORY
Aug 2019 – 2020 Healthplan Analyst / OptumRx
Accurately enter client pharmacy benefit data into the Client Central Repository (RxCCR) system
Review and respond to any error identification
Provide ticket submission support to upstream and downstream partners for new and existing client benefit information. Internal partners include however, not limited to implementation and client management teams
Collaborate and communicate with peers and internal business partners as needed during the ticket submission process
Professional and thorough handling of assigned tasks including research, ticket submissions and ticket tracking of assigned work
Meet establish team performance metrics
Perform data entry to system
Research, review and make updates as needed for any identified issues
Use procedures and resources to solve routine issues and conduct routine analysis
Prioritize and organize own work to meet deadlines
Ability to work efficiently in multiple systems, including RxCCR, RxClaim and Service Now
Apr 2017 – 2020
Colorado Springs, CO
Senior Claims Processing Trainer / United Healthcare Medicare and Retirement
Over achieved quality expectations in recent hospital and physician training classes that I have facilitated by updating training modules and improving the business process instructions, and with a 90% NPS score.
Successfully updated the claims new hire training curriculum, agenda, and calendar for hospital claims processing training which has been utilized by all hospital claims trainers.
Aided with the development of a mock training system called COPSIC, which was proven to be effective for the training program and usual tool for trainees.
Selected to be a mentor for all trainers in the Learning Solutions department so everyone can adopt the guided practice training technique in a similar way I deliver the technique in classes I have facilitated.
Feb 2015 - Apr 2017
Colorado Springs, CO
Associate Referrals & Authorization Trainer / United Healthcare Military and Veterans
Awarded $500 from Optum business partner for facilitating IT training on Pega application.
Managed hundreds of new hire employees while in training, to ensure these employees had the skills they required to perform their job successfully. Enforced UHC policies and procedures, and ensured new employees understood them.
Implemented training strategies that improved the overall training experience and curriculum on behalf of Tricare.
Mar 2013 – Feb 2015
Colorado Springs, CO
Authorization Coordinator / United Healthcare Military and Veterans
Exceeded all quality and efficiency goals in my role.
Expert in processing military authorization and referral requests from providers and military treatment facilities.
Hand selected to be a part of a specialized team ensuring provider selection was applied correctly and updated as needed.
Jun 2011 – Mar 2013
Colorado Springs, CO
Customer Service Representative / Triwest Healthcare Alliance
Quickly promoted to working in all tiers of customer service, allowing me the privilege to work with Tricare Providers and Tricare Beneficiaries to resolve concerns with claims, authorizations, referrals, and benefits.
Received many customer compliments for great service and compassion.
EDUCATION
Associates of Applied Science in Healthcare Administration / Pima Medical Institute – 2017
Bachelor of Applied Science in Healthcare Administration /
Pima Medical Institute – 2020
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