Switchboard Operator Customer Service
Resume:
SANDREA WILLIAMS
*******.********@*****.***
SUMMARY
Dedicated member services representative professional with over thirty years’ experience patient accounts, business office, human resources, customer service, and leadership. A specialist skilled in identifying errors and finding solutions for the customer/ facility by meeting their needs. Expertise in utilizing various systems in commercial, private, Medicaid and Medicare insurances as well as medical, dental, and life insurance. Knowledgeable in worker’s compensation claims, disability claims, prescription configuration, data entry/billing, collections, medical coding, and processing. An organized, dependable, proactive, flexible, responsive to change and problem solver who can support, mentor, and direct customers in teams through effective interpersonal communications.
PROFESSIONAL EXPERIENCE
Sacred Oak Medical Center 2019-Present
Administrative Assistant/Intake Coordinator
Performed weekly clinical note reviews/audits and document findings.
Ensured each referral data is entered in the Medworxs software system and analyzed information in the electronic medical record CareVue.
Contacted each patient to confirm demographics and update the provider, insurance information and report the census to upper level management and clinical staff.
Assisted the patient via the phone and scheduling appointments for the patient to receive services in the facility.
Maintained a professional and courteous working relationship with the community.
Verified patient insurance information and updated their financial accounts.
Collaborated with clinical and non-clinical staff to discuss patient information with examinations.
Maritime Association I.L.A. 1988-2019
Benefits Claims Specialist
●Performed comprehensive research related to the facts and circumstances of a member complaint, to include appropriate classification, validation, and processing claims.
●Analyzed and interpreted departmental, utilization, financial and operations data for decision-making for out of network and in network providers’ post service/pre-service appeals and grievances.
●Investigating and/or ensuring that questions and requests for information are responded to in a timely and professional manner resulting in accurate resolution of assigned accounts.
●Perform ongoing monitoring of accounts worked to ensure maximization of collection dollars through appropriate follow-up and documentation of actions taken in client and/or HBS computer systems as appropriate.
●Monitoring of accounts worked to ensure maximization of collection dollars through appropriate follow-up and documentation of actions taken in client and/or HBS computer systems as appropriate.
International Longshoremen’s Association- Local 1351 2010 - 2012
Clerk Checker
Inspected the incoming and outgoing loads, analyzed, and recorded the details of the report to the captain of the port.
Supervised the internal and external workflow with the cargo, docking, slips and terminal areas for the transportation of the goods.
Performed and inspected the hazardous areas to ensure the safety of the facility is handled efficiently.
Evaluated the data with the computerized system and the handheld scanners and ordering the seal numbers for the correct cargo.
Switchboard Operator/Maintained the front desk daily income and outgoing calls and scan documents in Paper Vision.
Reviewed the Byrne system, trained and mentored the new hires by maintaining the system.
.EDUCATION/PROFESSIONAL DEVELOPMENT
High School Diploma, Forest Brook High School, Houston, Texas, 1984
Associates Degree of Science, San Jacinto College, Houston, Texas
TRAINING CERTIFICATIONS
Ullico Group Life and Health
Completed Basic Coding Course
Customer Service Training
Claims Specialist Course
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