APAC - Licensed Representative for WellPoint Resume Example

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Matthew Harris

XXXX XXXXXX XX, Charlotte, NC 28208

Ph: XXXXXXXXXXXX

XXXXXXXXXXXXXXXXXXXXXXXXX

Professional Summary

Skills

HEALTH INSURANCE MARKETPLACE (AFFORDABLE CARE ACT) CERTIFICATIONS (2014)
Individual Marketplace Certification for Agents & Brokers
New York Health Benefit Exchange (NYHBE) Individual Market Certification
New York Health Benefit Exchange (NYHBE) SHOP Certification
Procedural Terminology

Strong Oral & Written Communication Skills
Organizational Skills

Customer Service Experience
Life/Health/Medicare Insurance Licenses

Telesales Experience

Experience

Licensed Representative for WellPoint (East Region) Dec 2013－Present APAC － Charlotte, NC Utilize strong insurance background to effectively educate, research and assist individuals in applying for Qualified Health Plan coverage. Provide coverage and subsidy information to individuals being introduced to the Affordable Care Act plans (for Empire Blue Cross/Blue Shield) offered in NY, ME, CT, VA, GA and NH. Manage incoming and outbound calls, assist customers in understanding the subsidy guidelines and calculations, explaining the different metal levels and comply with the standards set by the exchange. Completed Exchange specific training and certified to register with the exchange to ensure thorough knowledge in eligibility and enrollment of qualified individuals. Accessing multiple producer portals, maintaining an updated schedule for follow-up calls to customers and effectively utilizing a microsite ensures that each consumer's needs is addressed in a timely manner.

United Health Care Medicare/Group Retirees Telesales Agent (Enrollment/Education) Aug 2013－Dec 2013 Connextions, Inc., － Charlotte, NC
Utilized effective communication skills to manage incoming calls
from Medicare customers
in order to explain and enroll potential clients into UHC Medicare plans and services. Exhibited excellent verbal/written communication skills while ensuring each customer's HIPAA information was maintained according to CMS guidelines. Identified and determined any specialty needs of the current and potential clients to ensure that their individual insurance needs were addressed, easily understood and electronically processed in a timely manner. Processed telephonic enrollments in accordance with UHC, Medicare and each group retirees' guidelines

Retail Pharmacy Help Desk Agent Aug 2012－Sep 2013 Connextions, Inc. － Charlotte, NC

Provided efficient customer service to clients.

Contacted insurance providers to verify correct insurance information and get authorization for proper billing codes.

Verified payments by insurance companies were accurate and according to contract guidelines.

Thoroughly reviewed remittance codes from EOBS/AR's

PATIENT ACCOUNT REPRESENTATIVE Jul 2011－Dec 2011 CAROLINA HEALTHCARE SERVICES － Charlotte, NC

Provided efficient customer service to clients.

Contacted insurance providers to verify correct insurance information and get authorization for proper billing codes.

Verified payments by insurance companies were accurate and according to contract guidelines.

Thoroughly reviewed remittance codes from EOBS/AR's

FRONT OFFICE SUPPORT Jan 2011－Apr 2011 MECKENBURG PULMONARY SPECIALIST － Charlotte, NC

Provided efficient customer service to clients.

Recorded and filed patient data and medical records.

Precisely completed appropriate claims paperwork, documentation and system entry.

Professionally and courteously verified appointment times with patients.

Scheduled patient appointments.

CUSTOMER SERVICE Oct 2006－Mar 2009 SAM'S CLUB － Charlotte, NC

§ Answered questions regarding the store and its merchandise.

§ Greeted customers and ascertained customers' needs.

§ Maintained knowledge of current promotions, policies regarding payment and exchanges, and security practices.

Recommended merchandise based on customer needs.

Education

medical billing and coding college diploma Apr 2011 kaplan college － Charlotte, NC

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Patient Account Representative Referral Coordinator Customer Service

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APAC - Licensed Representative for WellPoint Resume Example

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