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Remote InBound Sales

Location:
Mount Juliet, TN
Posted:
September 13, 2022

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Resume:

Shannon Christie

PO Box ***

Spring Hill, TN ****4

615-***-****

Education:

Partners in Policymaking Leadership Graduate

Tennessee Council on Developmental Disabilities

Nashville, TN

Graduated May 2016

Belmont University, Nashville, TN

Business Administration

Santa Fe Community College, Gainesville, FL

Associate of Arts

Graduated December 1993

Applicable Skills:

* Customer service skills

* Pleasant phone demeanor

* Verify insurance eligibility

* Resolve filings

* File appeals and monitor for payment

Experience:

Veterans Source Group LLC - Temporary Employee

(May 2021 - current)

Ingram Content Group LLC - Warehouse Worker

(August 2020 - August 2021)

InsightGlobal - Temporary Employee

(October 2019 - August 2020)

UnitedHealth Group - ASSOCIATE CLINICAL ADMINISTRATIVE COORDINATOR

(April 2018 - September 2019)

* Placing a high volume of outbound calls to our valued members to schedule them for their in-home visits with a Physician or a Nurse Practitioner via an auto dialer system

* Answering inbound calls from our valued members and assisting them with their inquiries

* Enhancing our valued members experience within our business

* Validating member demographic information and obtaining additional member data via specific plan scripting

* Data entry of the members record with accurate information obtained on the call

* Ensuring that the appointments are scheduled accurately following department policies and procedures

* Resolving any scheduling issues or concerns

* Routing calls to the appropriate department as needed

* Ability to collaborate within a team environment TriWest - PSR OUTBOUND AND INBOUND (April 2017 - April 2018)

*Researches and contacts the VA for essential missing information

*Schedules appointments for Veterans using the medical management appointing function

*Manages multiple tasks lists in accordance with directed timelines

*Initiates automated or live outbound phone calls to Veterans and providers within timelines

*Contacts network providers to schedule, reschedule or cancel Veterans’ appointments

*Consistently displays professional and courteous service skills to internal and external customers

*Utilizes various software applications

*Understands procedures and processes of the VA program

*Responds to inquiries from Veterans and providers regarding specific aspects of the VA

*Demonstrates proficiency with the medical management system for tracking and updating

*Protects the privacy of health information of patients when using or disclosing PHI

*Takes appropriate measures to comply with HIPAA regulations to protect privacy

*Tracks, receives, reviews medical information for completeness in accordance with VA and TriWest

*Confirms medical documentation is received and complete to allow payment of a claim

*Documents every aspect of appointing, patient transfers, inquiries or complaints thoroughly

*Documents all communications involving Veteran and provider contacts

*Coordinates complete resolution of service issues by interfacing with TriWest

*Receives and reviews faxed documents to ensure appropriate entry into medical management

*Understands and utilizes the grievances and appeals process available to dissatisfied beneficiaries

*Identifies potential discrepancies in the medical management system to assure quality program

*Performs other duties as assigned

Home Shopping Network - WORK AT HOME SALES REPRESENTATIVE (November 2015 - July 2018)

*Fields inbound calls in a fast-paced environment

*Takes personal initiative to meet all key performance indicators, including AHT (average handling time), Quality, Compliance and Purchase Rate

*Commits to adhering to a work schedule (including specified break periods)

*Applies active listening, communication skills and enthusiasm to provide a superior interaction and one call resolution.

*Always demonstrates professional behavior

*Responsible for promoting sales and upsells and processing payments

*Responsible for providing various levels of support and customer service

*Receptive to coaching and eager to implement developmental suggestions for improving performance

*Remains highly engaged in a team environment through various channels including team meetings, instant messaging and email

*Maintains a quiet remote work environment free of any background noise Kohl’s Department Store - STORE ASSOCIATE/CASHIER (April 2013 - August 2015)

* Greets and assists customers & associates and efficiently resolves customer questions & requests

* Solicits/requests/explains credit, reward card, email

* Responsible for merchandise presentation

* Assists with department fitting room and sales floor recovery

* Assists with returned merchandise

* Initiative to work independently, but also able to work as part of a team & interact effectively

* Completes price changes and processes callback requests

* Performs RFID scans and assists with preparation and taking of inventory

* Assists with replenishment

HCA Physician Services - ACCOUNTS RECEIVABLE (February 2008 – September 2009)

* Patient accounting including insurance, billing and collection processes

* Monitor claims process and contacts insurance companies to resolve payment errors

* Assist AR Manager with special projects including, timely filing issues, working high dollar balance accounts, correcting patient accounts, providing quality assurance on collections & payment posting

* Work with governmental and non-governmental payers to identify payment, adjustment and recoupment trends

* Train new account representatives

American Homepatient - CPAP INSURANCE SPECIALIST (November 2007 - February 2008)

* Insurance verification, assignment of benefits, COB and prior authorization requests

* Acquire prescriptions/referrals from physicians

* Create and maintain managed care database

* Complete master file updates

MedSolutions - MEDICAL CLAIMS PROCESSOR (September 2006 - September 2007)

* Enter & Process incoming radiology insurance claims

* Audit & correct claims payment errors

* Research patients & providers enrollment with health plans

* Escalate claim processing on behalf of patients and providers MedInsights - FIRST REPORT OF INCIDENT AGENT (March 2001 - September 2006)

* Enter incoming insurance claims

* Contact adjuster for catastrophic claims

* Audit & correct other agent’s insurance claims

* Compile production into daily revenue reports

* Provide Claims Customer Service

* Create Administrative reports for management



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