Elizabeth Bourgeois
Lillington
Summary
Proactive professional with 28 years of experience in customer and provider services. Demonstrates strong problem-solving skills and a proven ability to build lasting relationships with clients and team members. Focused on driving team success and delivering positive outcomes. Adaptable to new challenges and environments.
Overview
8
8
years of professional experience
Work History
Providers Services Advocate
United Healthcare Group
Lillington
07.2016 - 08.2024
- Facilitated communication between providers and internal teams for efficient service delivery.
- Resolved provider inquiries using case management software and customer support tools.
- Maintained accurate provider records in the electronic health record system.
- Coordinated training sessions for new staff on provider services processes and protocols.
- Assisted in developing training materials for ongoing professional development initiatives.
- Collaborated with cross-functional teams to streamline provider onboarding procedures.
- Monitored service quality and compliance with organizational standards and guidelines.
- Provided feedback to management on process improvements for enhanced service efficiency.
- Adhered to all applicable laws, regulations, standards, and procedures when interacting with customers and providers.
- Developed relationships with new providers by providing guidance on how to use our systems, processes, and policies.
- Participated in training sessions as needed to stay current on industry trends and best practices related to Provider Services Representative duties.
- Assisted customers in navigating the online portal for self-service requests.
- Answered incoming calls from clients and routed them to appropriate personnel for further assistance.
- Verified accuracy of submitted documentation prior to processing claims or services rendered.
- Collaborated with team members to identify process improvement opportunities that could increase efficiency or reduce costs.
- Responded promptly to emails sent by providers concerning billing inquiries or other related matters.
- Maintained up-to-date knowledge of products and services offered by the company.
- Followed up with clients on outstanding documents or payments required for processing claims or services rendered.
- Maintained detailed records of client communications in the company's database system.
- Identified discrepancies between invoices received from providers versus payments made by the company.
- Resolved customer complaints and escalated more complex issues to senior staff members.
- Reviewed provider accounts regularly for compliance with established criteria.
- Ensured compliance with HIPAA regulations while handling confidential patient information.
- Processed claims and coordinated with providers, payers, and other third parties as necessary.
- Promoted high customer satisfaction by resolving problems with knowledgeable and friendly service.
- Mentored junior team members and managed employee relationships.
- Led on- and off-site customer support teams across multiple time zones.
- Prevented key account losses by researching discrepancies and correcting problems.
- Exceeded established service goals while leveraging customer service, sales, and employee management best practices.
- Updated system with order specifics and customer details, preferences, and billing information.
Education
Associate of Science - Licensed Massage Therapy And Health Educator
National Holistic Institute
San Jose05-2007
Some College (No Degree) - Peer Support Specialist - Behavioral Health
Take Your Heart To Work
SanfordSkills
- Customer relationship management
- Provider communication
- Case management
- Compliance adherence
- Team collaboration
- Training development
- Strong interpersonal skills
- Time management
- Goal-oriented mindset
- Problem-solving skills
- Data entry accuracy
- Understanding customer needs
- Needs assessment
- Written communication
- Teamwork skills
- Excellent communication
- Analytical thinking
- Quality assurance
- Multitasking Capability
Timeline
Providers Services Advocate
United Healthcare Group
07.2016 - 08.2024
Associate of Science - Licensed Massage Therapy And Health Educator
National Holistic Institute
Some College (No Degree) - Peer Support Specialist - Behavioral Health
Take Your Heart To Work