Alesha Cowart
Jacksonville,FL
Summary
Skilled in workflow optimization and delivering patient-focused care, I enhanced service levels at OptumRx by resolving complex issues and maintaining professionalism. Leveraging effective communication and EMR/EHR expertise, I consistently improved patient satisfaction and operational efficiency. My dedication to applicant support and meticulous record-keeping underscores my ability to excel in dynamic healthcare environments. Seasoned eligibility interviewer for government programs with comprehensive background in managing client interviews, determining benefits eligibility, and processing applications efficiently. Skilled in interpreting complex regulations and policies to provide accurate information and support to applicants. Demonstrated ability to maintain high levels of confidentiality and professionalism while making significant impacts in streamlining application processes for improved client satisfaction.
Overview
7
7
years of professional experience
1
1
Certification
Work History
Eligibility Specialist
Agape Family Health
JACKSONVILLE, FL
05.2024 - 01.2025
- Explained eligibility details and affordability options to patients with kindness and respect.
- Conducted interviews with applicants, explaining benefits process, and which programs were available.
- Prepared detailed reports outlining the reasons why an individual was denied benefits.
- Managed intake of new claims and performed routine follow-ups.
- Explained reasons behind application denials and recommended further action.
- Maintained comprehensive knowledge of program regulations, policies, and procedures.
- Proofread documents carefully to check accuracy and completeness of all paperwork.
- Communicated regularly with clients regarding their application status or changes in policies or procedures that may affect them.
- Answered questions and responded to inquiries to deliver high level of service to patients.
- Informed applicants of other agencies providing useful or related assistance.
Senior Member Service Advocate
OptumRx
JACKSONVILLE, FL
06.2018 - 08.2024
- Engaged in conversation with customers to understand needs, resolve issues and answer product questions.
- Enhanced member relationships by providing excellent service during each interaction.
- Resolved escalated issues or complaints in a timely manner while maintaining a high level of professionalism.
- Analyzed member eligibility for prescription benefits in accordance with plan provisions.
- Analyzed data from various sources to identify potential areas where cost savings could be achieved within the pharmacy benefit program.
- Facilitated communication between providers, pharmacists, and members concerning medication coverage issues or questions.
- Adhered to HIPAA regulations when handling confidential information related to patients' medical records.
- Reviewed prescriptions written by physicians for accuracy prior to administration or dispensing of medications.
- Followed protocols for disposing of expired or unused medications safely.
- Greeted customers and answered questions regarding personal medications or over-the-counter pharmacy products.
- Answered telephones to respond to questions or requests.
Medical Assistant
Pareto population health Management
JACKSONVILLE, FL
09.2023 - 05.2024
- Oversaw patient registration, insurance verification, form completion and appointment scheduling to maintain operational efficiency.
- Prepared laboratory specimens for analysis and organized lab results for review by the physician.
- Responded to patient callbacks and phone-in prescription refill requests.
- Documented notes during patient visits.
- Contacted pharmacies to submit and refill patients' prescriptions.
- Scheduled appointments for patients via phone and in person.
- Cleaned and maintained medical equipment following procedures and standards.
- Kept facility stocked with necessary supplies, equipment and instruments.
- Prepared treatment rooms for patient examinations.
- Organized patient charts before each day's clinic sessions began.
Education
Medical Assistant Certification -
Florida Career College
Jacksonville, FL 09-2022
High School Diploma -
First Coast Senior High
Jacksonville,fl06-2008
Skills
- Applicant support and service
- Effective communication skills
- Resource information
- Record keeping and data input
- Documentation and paperwork
- Application assessment
- Patient-focused care
- Proper sterilization techniques
- Medical terminology
- Restocking lab supplies
- Reliable team player
- EMR / EHR
- Vital signs and examinations
- Specimens collection and processing
- Customer service
- Customer support
- Relationship building
- Call center experience
- Workflow optimization
Certification
- Medical Assistant Certification
- First Aid/Cpr
- BLS Certification
References
References available upon request.
Timeline
Eligibility Specialist
Agape Family Health
05.2024 - 01.2025
Medical Assistant
Pareto population health Management
09.2023 - 05.2024
Senior Member Service Advocate
OptumRx
06.2018 - 08.2024
- Medical Assistant Certification
- First Aid/Cpr
- BLS Certification
Medical Assistant Certification -
Florida Career College
High School Diploma -
First Coast Senior High
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