Collection Representative Specialist Account
Resume:
Raleigh Holman
**********@*****.***
Thousand Oaks, CA 91360
Summary:
Highly motivated Customer service Representative with over 1 years of Relevant Working experience working in a Health Care Environment.
Experienced in handling inbound calls daily while documenting each call and providing resolution to Member inquiries. Experienced in providing Benefit verification, Insurance verification and follow-up for the provider, obtaining accurate benefits to qualify patients for co-pay and assistance programs. Experienced in customer service to all incoming/ outgoing callers and answer their inquiries. Performed extensive data entry
She is Proficient in MS Office including Word, Excel. She is Available anytime for an interview with 24 hours prior notice and can join immediately. Skills:
• Proficiency in Google platforms
• Microsoft Word
• Microsoft Excel
• QuickBooks
• Salesforce
• Real suite software.
• Investigation due diligence
• call center background persuasion strategies.
• Account reconciliations.
• Recovery techniques specialist account management.
• Insurance
• Customer Care
• Health Care
• Verification
• Patient Care
Education:
High School Diploma – CA
South High School, Torrence CA
Work Experience:
Anthem BCBS Remote Nov 2021 to Present
Utilization Department
• Responsible for collaborating with healthcare providers and members to optimize member benefits and to promote effective use of resources.
• Assesses the medical necessity, outpatient services, surgical and diagnostic procedures, and out of network services.
• Responsible for the effective and sufficient support of all Utilization Management activities to include prospective/pre-certification review of outpatient medical services for medical necessity and appropriateness of setting according to established policies
Passages Malibu, CA 03/2019 - 06/2020
Insurance Verification Specialist
• Proven health care professional working to ensure that patients’ health care benefits cover required procedures.
• Effectively contacts a patient’s insurance company to verify coverage levels and work with individuals to educate them on their medical benefit information.
• Convey to and serve as a valued member of the health care team, helping patients get the medical procedures they need. Also, as an insurance verification specialist I verify, if necessary, the transfer of benefits to any hospitals, clinics, doctor’s offices and more.
• Signally maintain accurate patient insurance records with ability to focus and work quickly, as insurance paperwork commonly needs to be processed in a timely manner. Realtor.com - Westlake Village, CA 07/2016 - 08/2018 Account Specialist
• Effectively settle accounts with clients to resolve issues with the intent of saving accounts from cancelation including inbound and outbound calls with the objective of collecting delinquent accounts, offering support to existing accounts, sell new products to prospecting clients as well as up-selling current clients.
• Research, analyse and settle all billing disputes. Negotiate settlements and established promise to pay.
• Meet or exceed targets monthly of $160,000+ in collected revenue effectively making 150-200 calls per day.
• Research new territories and market availability with the goal of selling more inventory to current clients.
• Help achieve a company goal of retrieving 2.3 million dollars in past due accounts monthly.
• Reallocate clients to new territory when available. American Recovery Service Incorporated - Thousand Oaks, CA 01/2010 - 06/2016 Collection Representative
• Collection for merchant accounts, all chargeback disputes.
• Processed payments over the phone and set up recurring drafts.
• Mentored new members on scripts, strategies, and company information to maximize performance.
• Utilized prescribed scripts and friendly but firm attitude with full knowledge of contractual requirements and legal remedies.
• Updated customer accounts with interactions, payments, and personal information.
• Created and distributed updated customer statements. Reached out to customers to verify information and follow up on issues.
RSH Mortgage - Newbury Park, CA 02/2005 - 01/2010
Loan Processor
• Evaluated financial statements and contacted institutions and customers to clarify details. •Created and completed loan submission package.
• Discussed loan needs and financial histories with clients, and conveyed information regarding the application processes.
• Filed completed packages in a timely manner.
• Managed any conditions sent from underwriting departments.
• Handled 60 cases per month.
• Retrieved pay stubs, proper tax documents, and any other information needed for loan processing.
Contact this candidate