Customer Care Service

EMPLOYMENT HISTORY

Patient Registration/Scheduler/Front office

Waldorf Dentistry/Southern Maryland Family Dental, La Plata, MD — Dec 2024 - Present Sr. Customer Care Representative - Remote

Matrix Absence Management — May 2023 - Present

Field Agent

Horace Mann Insurance Company, Pittsburgh, PA — Apr 2022 - Apr 2023 Hollywood, MD • 989-***-**** • *********@*****.*** Heather Scanlon

Sr. Customer Care Representative with extensive administrative experience, adept in insurance billing, scheduling, and registration to enhance workflow efficiency and customer satisfaction. Known for fostering inclusivity and problem resolution, utilizing tools like Akorbi for effective communication with diverse client bases. Demonstrates analytical thinking and resourcefulness, consistently achieving improved service quality and employee satisfaction through strategic process management. Manage front desk and patient registration, enhancing office efficiency and patient satisfaction. Coordinate scheduling and billing, ensuring seamless patient flow and accurate financial processing. Handle insurance billing and pre-authorizations, optimizing reimbursement and minimizing delays. Utilize Dentrix and Carestack for treatment plan entry and presentation, improving patient understanding. Implemented effective scheduling strategies, minimizing appointment overlaps and improving patient flow for timely care delivery.

Coordinated with dental staff to present treatment plans, fostering transparent communication that improved patient understanding and acceptance.

Utilized Dentrix and Carestack to optimize patient account management, resulting in noticeable gains in collections and reduced administrative workload.

Streamlined patient registration processes, leading to enhanced office efficiency and improved patient satisfaction scores.

Analyzed scheduling patterns to implement effective strategies, minimizing appointment overlaps and ensuring timely patient care delivery.

Provided exceptional customer service at the front desk, creating a welcoming environment that encouraged patient engagement and loyalty.

Manage leave applications, ensuring timely processing and compliance. Direct calls efficiently, enhancing customer satisfaction. Utilize Akorbi for seamless communication with non-English speakers. Escalate issues promptly, maintaining service quality. Full-time role with focus on customer care and problem resolution. Processed leave applications efficiently, contributing to a streamlined workflow and improved employee satisfaction through prompt responses.

Partnered with Akorbi interpreters to assist non-English speaking callers, enhancing accessibility and fostering inclusivity in service.

Maintained a positive demeanor while managing high call volumes, demonstrating resilience and commitment to exceptional customer care.

Licensed in Life, Health, and P&C, serving educators with tailored insurance solutions. Conducted engaging presentations at local schools, boosting policy renewals. Collaborated with educators, enhancing client satisfaction and retention. Utilized remote and local travel to effectively engage the natural market. Developed insurance plans, achieving measurable client satisfaction improvements. Agent

Globe Life Insurance Company, Pittsburgh, PA — Dec 2021 - Apr 2022 Coordinator III, Complaints & Grievances

UPMC Health Plan — Mar 2015 - Nov 2021

Commercial Enrollment Specialist III

UPMC Health Plan, Pittsburgh, PA — Sep 2011 - Mar 2015 Clinical Technology Rounder

MidMichigan Medical Center, Midland, MI — Jan 2011 - Sep 2011 Licensed in Life and Health, conducted daily outreach to small businesses, promoting insurance plans. Executed cold calls, effectively increasing client engagement and plan awareness. Traveled extensively, presenting tailored insurance solutions to businesses with 5-50 employees. Handled member complaints, ensuring timely resolution and satisfaction. Coordinated 3-member reviews, delivering clear decisions to members. Investigated fraud and service issues, improving complaint processes. Exceeded complaint resolution goals, enhancing member trust. Trained new staff, fostering a knowledgeable and efficient team. Investigated and resolved complex member complaints, leading to substantial improvements in service quality and member satisfaction.

Streamlined the complaints process, ensuring timely resolution and consistently meeting or exceeding departmental goals.

Coordinated multi-disciplinary reviews for second-level complaints, enhancing transparency and fostering trust with members.

Maintained comprehensive documentation for all complaints, ensuring compliance with regulatory standards and improving audit readiness.

Trained new team members on complaint handling protocols, promoting a culture of continuous learning and effective communication.

Processed medical, dental, vision applications, enhancing enrollment accuracy and efficiency. Collaborated with Member Services, resolving urgent issues swiftly, boosting member satisfaction. Led premium billing, ensuring error-free monthly processing, supporting financial accuracy. Trained staff on pharmacy systems, resolving issues, improving service delivery. Monitored email requests, ensuring timely processing, contributing to operational efficiency. Enhanced enrollment processes for medical and dental applications, achieving notable accuracy and reducing processing time significantly.

Partnered with Member Services to address urgent member inquiries, fostering improved communication and increasing overall satisfaction.

Developed and implemented streamlined premium billing procedures, leading to consistent accuracy and reliable monthly financial reporting.

Analyzed pharmacy system training needs, delivering targeted sessions that resolved recurring issues and elevated service quality.

Monitored and processed email requests efficiently, enhancing operational workflows and ensuring timely responses to member inquiries.

Supported physicians with EMR systems, ensuring smooth operations across multiple sites. Provided technical assistance, resolving computer issues to enhance workflow efficiency. Collaborated with medical staff to train on digital imaging systems, improving data accuracy. Managed on-call rotations, maintaining consistent support and system reliability. Facilitated EMR training, contributing to improved user proficiency and patient care. Trained physicians on EMR systems, enhancing their operational efficiency and ensuring seamless integration of digital tools in patient care.

Provided comprehensive troubleshooting for computer issues, resolving technical problems swiftly and minimizing downtime for medical staff.

Assisted in user training for EMR and imaging systems, fostering a supportive learning environment to boost staff confidence and competence.

Monitored system performance metrics, identifying areas for improvement that led to noticeable gains in user satisfaction and system reliability.

Secretary

J.C. Colville Crop Insurance, Harrison, MI — Oct 2008 - Jan 2011 Radiology Department Clerk

MidMichigan Medical Center, Clare, MI — Oct 2001 - Jan 2011 Managed claims processing, ensuring accuracy and compliance with regulations. Processed insurance claims efficiently, reducing turnaround time and enhancing client trust and satisfaction. Maintained accurate data entry and record-keeping, ensuring compliance with government regulations and improving operational efficiency.

Analyzed customer inquiries to provide tailored insurance quotes, boosting conversion rates and strengthening client relationships.

Coordinated with cross-functional teams to keep seasonal programs compliant, fostering a culture of shared responsibility and reliability.

Provided exceptional reception and customer service, contributing to a welcoming environment and positive client experiences.

Trained staff on systems, enhancing efficiency and accuracy in radiology operations. Resolved billing/report issues, improving department workflow and patient satisfaction. Managed patient interactions, fostering positive relationships with medical teams. Ensured HIPAA compliance, safeguarding patient data and privacy. Handled patient registration, streamlining processes and reducing wait times. Streamlined patient registration processes, resulting in reduced wait times and enhanced patient satisfaction through efficient data management.

Fostered effective communication among hospital staff and physicians, enhancing patient care coordination and satisfaction.

Provided empathetic phone support and reception services, ensuring a welcoming environment for patients and their families.

EDUCATION

General education diploma

Bishop Gallagher H.S., Harper Woods, MI

General computer courses

Delta College, Saginaw, MI

General computer courses offered through my employers - Late 1990’s SKILLS

Reception

Expert

Registration

Expert

Scheduling

Experienced

Billing

Skillful

Patient accounting

Skillful

Collections

Skillful

Insurance billing

Skillful

Dentrix

Experienced

Carestack

Experienced

Customer service

Expert

Call center

Expert

Complaint processing

Expert

Training

Experienced

Data entry

Expert

Troubleshooting

Experienced

HIPAA compliance

Expert

ADDITIONAL INFORMATION

Military Experience

U.S. Army Reserve, Military Police

Honorable Discharge

Awards

• Support Specialist of the year - MidMichigan Medical Center-Clare 2009

• Employee of the month - MidMichigan Medical Center-Clare March 2007

Contact this candidate