OSCAR WILLIAMS

Provided concierge service to health plan members, resolving inquiries and exceeding productivity and quality standards. Utilized software applications to address administrative issues related to health plan operations, including claims resolution and benefit interpretation.

Responded to escalated HIPAA questions via telephone and written correspondence regarding insurance benefits, provider contracts, eligibility, and claims. Analyzed problems and provided information/solutions, documenting inquiry outcomes for accurate tracking and analysis.

Processed claims following the Health First Hold Code Manual, either paying or denying doctors' billed forms. Calculated fee schedules for different hold codes and sent service forms for invalid patient information.

Managed escalated customer calls, providing assistance with difficult inquiries and escalating to corporate for final resolutions. Initiated system requests for new hires, including phone and payroll access, and created Excel files for user-name and password access.

Improved customer service, stockroom, money handling, and security procedures. Promoted to Front-End Supervisor, demonstrating leadership and operational efficiency.

Currently pursuing an Associate's degree at Houston Community College. This program is enhancing my knowledge and skills for future career advancements.

Undertook an Associate's degree program at Wharton Junior Community College. This period focused on foundational coursework to prepare for higher education or entry-level professional roles.

Completed high school education, earning a diploma. This foundational education provided essential skills and knowledge for further academic and professional pursuits.