Computer Literacy
Adora De Gout
Clinical Admin Coordinator
Sugar Land,TX
Summary
Experienced Clinical Administrative Coordinator well-versed in handling clerical, case management and claims reviews in busy healthcare environments. Highly organized and detail-oriented with excellent planning and communication skills. Prepared to offer seven years of related experience to a challenging new role with room for advancement.
Overview
13
13
years of professional experience
1
1
year of post-secondary education
Work History
Clinical Admin Coordinator
UnitedHealth Group
Sugar Land, TX
01.2016 - Current
- Make outbound calls to Medicare and Medicaid members in regards to approval(s) or denial(s) service request.
- Make outbound calls to providers
- Answer provider calls and respond to emails.
- Supported EE Focus group
- Assist with on boarding training new hires and cross training current employees
- Check voicemails and return calls to members and providers.
- Coordinated, monitored, assigned, and documented patient and clinical care activities.
- Implemented new policies and educated staff on changes.
- Reviewed cases to determine need for escalation.
- Maintained complete documentation for permanent records and auditing purposes.
- Maintained high-level knowledge of federal and [State] regulations on patient privacy.
- Provided comprehensive administrative support to department staff.
- Presented feedback on current and new procedures at monthly clinical meetings.
- Assessed clinical policies and procedures for compliance with changing regulations.
Senior Processing Specialist
First Data
Houston, TX
07.2013 - 01.2016
- Assisting consumers with forgery debts in system, how to clear transaction from their name or bank account and informing them to submit forgery affidavit, police report, or bank letter notarized listing debts in system that consumers didn’t authorize.
- Answering inbound calls and placing outbound calls.
- Update consumers file to show positive status in order for them to be able to present checks Provided timely, courteous and knowledgeable response to information requests; screened and transferred calls.
- Prepared official correspondence handle consumer’s forgery affidavits, Id Theft Affidavits from the Federal Trade Commission and police reports to ensure victims maintain a good check writing history.
- Ability to work independently and with minimal supervision.
- Assist with recruitment process (Answering phone calls/responding to emails.)
- Demonstrated ability to use good judgment in decision making.
- Supported management team with escalated issues and by taking supervisor calls.
- Developed and maintain the Forgery Training Checklist for the new hires.
- Training new hires on forgery and bankruptcy documentation.
- Assisted new hire classes once training is completed and they are assigned to a work station.
- Created a Consumer Training Agenda to assist new hires.
- Provide feedback to management on trainee progress and further suggestions.
- Provided testing material for trainees and monitor all progress.
- Assist with selecting new candidates/ new employees with on boarding process and any test.
- Verified client information by analyzing existing evidence on file.
- Processed and recorded new policies and claims.
- Reviewed outstanding requests and redirected workloads to complete projects on time.
- Revised and finalized letters, briefs, and memos.
- Followed all company policies and procedures to deliver quality work.
- Carried out administrative tasks by communicating with clients, distributing mail, and scanning documents.
Roadside Dispatcher/ Cspire Customer Service
Interactive Response Technologies
Houston, TX
07.2010 - 07.2013
- Answering inbound calls.
- Locate service provider to assist with roadside situations such as towing, lockouts, key makes, tire changes etc.
- Making Outbound Calls.
- Updating customer plans and making changes to account upon request.
- Monitored and tracked dispatch communication systems.
- Coordinated with drivers to facilitate efficient delivery routes and timely deliveries.
- Adhered to company policies and scripts to consistently achieve call-time and quality standards.
- Helped large volume of customers every day with positive attitude and focus on customer satisfaction.
- Resolved concerns with products or services to help with retention and drive sales.
- Documented and detailed calls and complaints using call center's CRM database.
- Sought out extra training opportunities to enhance customer relationship management abilities.
- Actively listened to customers, handled concerns quickly and escalated major issues to supervisor.
- Addressed customer account discrepancies and concerns.
- Attended telephone skills and program information training sessions to boost aptitude.
- Placed outbound customer service or customer satisfaction calls to follow up on issues.
- Collaborated with staff members to enhance customer service experience and exceed team goals through effective client satisfaction rates.
- Educated customers about billing, payment processing and support policies and procedures.
Education
Stanford Brown Certified Pharmacy Technician -
Stanford
01.2011 - 01.2012
Associate of Applied Science - Allied Health and Science
Sanford Brown
Houston, TX 08.2010 - 1 2012
Skills
Proficient in Windowsundefined
Software
Timeline
Clinical Admin Coordinator
UnitedHealth Group
01.2016 - Current
Senior Processing Specialist
First Data
07.2013 - 01.2016
Stanford Brown Certified Pharmacy Technician -
Stanford
01.2011 - 01.2012
Associate of Applied Science - Allied Health and Science
Sanford Brown
08.2010 - 1 2012
Roadside Dispatcher/ Cspire Customer Service
Interactive Response Technologies
07.2010 - 07.2013
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