Applicant # 116159

Experience:     Boston IVF, 04/2000 – Present
                        Patient Accounts Appeals Representative
                        - Identify incorrect insurance dispositions
                        - Run and work aged medical accounts receivable report to identify problems related to third party payers
                        - Initiate and follow up on the claims appeal process
                        - Resolve patient inquiries, complaints, and concerns
                        - Educate patients on their health benefits, limits, and restrictions
                        - Involve the Commonwealth Division of insurance on unresolved and inappropriate insurance practice 

Tufts Health Plan
Provider Specialist, 07/1999 – 03/2000
- Investigate various claims discrepancies and problem solve claims in a timely fashion
- Educate and train new provider specialists on handling complex claims issues
- Resolve complex and escalated calls that require supervisory attention
Resource Coordinator, 07/1998 – 07/1999
- Work with medical provider staff and patients to problem solve claim issues
- Educate answer reps at the Tuft’s Resource Desk to maintain quality customer service
- Resolve intricate issues through in-depth investigation
Customer Relations Coordinator, 11/1997 – 06/1998
- Act as a direct liaison between Tuft’s Health Plan and members
- Promote products and services offered to prospective members
- Investigate enrollment issues as Team Representative
- Resolve balance-billing issues for members

N.M.H.C.C., Inc., 04/1996 – 11/1997
Summit Account Manager
- Increased attendance at conferences by 35% through aggressive telephone sales and direct marketing
- Assist with the organization of all managed care health conferences by overseeing registration, directing delegates, and monitoring sessions
- Organize conference vendors to assure quality services 

Frito Lay, Inc., 09/1999 – Present
Sales Associate (Part-Time)
- Successfully increasing shelf space at various supermarkets and chain stores by an average of 20%
- Assemble product displays and maintain a healthy relationship with store managers
- Record precise inventory of products on store shelves daily 

Boston Sports Club, Inc., 06/1993 – 09/1995
Assistant Manager / Membership Sales
- Responsible for all facets of staffing, including hiring, progress reviews, interviewing
- Approve time off requests and disciplinary action
- Increase membership sales through direct mail marketing, telemarketing, and local advertising
- Implement a successful personal training program for members 

Education:      University of Massachusetts at Dartmouth, 1987
                       Bachelor of Arts - Sociology
                       Minor – Criminal Justice