Remote Customer Service & Health Support Professional

Mary R. O’Neil

802-***-**** ********@*****.*** Spring Hill, Kansas

PROFESSIONAL EXPERIENCE

Community Health Worker 12/2024 - 8/2025

Elevance Health

● Coordinate care among members, communities, and health and social service systems.

● Conduct outreach through home visits.

● Identify health related issues and any barriers preventing members from accessing available resources.

● Advocate for members regarding housing, food security, and other needs.

● Provide necessary referrals to resources.

● Increase member participation in assessments to improve their health and well-being. Remote Customer Service Representative 6/2023 - 11/2024 Aetna Better Health

● Answer high volume inbound calls via an automated phone system.

● Utilize resources to troubleshoot and resolve patient issues.

● Screen and route member and provider calls to other departments efficiently.

● Assist members in website navigation.

● Provide contact information for network providers within members’ service area and assist in scheduling appointments.

● Authorize short notice trips and aid in scheduling transportation. Remote Customer Service Representative II 12/2021 - 2/2023 Molina

● Support provider needs with a wide variety of inquiries.

● Identify opportunities to improve the provider experience.

● Assist with claims, authorizations, appeals, contracting and credentialing.

● Conduct initial research and work to immediately resolve issues.

● Escalate issues based on necessity and established risk criteria.

● Accurately document all calls and interactions.

Medicare/Marketplace Dual CSR 9/2018 - 8/2021

Maximus

● Act as a liaison for patients, vendors, insurance companies and other medical facilities.

● Answer questions and resolve emerging problems.

● Collaborate with members to determine the most cost effective part D or part C plan.

● Assist with healthcare application for coverage through the Marketplace.

● Educate members on Cost Sharing Reduction.

● Assist with utilization of premium tax credit.

Records Specialist 1/2018 - 7/2018

Clara J. Charlebois Melendy, CFP, ChFC, CLU, CRPC, APMA Private Wealth Advisor for Ameriprise Financial

● Verify client identification.

● Assess documents and categorize appropriately.

● Remove and shred obsolete documents.

● Create digital files of remaining pages.

● Assist in meeting compliance deadline.

Staffing Agency Recruiter 6/2017 - 12/2017

Manpower

● Provide support to temporary employees to ensure job performance and satisfaction.

● Manage candidate intake process and follow-up in a timely manner.

● Effectively manage candidate database to ensure information is current. This includes availability for work, working hours, desired pay rate, personal information, complaints, testing and performance appraisals.

EDUCATION

University of Texas Major, English Minor 1993 - 1997 University of Rhode Island English Major 1991- 1992 TRAININGS/CERTIFICATIONS

First Aid CPR AED 2025

Heartsaver CPR Solutions

Safe Schools 2017

South Burlington School District

Vermont Certified Victims in Crisis Worker 2013

H.O.P.E. Works

Recovery Coach Academy 2012

Vermont Association for Mental Health and Addiction Recovery VIRTUS 2008

The National Catholic Risk Retention Group, Inc.

VOLUNTEER EXPERIENCE

Administrative Assistant/Recovery Coach 3/2010 - 8/2016 Vermont Recovery Network/Turning Point Center

● Guide and support persons in recovery from addiction by taking an active role in their lives.

● Identify recoveree’s primary goal.

● Facilitate creating and following a recovery wellness plan to attain said primary goal

● Responsible for maintaining a safe, substance free environment for those in recovery.

● Aid in fundraising and the scheduling of meetings, groups, classes and activities.

● Facilitate clients’ navigation through resources available outside of Turning Point.

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