Dedicated professional with history of meeting company goals utilizing consistent and organized practices. Skilled in working under pressure and adapting to new situations and challenges to best enhance the organizational brand.
Overview
14
14
years of professional experience
Work History
Application Reviewer
National Board Of Certified Counselors
03.2019 - 07.2022
Reviewed Professional Counseling applications provided by client.
Communicated clearly and concisely with applicants, clients, and other professionals via letter, telephone, and email.
Ensured each applicant meets licensure requirements and regulations set forth by state
Demonstrated professional, political, and cultural aptitude with ability to work with diverse individuals, groups, and organizations.
Exhibited high degree of self-motivation and ability to work independently.
Educated applicants on state's licensing procedures and processes.
Completed paperwork, recognized discrepancies and promptly addressed for resolution.
Managed competing deadlines with efficiency.
Compliance Agency Licensing Specialist
Key Risk
07.2017 - 12.2018
Acted as licensing support for all agents, both internal and external via telephone / email.
Initiated initial and additional appointments, appointment renewals,terminations, follow up on appointments, termination rejections; update systems, pay invoices.
Understand use of agent data base, such as SIRCON, NIPR, PDB.
Ensured agency compliance by maintaining and following up for documentation such as contracts, agency and producer license and errors and omissions policies.
Received and reviewed state insurance department announcements of agents' renewals and reconciles with company agent listing.
Utilized systems and state specific websites to process transactions and to stay abreast of changes and revisions in insurance industry.
Submitted and received requests for background investigation on agents and determines if contracts submitted are allowed based on company guidelines.
Implemented new processing system method with all renewals or terminations
Performed research on agent data problems and commission errors related to licensing and provided resolutions to resolve any issues.
Customer Relations Manager
VG Home Solutions
01.2014 - 05.2017
Lead a team of four customer service representatives.
Assessment of individual and family needs, developed a plan of care for each new client, arranges or provide home safety evaluations.
Prioritized and managed multiple tasks requiring extensive timely follow up and completion of all projects.
Facilitated inter-departmental communication to effectively provide customer support.
Investigated and resolved customer inquiries and complaints in an empathetic and timely manner.
Scheduled staff shifts to cover peaks and lulls in customer inquiries.
Monitored client accounts and identified possible issues.
Devised metrics to measure the company's success in delivering world class customer service.
Contacted insurance payers on behalf of physicians' offices to verify patients Medical and Pharmacy eligibility and benefits coverage
specific to the drug “Orencia”,
Completed data entry and /or appropriate forms,
Verified prior authorizations research and insurance reimbursement processing to ensure patient coverage for yearly enrollment.
Member Service Representative
Aetna
05.2008 - 11.2013
Helped large volume of customers every day with positive attitude and focus on customer satisfaction.
Adjudicate medical/pharmacy claims.
Part of the escalation team that responded to supervisor issues to ensure timely response to all employee inquiries and complaints
to guarantee quick, equitable, and courteous resolution.
Learned and maintained in-depth understanding of product and service information to offer knowledgeable and educated responses to diverse customer questions.
Complied with all federal programs such as HIPAA, COBRA, and FMLA,
Assisted in various research requests, including timely responses to audit inquiries, assisted in developing and preparing reports, letters, and spreadsheets
Consistently exceeded required response time by 69% with optimal call control and proper use of internal knowledge bases.