Call Center Representative at Ascension/ABS (2023-12 – Present)
Handled phone inquiries regarding Medical, Dental and Vision claims and benefits from patients, Providers and other insurance carriers.
Delivery Driver at DoorDash (2022-05 – 2023-12)
Serviced inquiries for six insurance lines, including Cherokee Insurance, Edward C. Levy, My Michigan/Connectcare Ins. Co., Smarthealth Women's Health Plan, MAP Seton, and MAP Charity Medical Access Plan of Texas.
- Respond to medical Providers via Authorization Inquiry line.
- Verified pre-certification requirements for medical procedures.
- Handled sensitive medical information, per HIPAA guidelines.
- Verified authorization requirements and coordinated benefits and appeals using Facets interface.
- Escalated complex issues to senior representatives for further assistance.
- Trained new staff on call handling procedures and customer service techniques.
- Maintained up-to-date knowledge of services offered by the organization.
- Documented customer interactions accurately in the internal database system.
- Conducted extensive research on the Schedule of Benefits and Plan Documents.
- Routed issues to Management for extensive research and resolution.
- Hybrid position, requiring in office attendance once monthly.
- Provided pre-service and retroactive authorization information to Physician Staff for medical services and devices.
- Executed timely deliveries of food items from local restaurants to businesses and residents.
- Served clients by delivering pet food and supplies efficiently.
Recruiter / Independent Contractor (Remote) at Quick Start Staffing (2020-10 – 2022-04)
Remote position vetting and placing individuals with local auto manufacturers and auto suppliers in the Metro Detroit area.
- Recruited, vetted, and placed individuals in temporary to permanent positions in a remote role.
- Hired individuals for clients seeking temporary workers, facilitating potential permanent placements after 90 days.
- Recruiting Candidates via Facebook, Instagram and in person career fairs for positions at auto manufacturers; i.e., Jefferson North Assembly Plant, Stellantis, Magna Seating.
- Daily interaction with potential employees and Clients for placement, consultation and termination.
- Verify and confirm available positions matching with available candidates daily via email, telephone and Simple VMS.
- Communicate daily via online interface including, Facebook, Messenger and Instagram.
- Compose social media posts inviting potential candidates to Zoom meeting to introduce potential employees to the hiring Client.
- Confirm and verify hours weekly with Clients, resolve HR issues directly with the Client to ensure the proper Candidate has been placed.
- Personally responsible for vetting, hiring and employee retention for both first and second shifts at Grupo Antolin in Canton, MI.
- Conducted weekly Zoom orientation meetings and onsite new hire orientations, fostering a smoother onboarding experience for new employees.
- Communicated daily with clients via email to verify attendance and address human resources issues, ensuring effective management of work performance and employee transitions.
- Pay Day Pop-up lunches, in-house staff meetings.
- Logging work hours, loss time and potential disciplinary issues.
- Gold Standard expectations and incentives.
Call Center Representative at Detroit Medical Center / Children's Hospital of MI (2019-11 – 2020-09)
- Scheduled pediatric patients for Primary Care and Specialist visits, ensuring timely access to healthcare services.
- Communicated with Physician office personnel to resolve scheduling issues and confirm appointment times/dates per AMA and Physician guidelines.
- Verified insurance and conducted HIPAA compliance checks for patient/parent identification.
Concierge Specialist at Ascension/St. John Providence Hospital (2018-03 – 2019-11)
- Managed logistics for diverse products, including hot/cold food, groceries, and beverages.
- Ensured accurate order fulfillment to maintain high customer satisfaction.
Call Center Customer Service Representative at Ascension Health / St. John Providence Hospital (2016-12 – 2019-11)
- Assisted patients in locating and scheduling appointments with primary care physicians and specialists in a high-volume inbound call center.
- Triage calls to identify resolutions, schedule lifestyle and childbirth classes, and coordinate CareLink education and workshops across various medical disciplines.
- Searched for providers based on patients' locale, insurance, medical needs, and preferences.
- Schedule diagnostic services including mammograms and ultrasounds.
Emergency Department Appointment Specialist at Ascension Health / Providence Park Hospital Emergency Department (2018-05 – 2018-08)
- Provided elite customer service to Emergency Department patients, facilitating follow-up appointments with Ascension Physicians before discharge to ensure continuity of care.
- Collaborated to develop processes and procedures for National Appointment Specialist Pilot Program, enhancing appointment efficiency.
- Reported directly to national consultants and high-level management, facilitating effective communication.
Customer Service Representative II at Blue Care Network of Michigan (2008-04 – 2016-01)
- Facilitated communication with health care members and professionals through inbound calls and written correspondence.
- Verified and identified health care benefits, claims, provider enrollment, pharmacy issues, and authorization approvals/denials to resolve member inquiries.
- Advised members and health care professionals on account status, benefit information, and claim status.
- Communicated with outside entities, including Health Insurance Marketplace, to ensure accurate information exchange.
- Direct communication with Pharmacy/Pharmacists to resolve member and membership issues via Pharmacy Services help desk, up to and including testing sample claims.
- Advocated for members on services rendered, billing issues, claims, authorization, prescriptions, and medical policy criteria to enhance member satisfaction.
Call Center Customer Service Representative at Ascension/St. John Providence Hospital (2018-03 – 2019-11)
- Coordinated scheduling of follow-up and referred appointments using Athena interface, enhancing patient access to care.
- Streamlined management of physician referrals through Athena online scheduling, effectively arranging appointments for patients and referred physicians.
- Responded to physician referrals with focus on priority cases (cardiology, neurology, orthopedics), documenting interactions in Athena and maintaining accurate data in two Excel spreadsheets.
- Facilitated communication between patients and physicians to ensure understanding of care plans.
