Senior Account Representative
Resume:
Stephanie McCracken
Green Bay, WI 54302
SKILLS SUMMARY
Training skills in classroom setting of 1-10 people. Leadership, organization, computer, phone, and people skills are just some skills I have. Over 15 years of Customer Service, Insurance background, provider contracting, data entry, and medical claims are some other skills I have as well. I have worked with Microsoft programs, internet based programs, and learn new systems quickly. I also can type 45 wpm and over 12000 kph.
EMPLOYMENT
Multiplan by HealthEOS
February 2008 - present
Green Bay, WI
Senior Key Account Representative is my current title. I was previously a Key Account Rep/Service Advisor/Webmail/Mentor and also have assisted other departments with issues.
Took inbound and made outbound calls to providers/clients in regards to their contract and claims.
Assisted clients with their questions or concerns directly, regarding provider’s participation status or pricing of claims.
Adjusted claims and entered claims manually in our systems.
BIRT Specialist (Billing Issue Resolution Team) – I would verify how the claim was priced. If priced incorrectly, I would correct the allowed amount(s) on the claim and contact the insurance company to have them reprocess the claim for payment.
Volunteered for overtime when it was needed.
Assisted supervisors in finishing projects that were ‘rush’, by the deadline and with best quality.
Created shortcuts, grids, and maps to help associates with their daily jobs.
Humana – Employers Health Insurance
March 2005-January 2008
Green Bay, WI
Provider Contracting Representative was my title, for commercial and Medicare plans.
Took average of 30-40 calls per day.
Assisted providers with questions on their contracts, for commercial and Medicare.
Helped members find providers that are in network for their policy.
If providers were disputing the reimbursement rates that they received for a claim(s), I would verify the verbiage of the contract what the claims should allow, educated the provider, and made sure the systems were updated accordingly.
I was a SME (Subject Matter Expert) for our main documentation systems, as well as all our system resources. I trained old and new associates in this are and helped when they had questions.
Put in above the requested amount of overtime to help lower our quantity of work – even worked Saturdays.
Assisted supervisors in finishing projects that were ‘rush’, by the deadline and with best quality.
Created shortcuts, grids, and maps to help associates with their daily jobs.
Schneider National – through temp serv.
January 2005 – March 2005
Green Bay, WI
Helped with an address clean up in their systems.
Searched the web for correct addresses of locations, for their drivers to find.
Morning Glory – through temp service
August 2004 – Dec. 2004
Green Bay, WI
Data Entry of dairy orders received.
Took inbound and made outbound calls to obtain dairy orders from stores.
Sorted mail.
EDUCATION
Preble High School 1997 – 2001
2222 Deckner Ave Green Bay, WI 54302
Studies: General Education, Agribusiness, Floriculture, Animal Studies, FFA.
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