Service Advocate Provider

Shirley A. Lee

*** *. *** ****** ***. A *** 563-***-****

Eldridge, Iowa 52748 *********@*****.***

Summary

Compassionate Service Advocate recognized for high productivity and efficient task completion. Skilled in client relationship management, conflict resolution, and policy advocacy. Excel in communication, empathy, and problem-solving to enhance service delivery and client satisfaction while using multiple computer systems and monitors. I appreciate challenges and desire to make a difference .

Senior Provider Service Advocate / United Healthcare May 2020 – May 2024

• Volunteered to sign on to position as Provider Service Advocate for Medicare/Medicaid

• Started with State of Iowa,then transitioned to all states

• Following continued updates from Medicaid from the state level and updates from Medicare

• Volunteered for Click2Chat program, using systems to on-line chat with providers, while assisting with in-bound calls Provider Service Advocate / United Healthcare

August 2019 – May 2020

• Accepted position as Provider Service Advocate for Commercial United Health care

• Completed 6 weeks training

• Research and resolve for providers claim issues, payments, benefit and authorization discrepancies

• Submitted authorizations for providers for inpatient, outpatient services

• Educated providers on procedures and policy limitations for and plans Member Service Representative / United Healthcare

Jan 2018 - Aug 2019

• Answered calls from members in regard to insurance coverage with Medicare/Medicaid, which providers are contracted and reaching out to providers for appointments

• Identified and resolved member issues in a timely manner, including claim disputes, payment inquiries, authorizations and prescriptions

• Maintained professional relationships with members

• Displayed strong telephone etiquette, effectively handling difficult calls

• Maintained positive working relationship with fellow staff and management

• Engaged in continuous professional development to stay informed on advocacy best practices and emerging issues

• Accepted additional positions suggested by supervisor, such Voice Mail Champ - listening to voicemails, returning calls to concerned members

Customer Service Representative Siruis/XM Radio

Feb 2015 - Jan 2018 Inbound Call Center

• Answered customer inquiries and provided accurate information regarding products and services

• Continuous high record of maintaining customers and adding new clients

• Maintained a high level of professionalism when dealing with difficult customers

• Resolved customer complaints promptly and efficiently

• Identified opportunities for upselling additional products or services based on customer needs

• Accepted Customer Service Escalation and Retention position Education and Training

United Healthcare

Siruis/XM Radio

Continuing education with employer