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Enrollment Specialist Processing

Location:
Atlanta, GA
Salary:
57,000
Posted:
June 22, 2023

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Resume:

404-***-**** (c) • adxums@r.postjobfree.com

Willie L. Mosley

CUSTOMER SERVICE

With over 10 years’ experience able to build relationships with customers through active listening, articulating product benefits and creating solutions that provide value to both the customer and organization

Action-oriented with proven problem-solving skills effective for customer satisfaction

Excellent recruiting, interviewing, selection and training skills

Extensive experience in creating, following and guiding others through best practices

Proven reliability with great capacity to work successfully under stressful situations and tight deadlines

Strong verbal and written communication skills, able to complete detailed reports in a timely fashion, and able to manage confidential information

Work Experience:

Delta, Cabin Services, Atlanta, GA 2021 – Present

Ensure the aircraft and passenger area is thoroughly cleaned within a specific time frame.

Restock aircraft with food beverages, magazines, pillows, and other supplies.

FedEx Courier, Alpharetta, GA 2018- 2021

Responsible for the loading and unloading of delivery truck.

Perform vehicle inspection before and after every daily route.

Secured all packages safely inside the truck to prevent damages.

Maintained delivery log for pickup and delivery of products to various locations.

Provide considerate and efficient pickup and delivery of customer packages.

Deliver packages that are on the days manifest.

Northside Hospital, Collector – Atlanta, GA 2017 – 2018

Responsible for making financial arrangements with patients and or insurance companies to collect accounts by telephone, mail and or personal interview.

Maintain patient account balances based on required time frames

Manage delinquent accounts initiating collection procedures as required

Advise in resolution of customer billing issues through typical inquiries

Work with customers to establish patient payment plans

Gather medical records to input and update patient information in computer system

Ensure medical collection activity was conducted as per company local and state guidelines

Report patient and payer credit balances on monthly basis

Express Claim Associate, State Farm - East Dunwoody, GA 2016 – 2017

Handled inbound calls to review and resolve auto claims.

Applied claim handling procedures to process claims, initiate payments, and close claim files.

Managed contractual relationships with policy holders through negotiating and policy modification.

Participated with the development and implementation strategies to enhance business processes as it relates to contracts and customer relations.

Successfully coordinated rental reservations for clients.

Utilized electronic remittance advice (ERA) to provide claims and payment explanations.

Coordinated and processed dispute letters regarding claim denials.

Managed polices to ensure that coverage is in alignment with the state guidelines.

Processed payment to insured and select services.

Processed electronic funds transfer (EFT) as per client request.

Adhered to call wrap times as it relates to business protocol.

Processing Specialist, JP Morgan Chase – Duluth, GA 2013 – 2016

Applied premium payments for established escrow accounts to ensure continuous coverage.

Managed special projects for various clients with minimal lose regarding homeowners’ policy.

Processed appropriate updates to client database in order to meet regulatory obligations.

Communicated and coordinate with insurance agents and/or insurance carriers in order to verify client information.

Maintained internal working relationships amongst various functional groups in order to meet company goals.

Provider Enrollment Specialist, Gateway EDI - Oklahoma City, OK 2011- 2013

Initiated and coordinate the set-up and enrollment process through the EDI data base for new providers.

Utilized electronic remittance advice (ERA) as a safe and convenient alternative to paper reports.

Worked pre-billing and production reports associated with new providers.

Produced weekly enrollment reports.

Verified correct enrollment and mail completed agreement to proper payer/vendor for approval

Verified explanation of benefits (EOB) between payer and clients.

Utilized the document format 850 purchase orders when initiating the set-up of EDI.

Regularly followed up with payers and vendor regarding enrollment. Processed all required information and approvals into the GEDI and Enroll Link System to ensure provider enrollment.

Customer Service Supervisor, Ricoh Americas Corporation - Duluth, GA 2007- 2011

Managed approximately fifteen staff members and one team lead.

Developed, implemented, and updated best practices to streamline operations, standardize processes, and enhance customer service.

Created business matrix for the accounts receivables department.

Created escalation matrix for unresolved billing disputes.

Hired, trained, developed and evaluated administrative personnel.

Monitored inbound calls and wrap times as a coaching and developing tool.

Continuously monitored call center performance and ensured policies and procedures were met

Set goals, standards and benchmarks that evaluated individual employees and customer satisfactions associated ratings.

Implemented operational improvement strategies in regards to workflow optimization and increased levels of quality support.

Prepare cost estimates for budget recommendations, submitting justifications for items, and monitoring expenditures. Responsible for checking and submitting bonds and payroll in a timely fashion.

Pharmacy Technician Veterans Medical Center - Miami, FL 1996- 2007

Performed pharmacy functions for the surgical and oncology ward.

Picked up and entered orders as per Dr’s orders.

Assisted the pharmacist with daily inventory and creating purchasing requisitions as needed.

Filled and delivered prescriptions while also applying medical terminology.

Answered phone calls from doctors, customers and dealers.

Applied medical terminology to all packaged and labeled medications.

Maintained patient/customer information along with the prescription taken in the system.

Processed prescriptions from customers provided by the health professional and dispense the appropriate medicines.

Created compounds or mix medications as prescribed by the doctors.

Worked as an intravenous chemotherapy technician for oncology ward.

EDUCATION

American Senior High School, Miami, FL Graduated

United States Navy, Central Assignments Records Desk (C.A.R.D.) Supervisor 1988-1992

Core Competency

Proficient in Microsoft Office, Oracle, PeopleSoft and Microsoft excel



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