Sandra Robinson

Licensed Accident & Health Insurance

Licensed Property and Casualty Insurance Service Professional

National Accounts Support / A.R. Specialist / Administrative

Customer Service Supervisor & Trainer / Health Insurance Specialist

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Whitinsville, MA

Cell: 386-***-****

adyp2n@r.postjobfree.com

Fully licensed Accident & Health Insurance Service Advisor, AHIP Certified 2024. Listening, consulting and advising clients over the phone on their health insurance options. Working with top national and regional health insurance companies for client options. Certified with most major carriers and licensed in many states.

Property and Casualty Insurance Service Professional in Massachusetts and Michigan, working in the Customer Service Center Personal Lines Department at Hanover Citizens Insurance. More than 20 years' successful experience in customer service and many years supervising, store management, training and support with recognized strengths in claims review and resolution, accounts receivable, problem-solving and computer/copy machine troubleshooting, creative design, hiring, scheduling and more. Over 11 years’ experience with knowledge of Health Insurance Policies, Procedures, following strict HIPAA guidelines AHIP certified and answering member, provider, and broker calls - face-to-face, on the phone, or via fax, email requests for benefits, eligibility, precertification guidelines and more. Possess solid computer skills. Excellent working knowledge using Microsoft Office, Internet research and quick learning of in-house software. Ability to train, motivate, and supervise customer service employees with careful follow-up and coaching. Maintain/update data with quality and accuracy.

Work Experience

Associate Benefit Advisor

eHealth Insurance Inc. May 30, 2023 - Present

Fully licensed Accident & Health Insurance Service Advisor, AHIP Certified 2024, working to help Medicare beneficiaries navigate one of the most important purchasing decisions of their life as they select their health insurance coverage. As a Benefit Advisor I listen, consult, and advise clients over the phone on their health insurance options. Working with top national and regional health insurance companies, I can ensure my clients are getting the right coverage based on their needs for their health and well-being, paired with Medicare A & B and sometimes Medicaid, Extra Help, and chronic illness eligible individuals as well.

Insurance Service Professional

Hanover Insurance – Worcester, MA November 4, 2019 to March 29, 2023

My daily work includes working with independent agents and their customers in the Hanover/Citizens Insurance Customer Service Center Personal Lines department providing consultative service and offering education to the insureds as well as offering Property and Casualty products. Answering customer inquiries, processing of policy and billing changes while also researching coverage and policy related needs. I obtained my Property and Casualty Licenses after a great extent of studying, quizzes and a 2-day course of training for the exams.

I receive inbound calls to assist agents and policyholders with questions regarding their insurance needs. Along with interpreting and verifying policy coverages I work with the changes, renewals and new business transactions. I provide insurance quotes to agents and policyholders and follow up to address and resolve all their needs within a timely manner. I strive to continually achieve a first call resolution strategy with quality and effectiveness as I respond to all inquiries.

National Accounts Sales Support Rep. /Accounts Receivable Specialist

Johnson Controls (previously SimplexGrinnell) - Westminster, MA June 2017 to October 2019

Supporting the sales representatives with daily research and retrieval of information pertaining to fire suppression, sprinkler systems, and other contracts, using 2-3 computer monitors and several software systems. Creating spreadsheets and pulling inspection reports. Review of reports to find device counts for locations, contract information working at home/remotely, while also attending Skype meetings with team members and Managers. Previously Johnson Controls was SimplexGrinnell and I was working in the A/R department. I was maintaining portfolio for the Atlantic coast. Account maintenance, escalating accounts, filing liens, invoice disputes and resolution control, handling remittance advice and payment. Spreadsheets and creating adjustments on payments, net terms control. Working with customers past due balances and using a three step approach of invoices either being Paid, disputed or non- payment and then being considered for collection process. The company merged with Johnson Controls and the A/R department was moved to a new location so I then applied to the National Accounts Department and was hired in the office which changed to a remote position.

Clerk of the Office of Sponsored Programs

WPI - Worcester, MA

April 2017 to June 2017

Working on proposals for grants and aid to faculty and students for trials, engineering and many types of research.

Producing quality entry into system software. Scanning, faxing and much administrative work.

Administrative Assistant

Premier Foot and Ankle - Worcester, MA

October 2016 to April 2017

Working with one orthopedic Doctor and two podiatrists. Greeting patients, answering phones, making

Appointments, insurance verification and data entry. * Obtaining pre-authorizations, referrals, scheduling and ordering/

Imaging. Working on in office projects and more.

Customer Service Representative

Health Plans Inc. - Westborough, MA April 2011 to October 2016

Assisting all claims Provider, Member, Broker calls. Working with team leads/management/supervisors.

Overnights/On Call Pre-certifications Representative for Emergency Inpatient Substance Abuse/Behavioral Health.

Claims processing review, answering all provider and member call types verifying Checks/payments, Research,

Ordering Supplies, Mentoring, working with ICD-9 and ICD 10 codes, diagnoses codes. Receive incoming calls via

A business toll free and forwarded lines and address and/or refer our member/provider calls and inquires.

Creating Letters/documents, email, templates.

Provide information & direction regarding all plan policies: Medical & Dental, regarding procedures, and benefits

And accurate documentation and logging of everything on phone call/email/fax.

Obtain and maintain all pertinent information in members' accounts and follow strict HIPAA guidelines and rules.

Reception, H.R. Assistant

Seven Hills Foundation - Worcester, MA December 2010 to January 2011

Answering multi-line telephone. Assisting Human Resources in many projects

Mail Distribution. Problem solving/direction for walk-in employees & clients

Data Entry & Reception

Claims Customer Service Representative, Assistant Trainer & Supervisor

Fallon Community Health Plan - Worcester, MA April 2005 to November 2010

Claims Provider calls, Member calls. Claims Processing review, answering all provider and member call types

Verifying checks/payments, ICD-9 codes, diagnoses codes. Work closely with assistant trainer and head trainer

to develop new and updated procedures when training representatives.

Ensure business procedures and protocols are taught and demonstrated correctly and accurately at all times.

Create and teach training techniques for our new and seasoned representatives to ensure that they follow business

guidelines and guarantee quality customer service for members and providers

Assist new and seasoned representatives in order to organize and set up their work stations

Work with 30+ customer service representatives in a supervisory role answering and properly assisting them with

any questions they need. Receive incoming calls via the business toll free and forwarded lines and address and/or refer our member/provider

calls and inquiries. Provide information & direction regarding all plan policies, procedures, and benefits

Document and log all pertinent information in members' accounts and follow strict HIPAA guidelines and rules

Education

Certificate in Medical Coding & Third Party Billing

Assabet Valley Reg. Voc. H.S. - Marlborough, MA

Certificate in Travel & Tourism

Garber Travel School - Boston, MA

High School Diploma

Marlborough High School - Marlborough, MA 1987

Certifications/Licenses

Accident & Health License Resident in Massachusetts

AHIP 2024 certified

Property and Casualty Personal Lines Insurance License

Hanover Insurance (Currently - State of Massachusetts & Michigan)

Licenses

Travel and tourism

Garber Travel School (Boston—now closed)

Certification

Medical Coding and third-party billing

Assabet Valley – Medical Billing and Coding

Certification

Additional Information

Recertifying as Notary Public – Massachusetts

Hobbies

Writing poetry, reading, travel, music, family, animals.

Contact this candidate