Customer Service Health Care
Resume:
Robert Macher
Pensacola, FL 32507
**************@*****.***
Objective
Utilize my insurance background and customer service skills to further build my career and help my employer’s organization.
Highlights of Qualifications
Worked effectively as customer service representative and insurance professional.
Awarded by United Health Care and AT&T for outstanding commitment to customer service.
Health Insurance Experience
Customer Care Representative III
Carelon Behavioral Health; Latham, NY. August 18, 2014-June 26, 2024
Answered members’ and health care providers’ claims and benefits questions for call center of major health insurance plan.
Handled supervisory level calls and initiated follow-i[ to resolve complex issues for members and providers.
Assisted monitoring telephone compliance and adherence of colleagues working evening shift.
Customer Care Professional
United Health Group; Kingston, NY. April 2007-December 7, 2009
Informed health care providers and members regarding major health insurance program’s benefits and claims utilizing multiple computer systems.
Educated and advised members on key points of health plan prior to seeking services.
Directed members or providers who reached the caller center to the appropriated department or vendor in order to resolve their issue promptly.
Claims Examiner
Norman Staffing; Kingston, NY. June 2006-April 2007
Entered billing information into computer fee-scheduling system of Managed Physical Network.
Processed claims primarily in the fields of physical therapy and chiropractic.
Maintained a high degree of speed and accuracy consistently in work performance.
Medical Claims Examiner
AIG Claim Services; Albany, NY. January 2001-March 2005
Entered billing information into fee-scheduling system for major insurance company.
Processed no-fault claims bills from a variety of health care providers including hospitals, family practitioners, specialists, chiropractors and physical therapists.
Accurately and consistently processed approximately 100 bills per day.
Customer Service Experience
Revenue and Account Management Associate
Pitney Bowes, Colonie, NY. October 1997-August 1999
Handled telephone inquiries and requests at customer support center for major mailing and office machine company.
Utilized multi-screen computer system to place service calls, sales leads and access information for customers.
Directed callers to appropriate person, department or office in major corporation.
Communications Assistant
AT&T; Clifton Park, NY. March 1994-September 1995
Relayed telephone conversations for hearing-impaired callers by speaking and typing information over the phone line.
Facilitated telephone/teletype conversations and established billing and dialing information via computer system.
Instructed first-time users about the relay system for teletype phones and provided answers to consumers’ inquiries.
Most Relevant Work History
8/18/14-6/26/24 Customer Care Associate III, Latham, NY.
3/15/10-6/29/12 Data Entry Operator; Focused Technologies, Menands, NY.
4/23/07-12/07/29 Customer Care Professional; United Health Group, Kingston, NY.
06/05/06-04/19/07 Claims Examiner; Normann Staffing; Kingston, NY.
01/15/01-03/18/05 Medical Claims Examiner; AIG Claims Services. Albany, NY.
10/97-8/99 Revenue and Account Management Associate; Pitney Bowes, Colonie, NY.
2/96-10/97 Operator; Secrephone, Colonie, NY.
3/94-9/95 Communications Assistant; AT&T, Clifton Park, NY.
Education
1986 B.A. English Literature, New York University.
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