I am highly customer service oriented, and value quality customer service over quantity, although I can and have worked under strict time limits and deadlines. I think outside of the box to problem solve successfully.

COMPANY	POSITION HELD	DATES WORKED
UPMC Health Plan	(Confidential)	1/2000 - 3/2006

SCHOOL	MAJOR	YEAR	DEGREE
Butler County Community College	Medical Billing & Coding	2007	Trade School Degree
Community College of Allegheny County	Medical Insurance Specialist	1999	Trade School Degree

Highlights:

Creation of Medical Review Representative position at UPMC Health Plan, and being eventual Team Leader over 7 other Representatives

Companies I like:

Highmark, Humana, United Healthcare, Blue Cross, Blue Shield, Cigna, Aetna, Liberty Mutual, HMO

P&L responsibilities
Presentation
Ecommerce Strategy and digital marketing channels optimization - SEO, SEM, email, affiliates - for high-profile accounts.
Technology Solutions
Sales Support
Software Implementation
Requirements Analysis & Specification
Leadership
Patience
Motivation
Quick Learner
Team Leader
Self Starter
HMO
PPO
POS
Medicaid
Medicare
Customer Service

• medical review
• authorization representative
• pre-certification representative
• utilization management assistant

Authorization of covered benefits medical requests from que line provider requests, ICD-9 and CPT-4 coding, Data Entry of patient demographics, gathering paperwork and information for peer to peer review, routing callers on que line to appropriate department, answering provider requests for referrals and authorizations.