Alexis Richards
Merritt Island
Summary
Member Engagement Specialist with proven success at enhancing member retention through strategic outreach and relationship building. Skilled in HIPAA compliance and claims processing and examining, I excel in delivering exceptional customer service while effectively managing multiple priorities to drive engagement and satisfaction.
Overview
15
15
years of professional experience
Work History
Member Engagement Specialist
Healthmap Solutions
11.2024 - Current
- Conducted regular assessments of member needs, preferences, and satisfaction levels.
- Established relationships with key stakeholders within organization to support member engagement initiatives.
- Tracked progress against goals using key performance indicators KPIs related to membership growth and engagement.
- Offered guidance on how best to utilize available resources within organization for maximum benefit.
- Developed and implemented community outreach programs to increase awareness of services offered.
- Utilized negotiation skills to close consents successfully.
- Assisted in development of marketing materials to support outbound sales efforts.
Strategic Outbound Specialists/ Care Guide
Oscar Health
09.2021 - 11.2024
- Manage a high volume of inbound phone and email contacts
- Maintained strict confidentiality of all patient health information in compliance with HIPAA regulations.
- Ensured timely payment of medical claims by maintaining accurate records and submitting claims within required timeframes.
- Collaborated with healthcare providers to obtain necessary documentation supporting validity of each claim.
- Followed up on unpaid or denied claims to determine cause and initiate corrective action as needed.
Customer Service Representative/Call Center/ Scheduling
Health First
03.2020 - 09.2021
- Maintained strict confidentiality of all patient health information in compliance with HIPAA regulations.
- Followed up on unpaid or denied claims to determine cause and initiate corrective action as needed.
- Ensured timely payment of medical claims by maintaining accurate records and submitting claims within required timeframes.
- Collaborated with healthcare providers to obtain necessary documentation supporting validity of each claim.
- Followed up on unpaid or denied claims to determine cause and initiate corrective action as needed.
- Assisted patients with rescheduling or canceling appointments as needed.
- Assisted new patients in completing registration paperwork prior to their first appointment.
- Numerous referrals from primary care physicians were received.
- Scheduled patient appointments for various medical services, including consultations, screenings, and surgeries.
Optical Technician
Florida Eye Associates-Viera, FL
10.2017 - 03.2020
- Cleaned and sterilized examination instruments after each use according to office protocol.
- Communicated effectively with both coworkers and patients to provide seamless coordination of care.
- Adjusted frames to ensure proper fit and comfort for patients upon dispensing eyeglasses or contacts.
- Prepared work orders with accurate patient measurements.
- Supported operations with expertise in administrative support, patient care and file management.
- Managed inventory of contact lenses, frames, and other optical supplies.
- Assisted patients in selecting appropriate eyewear based on prescription requirements and personal preferences.
Optical Technician
Jcpenney Optical
05.2010 - 10.2017
- Cleaned and sterilized examination instruments after each use according to office protocol.
- Communicated effectively with both coworkers and patients to provide seamless coordination of care.
- Adjusted frames to ensure proper fit and comfort for patients upon dispensing eyeglasses or contacts.
- Prepared work orders with accurate patient measurements.
- Supported operations with expertise in administrative support, patient care and file management.
- Managed inventory of contact lenses, frames, and other optical supplies.
- Assisted patients in selecting appropriate eyewear based on prescription requirements and personal preferences.
Education
High School Diploma - General Studies
Merritt Island High School
Merritt Island, FL05.2013
Associate of Science - Healthcare Navigator
Eastern Florida State College
Cocoa, FL12-2026
Skills
- Member retention strategies
- HIPAA compliance
- Medical terminology
- Customer service focus
- Claims processing proficiency
- Insurance claims
- Insurance verifications
- Multi-task management
Timeline
Member Engagement Specialist
Healthmap Solutions
11.2024 - Current
Strategic Outbound Specialists/ Care Guide
Oscar Health
09.2021 - 11.2024
Customer Service Representative/Call Center/ Scheduling
Health First
03.2020 - 09.2021
Optical Technician
Florida Eye Associates-Viera, FL
10.2017 - 03.2020
Optical Technician
Jcpenney Optical
05.2010 - 10.2017
High School Diploma - General Studies
Merritt Island High School
Associate of Science - Healthcare Navigator
Eastern Florida State College
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