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Administrative Insurance Sales Specialist

San Antonio, TX
December 12, 2021

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Kelley E. Mooney

**** ******* ******* • San Antonio, TX 78244 • 210-***-****

Professional Summary Expert knowledge in Medicare/Medicaid/HIPAA/PHI/CMS guidelines and regulations to excel as a Insurance Sales Specialist. Resourceful healthcare team player with Senior Insurance Verification skills to confirm member benefits/eligibility. Acquire self motivation, hard-work while being a team player using superior customer service skills and outstanding attention to detail as a Data Entry agent.

Core Qualifications

● Data Entry (54 wpm)

● Extensive experience in handling insurance discrepancies and authorizations

●Profound knowledge with MS Office applications: Excel, Word, Quickbooks,etc.

● Senior knowledge of ICD-10 and HCPC billing and coding

● Understanding of Medical Terminology

● Ability to multi-task while resolving internal/external customer issues

● Broad understanding of Medicare and Medicaid~CMS to sale based on members’ needs for healthcare.

Work Experience

05/2018 to 07/2019 DMS Sales Agent

Humana * San Antonio, TX

● Keen expert on Medicare Supplemental plans and Medicare Advantage products. Also, individual dental and vision plans for those outside the Medicare/Medicaid population

● Computer proficiency excelled in order to navigate multiple online agent tools in order to confirm in network providers or simple medication price matches.

● Displayed excellent telephone etiquette and verbal communication skills for an optimal customer service experience via Inbound/Outbound Sales metrics.

● Maintained over 95% QA average to ensure Humana’s protocols and procedures were displayed on every call.

● Simplified complexity with the Senior population in order to identify the member’s healthcare needs and closing the sale at 92% avg. rate. 03/2017 to 10/2017 Intake Specialist

Aerotek-KCI • San Antonio, TX

● Responsible for verifying patient’s DME benefits and eligibility

● Educate internal/external customers on the advantages of wound vac therapy

● Conducted timely filing and authorization submissions to various insurances

● Strong and open communication with Territory Field agents to ensure customer satisfaction on every wound vac order

● Reconciled and processed Workers Comp and Auto caused cases

● Provided accurate use of ICD-10 and HCPC billing and coding 06/2011 to 12/2016 Sr. Patient Financial Services Insurance Collection Specialist Medtronic Inc . • San Antonio, TX

● Ability to process orders under the Diabetic DME benefit provisions

● Knowledge of private and public insurance companies which follow Medicare/Medicaid guidelines

● Provided inbound customer order support

● Initiated and Received authorization timely filing

● Provided accurate use of ICD-10 and HCPC billing and coding 02/2008 to 11/2010 Medication Aide

San Pedro Manor • San Antonio, TX

● Administered medications

● Performed and recorded basic vital signs and routine shot administrations.

● Monitored and reported patients adverse reactions or progress while maintaining a clean-safe environment.

● Performed general office duties such as fax, answer MD calls and file charts

● Collaborated with nursing staff to lead productive staff meetings and quarterly reports

04/2007 to 02/2008 Home Health Provider

Community Council Oaks Ltd . • San Antonio, TX

● Evaluated the physical and mental conditions during daily grooming

● Administered am/pm medications

● Performed and recorded basic vital signs and routine shot administrations.

● Provided housekeeping and laundry services for the designated group homes

● Maintained friendly and Open-minded relationships with down-syndrome teens, their family and staff to continue positive rehabilitation. 01/2007 to 06/2008 Medical Assistant

Texas Medclinic • San Antonio, TX

● Maintained clean and sterile environment for staff and patient interaction

● Meet and Greet patients

● Organized daily financial reports while performing clerical duties such as filing, typing and scheduling appointments

● Collected payment for services rendered

● Performed and recorded basic vital signs and routine shot administration Education 2016 to 2018 • Business Administration-Healthcare

St. Philip’s College • San Antonio, TX

2009 • Medication Aide

Dept of Aging • Austin, Texas

2008 • Vocational Nurse Diploma

Texas Careers (Kaplan College) • San Antonio, Texas 2007 • Medical Assistant Diploma

Texas Careers (Kaplan College) • San Antonio, Texas 1999 • High School Diploma

Judson Senior High School • Converse, Texas

References Available Upon Request

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