Claims Specialist Service Representative
Resume:
To,
HBCS
Delaware *****
USA
RE:
Dear Sir/Madam,
Application for: Healthcare Claims Specialist
Upon learning about this position of Health Claims Specialist at HBCS. I felt enthusiasm to express my job interest. When reviewing the job description, I was excited to see how well my experience aligns with your organizations needs and position requirements as healthcare claims specialist. After reading the description, I feel your core mission and culture suit what I offer as a professional HBCS. I strongly believe I have the Necessary skills, qualities, and experience to carry out the responsibilities associated with the job role.
Having already worked with similar field and environment, I have the knowledge and experience needed for the role. As 18 years of experience in the health care industry I’ve had the opportunity of working with some of the renowned insurance carrier in the field like Aetna as Customer Service Pharmacy Tech Representative and in individual billing department as team leader. I understand insurance-field concepts, practices and procedures and hold an extensive background and knowledge of working in different roles from insurance claim processing agent to marketing sales representative. A diverse skill set that I believe adds a unique element. In addition to being an exceptional communicator and skilled in field of insurance, I am a person who understands how important my performance in this role will be for the success of your vision and mission of the organization across the country.
If I’ll be successful, I will constantly seek to add value in my work to help our organization to maintain its position with high values, and to ensure you see a positive return from your decision. If you are seeking a person with extensive experience, in-depth knowledge of this field then, I am available for an Interview and can be contacted via any of the details right above. Please take a look through my enclosed resume in order to gauge my educational and professional background, as well as my enthusiasm to be the part of your group.
Thank you for considering my application.
Sincerely,
Shaunder Collins
SHAUNDER COLLINS
h
adt6oh@r.postjobfree.com
Pennsylvania, United States
484-***-**** adt6oh@r.postjobfree.com
Dedicated and enthusiastic insurance customer service representative with 18 plus years’ specialization in insurance sector and marketing. Strong multitasking ability, high skills in managing insurance claims and completing tasks quickly, recognised for excellent communication skills and talent to manage and enthusiastically engage with clients. Maintain proficiency in growing key customer relationships. Represent establishment with friendly and professional demeanour at all times.
CORE PROFICIENCIES
Customer Relations expertise, Client Interaction Creative Marketing Multi-tasking Negotiation, Persuasion Sales Presentation, High Sales Performance Critical Thinking and outstanding ability to identify the problem and provide effective resolution High skills claim resolution and case support Proficiency in Suite programs Expertise in policy comprehension Proficient knowledge of health care claims Excellent written and verbal communication skills.
PROFESSIONAL EXPERIENCE
2000-2005
Aetna- Customer Service Pharmacy Tech Rep
Ability to communicate effectively with clients.
Achieve or exceed target of insurance sales, queries related to payment method, customer satisfaction in delivery confirmation, benefit information, etc.
Secured, facilitated, and maintained working relationships with customers to enable the connection of services to those in need.
Answer any question or concern policy holders have with their insurance claims.
Develop new business and improve profitability.
2005-2010
Aetna – Individual Billing
Answer participant/provider questions, as well as questioned callers to obtain full understanding of what assistance is needed.
Documented all calls accurately using call tracking system and monitored call status for responses from other departments, as needed, return calls are done in a time bound manner.
SHAUNDER COLLINS
Received inbound calls from participants and providers with regards to plan benefits and claim status information.
Review open accounts to determine and take appropriate action through understanding charges, billed claims,payments, denials adjustments, refunds.
Process all correspondence with adherence with the Health insurance Portability wherever the health insurance Portability and guideline where applicable. 2010- 2017
Aetna – Individual Billing -TEAM LEADER
2018-2021
CVS (Aetna-CVS merger) – TEAM LEADER
Volunteered to participate in a special project transferring paper charts to digital systems.
Found a new way to perform a task that saved time costs and utilized computerized resources.
Strictly followed all operational guidelines and regulations.
Key player in department achieving perfect score on external accreditation survey.
Trained others for example; provided one on one training to new team members enhancing confidence and enabling them to function independently within a few weeks.
Worked successfully with diverse group of coworkers to accomplish goals and address issues related to products and services.
EDUCATION & CREDENTIALS
Certification: 1997 – in Medical billing and coding From Dawn Training Institute
REFERENCES
Lynette Armstrong
Team Lead
Aetna
Nadine Sturdivant
Alicia Bishop
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