Krystyn Wright 267-916-2980 Muffin1984.kw@gmail.com Day Care Office Support Assistant Dean’s Early Education Academy-Phila, Pa August 2018-Present • Answering Phones • Signing in Visitors • Receiving Payments • Processing Payroll • Data Entry • Other administrative tasks as assigned Precertification Specialist Independence Blue Cross - Philadelphia, PA November 2017 to January 2018 Answers incoming telephone calls in a high-volume Call Center environment from members and health care professionals regarding requests for precertification of health services. Verifies member eligibility by accessing multiple eligibility systems Verifies participation status of professional and facility providers, by product and state utilizing multiple database systems including the National Provider Identification(NPI) Registry Processes precertification requests from members and providers received telephonically or via NaviNet per department guidelines • Obtains all clinical information including procedure and diagnosis codes • Enters all pertinent data in the appropriate computer system • Approves selected services per departmental guidelines • Identifies precertification requests that warrant a medical necessity review • Identifies potentially cosmetic and investigative/experimental procedures Adheres to the departmental standards for staff time, after call work, attendance and non-queue production Adheres to the corporate quality customer-focused professionalism and accuracy standards 4. Responds to voicemails and emails within one business day, as necessary Performs additional duties as assigned Customer Service Representative Optum United Health Group - Horsham, PA July 2017 to October 2017 Answer incoming calls from our customers on issues related to benefit eligibility questions and prescription status inquiries Help guide and educate customers on their prescription benefits, use of plan, formulary, premiums and status of orders, and claims or inquiries Ask appropriate questions and listen actively to identify any questions or issues while documenting required information in computer systems Identify issues and communicate solutions and steps to customers, pharmacies, and physicians with prescription orders and reorders Escalate drug related calls as appropriate to licensed pharmacist for resolution Coordinate internal resolution of claims exceptions and other issues to include determining appropriateness of overriding pharmacy claims edits and error messages Make outbound calls to customers on prescriptions withhold orders and payment issue May also assist with entering new prescription orders into system Meet the performance goals established for the position in the areas of: efficiency, call quality, customer satisfaction, first call resolution and attendance Customer Care Specialist Greater Philadelphia Health Action, Inc September 2016 to July 2017 responsible for ensuring that a patient's insurance allows them to access the services of the specialist's health care provider • Scheduling and rescheduling of all routine and non-routine medical services for assigned patient population. • Coordinate scheduling and referrals to other healthcare providers and services. • Daily confirmation of all on-site clinic and off-site appointments. • Order, prepare and generate appropriate medical records. • Receive, screen and coordinate telephone calls from healthcare providers. • Assist with maintaining and updating of all provider addresses and phone numbers. • Receive incoming correspondence and review/forward to appropriate staff. • Daily data entry of medical appointments, special instructions, patient information/jurisdiction, and pre/post operative instructions. • Prepare reports and forms as directed by licensed staff and in accordance with established policies. • Perform a variety of administrative duties including but not limited to: answering phones; faxing and filing of confidential documents; and basic Internet and email utilization. • Provide excellent customer service to all internal and external customers. Reservationist EDENS - Philadelphia, PA October 2015 to September 2016 *Answered inbound calls in a professional manner. *Served as contact person for all workers within assigned territories. *Arranged for transportation pick up for patrons riding SEPTA CCT. *Gave general wait times and locations for pick up. Direct Care Worker Epic Health Services - Philadelphia, PA June 2013 to May 2015 *maintained records of patient care, condition, progress or problems to report and discussed observations with supervisor and case managers. *Provided patients with help moving in and out of beds, baths, or automobiles. *Cared for patients by changing bed linens,washing and ironing laundry, cleaning or assisting with their personal care. *Prepared meals for patients and completed other chores as necessary. Customer Service Manager Walmart - Philadelphia, PA July 2002 to August 2013 *Oversaw employee activities to ensure timely and efficient service to customers. *Handled monetary transactions including cash, credit, and debit purchases. *Processed refunds exchanges & voids. *Assisted with troubleshooting customer issues complaints & concerns. Account Representative NCO financial February 2009 to June 2010 *Responded to a high volume of calls regarding bill balances, payment plans, pricing, insurance billing, and general customer concerns. *Posted payments to customer accounts. *Located and monitored overdue accounts via computer. *Recorded information regarding financial status of customers and status of collection efforts. Skills Customer Service (10+ years), Microsoft office suite (6 years), Ability to multitask (10+ years), Strong organizational skills (10+ years), Highly developed interpersonal skills (10+ years), Years of office task experience (6 years)   Education Certificate Lincoln technical institute Medical Administration 2005 Certificate Philadelphia O.I.C. Front Office Administration 2006 Diploma Frankford High School 2002