Co-facilitates 1 fall quarter course - Social Justice in South Africa

PRN basis

• Identifying, researching and reconciling billing payments amounts to ensure accurate eligibility determination, payment, revenue and membership records.• Setting up and maintaining member data including but not limited to processing enrollments, corrections, retroactivity adjustments and terminations.• Supporting eligibility inquiries.• Ensuring bills are correct and mailed timely.• Interacting with purchaser benefit administrators to answer questions and explain Health Plan policy and contractual provisions related to membership and billing. Resolving related problems.• Assisting Health Plan purchaser contacts and sales and service representatives in the sales process and the analysis and resolution of problems related to membership accounting.• Conducting audits of purchasers with large payment variances, unallocated payments or other specified criteria. Resolving payment discrepancies and delinquencies.• Ensuring purchasers compliance with Health Plan policies and contractual provisions.• Preparing reports and managing purchaser correspondence.• Receiving, entering data, reviewing, researching balancing, and applying daily purchaser deposits and sources from the bank in a timely and accurate fashion.• Assisting with the production and distribution of payment-related reports required by purchasers and management, and by operating and maintaining printers and other related peripheral equipment.• Supporting Medicare processing and reporting requirements.• Ensuring that changes to contract are quickly and accurately updated in the contract systems.• Assisting with the production and distribution of contracts and related notices for new and renewing purchasers and individuals.• Answering, researching, issuing and resolving problems related to medical records numbers (MRN) and performing any required follow up activities.

• Initiates contact with Clients within a specified time to resolve benefit disputes.• Receives inbound calls from customer to provide central point of contact. • Analyzes escalated issues or inquiries and uses appropriate resources to ensure satisfactory resolution.• Resolves member issues and customer inquiries accurately within specified time frame.• Uses knowledge network to ensure successful resolution of member issues and customer inquiries.• Effectively consults with cross functional teams to demonstrate value and build commitment to customer satisfaction.• Acts as a liaison between Members, Plan Administrators and Employer Groups to ensure appropriate documentation for the plan benefit activities. • Resolves customer issues and members inquiries accurately within a specific time frame. • Analyzes escalated issues or inquiries and uses appropriate resources to ensure optimal resolution.• Provides real time status updates on plan benefits and membership activities.• Identifies and reports trends to appropriate internal stakeholders for quality control and root cause analysis.

• Demonstrated functional skill to troubleshoot and resolve technical problems and other general account inquiries over the phone in a single customer interaction to maximize the customer experience, with demonstrated ability to articulate relevant information and directions in an organized and concise manner.• Followed established troubleshooting procedures, including use of appropriate resources and desktop tools. When necessary, produce work order according to established business rules.• Demonstrated ability to establish and maintain effective relationships with customers. Effectively gained the customer's cooperation to work through the troubleshooting process, ensuring customer problem resolution.De Andra I. Sharp Page 2 of 2 • Acted as a product consultant, articulating product features and benefits and making recommendations based on customer needs/interests; identifying buying signals and asking for the sale, reselling current value or right-size, delivering a quality customer experience.• Demonstrated awareness of company policies and procedures while applying sound judgment within the scope of their empowerment and follows guidelines for Customer Proprietary Network Information (CPNI) and Personal Identifiable Information (PII).

• Acted as a product consultant, articulating product features and benefits and making recommendations based on customer needs/interests; identifying buying signals and asking for the sale, reselling current value or right-size, delivering a quality customer experience.• Demonstrated awareness of company policies and procedures while applying sound judgment within the scope of their empowerment and follows guidelines for Customer Proprietary Network Information (CPNI) and Personal Identifiable Information (PII).ADT Security Services, Aurora ColoradoInbound/Outbound Emergency Dispatch Operator/Special Operations Representative (2007-2010)• Dispatched proper authorities during emergency situations. • Reviewed and cleared Department of Defense government contracted accounts.• Supported false alarm research and damage claims, as well as provided support for other data cleanup projects.• Completed data entry associated with downloading, including confirmation of test signals.• Completed national and residential work orders via email and inbound calls. • Handled video and 2-way emergency calls for residential and national accounts.• Communicated one on one with national security.