MARIO J. FIORUCCI

OBJECTIVE

I am seeking a medical insurance, customer service

representative position. I have experience resolving customer issues by providing one-call, quality service. I also have processed grievances and appeals for Medicare Advantage plans, PA Medicaid, ACA Marketplace and all other types of corporate benefits.

EXPERIENCE

Futran Solutions/DXC/MetLife Sugar Notch, Pa, PA LIFE INSURANCE CUSTOMER SERVICE

REPRESENTATIVE

01/2023 -

06/2023

I answered questions for Term, Whole Life and Universal insurance policies for callers to MetLife. I processed personal data changes and sent out forms to make changes within the policies. I was also able to process cash surrender requests or partial withdrawals for policyholders. SGS Consulting/Aetna Sugar Notch, PA

MEDICAL CUSTOMER SERVICE

REPRESENTATIVE

10/2022 -

11/2022

I answered calls from medical providers, pharmacies and members enrolled in Aetna Group Medical policies. I provided coordination among providers to assist members with new or ongoing appointments. I updated coordination of benefit indicators and processed pre-certification referrals. I also verified what services, medical equipment and procedures were covered by Aetna, for the insured and their families.

WIPRO - AT&T Wilkes-barre (remote), PA

CORPORATE BENEFITS SPECIALIST 08/2021 - 04/2022

I answered calls from current and retired AT&T management and union employees, to enroll or re-enroll them, in corporate benefits. I helped callers compare various medical, Medicare, pharmacy, dental, vision, and insurance products for themselves and their families. I also processed benefits under COBRA, for employees and dependents.

Accenture - TN Dept. of Labor Nashville (remote), TN CUSTOMER SERVICE

REPRESENTATIVE

03/2021 -

06/2021

I resolved unemployment claim issues for the Tennessee Department of Labor, Office of Unemployment. I answered calls from residents that wanted to file for unemployment or wanted to file for their weekly benefits. I also helped claimants write appeals for issues that were impeding their claims or benefit payments. U. S. Census Bureau Allentown, PA

ENUMERATOR 08/2020 - 10/2020

I went door to door to interview people for the U. S. Census Bureau. I traveled throughout Northeast PA to find people that needed to complete their 2020 Census application. I used an iPad to record my interviews and complete my assignments.

Geisinger HealthPlan Pittston Twp., PA

MEDICAID CUSTOMER SERVICE

REPRESENTATIVE

10/2018 -

12/2019

I answered calls from medical providers, pharmacies and members enrolled in PA Medicaid . I provided collaboration and coordination among providers to CONTACT

adyhs6@r.postjobfree.com

570-***-****

SUGAR NOTCH, PA

EDUCATION

Master’s degree

Political Science and Government

Georgetown University

09/1980 - 06/1982

Bachelor's degree

College Misericordia

09/1976 - 06/1980

SKILLS

• Type 60+ WPM

• I am intermediate skill level for MS

Excel

• I am intermediate skill level for MS

Outlook

• I am intermediate skill level for MS

Word

MARIO J. FIORUCCI

achieve better results for patients, including implementing mentoring options. I updated coordination of benefit indicators and processed pre-certification requests. I also approved pharmacy overrides and approvals for specialty drugs from pre-approved companies.

Maximus Federal Pittston Township, PA

MARKETPLACE APPEALS WORKER 03/2018 - 05/2018

I facilitated hearings for appellants with Federal Judges, to resolve Grievances and Appeals filed under the Affordable Care Act of 2010. In this capacity, I consulted with appellants to prepare them for issues that would be addressed in the hearings. I was able to help them attain a high degree of approval for their challenges to denials, for full or partial subsidies. I typed complete 'minutes' of the hearings and also tracked all completed cases, in order to assist the Operations Department, in fulfilling decrees enacted by court orders. SGS - CVS Mail Order Pharmacy Hanover Township, PA CUSTOMER SERVICE

REPRESENTATIVE

11/2017 -

02/2018

I answered calls from regular CVS customer service locations across the U.S. I corrected prescription order problems due to insurance payment issues, drug interaction, or loss due to theft or damage. I also processed Grievances and Appeals and tracked their progress in Excel.

GenPact Mortgage Services Hanover Township, PA

CUSTOMER SERVICE SPECIALIST 07/2017 - 10/2017

I updated and coded information for mortgage foreclosures on MERS, a national internet portal for mortgages. I took inbound calls from MERS members and made outbound calls to banks, mortgage investors and real estate professionals. OneSource Staffing and Navient Wilkes-barre, PA

INCOME TAX COLLECTION SPECIALIST 04/2017 - 06/2017 I was employed for an 8-week assignment for Pennsylvania's Tax Amnesty Program. I worked in Navient's Hanover Township, PA call center to collect back taxes owed to Pennsylvania's, Department of Revenue. WNS Global Travel Hanover Township, PA

CUSTOMER SERVICE

REPRESENTATIVE

06/2016 -

12/2016

I booked Bank of America and US Bank, credit card reward members for flights, hotels and car rental reservations. I also serviced all reservations, which required flight changes or cancellations. Koury Realty Wilkes Barre, PA

PROPERTY MANAGER 07/2014 - 05/2016

I managed a six story office building and three story parking garage. I also helped with office rentals and vendor visits by using MS Excel 2013 to track unpaid rental fees and payment to vendors, on a timely basis. Xerox Call Center and Highmark BCBS Scranton, PA CUSTOMER SERVICE

REPRESENTATIVE

03/2014 -

05/2014

I was a Temp Medical CSR and for Highmark Blue Cross Blue Shield in a Xerox Call Center, in Scranton, PA. The position was temporary, as a new billing service department, using existing CSR's, created a short term gap in manpower, for Highmark Blue Cross and Blue Shield. TMG Health Scranton, PA

MEDICARE CUSTOMER SERVICE

REPRESENTATIVE

09/2013 -

12/2013

TMG Health was a call center that was contracted by various medical insurance companies, that offered Medicare Advantage Plans and Medigap insurance. I also took overflow calls from the Medicaid department, for providers and insured. Duties included writing up appeals for payment by both providers and insured individuals. Telerx Hanover Township, PA

CUSTOMER CARE REPRESENTATIVE 04/2012 - 05/2013

MARIO J. FIORUCCI

I answered questions and processed complaints about Campbell's soups, V8, Prego and Pace food products. I also investigated claims of defective products to determine if the consumer was eligible for a financial settlement. Diversified Information Technologies Scranton, PA MEDICAL RECORDS CLERK 05/2002 - 08/2010

I checked all claims for appropriate coding and I performed quality audits to correct medical classifications, before imaging paper claims. I was also assigned to Quality Control, where I was tasked with writing a report on internal functions, which was used in our application for ISO 2000 quality certification and reorganization. Copeland and CitiStreet, Inc. Mechanicsburg, PA

DEFERRED COMPENSATION

REPRESENTATIVE

01/1998 -

11/2000

I was a registered NASD Series 7, benefits represenative, covering a 10 county area in Northeast PA. I presented deferred compensation options to invest in available plans to all Commonwealth of Pennsylvania employees, at their office locations.

Montauk Securities Scranton, PA

REGISTERED REPRESENTATIVE 01/1996 - 12/1997

I was a stock broker and life insurance agent, in Scranton, PA. I brought in business that participated in financial planning services, portfolio management services, mutual funds, annuities, stocks and bonds. Christensen Advisory Stamford, CT

INVESTOR RELATIONS CONSULTANT 01/1993 - 11/1995

I targeted the Broker/Dealer network in the US, by creating and mailing investor Fact Sheets to their stockbrokers. I also helped train corporate executives, when presenting their financial performance to "Wall Street" or the financial media. Friedberg Mercantile Group New York, NY

FUTURES TRADER/ACCOUNT

EXECUTIVE

12/1990 -

12/1992

I was a stock and futures broker at 67 Wall Street for Friedberg Mercantile (HQ: Toronto at 181 Bay St, Toronto ON M5- phone:1 416-364-1171I). I was their Executive Sales Agent for all Managed Futures investment programs in the U.S. I also worked during this time frame, with London Investment Trust, as a trader on the floor of the Commodities Exchange Center (CEC) at the World Trade Center, in NYC.

QUALIFICATIONS AND ACHIEVEMENTS

Member, Advisory Board, Area Agency on the Aging 04/01/2017 I was appointed by unanimous vote of the Luzerne County Council to serve as a member of the Advisory Board for the Luzerne-Wyoming Counties, Area Agency on the Aging, a state funded entity. Member of Municipal Council 01/01/2010

I was elected to the Sugar Notch Borough Council in 2010 and served two, four year terms. My duties included voting on all necessary issues brought before council, including creating an annual budget and capital budget. References are available upon request

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