Alithea Hines
Buford
Summary
Knowledgeable and dedicated customer service professional with extensive experience the medical industry. Solid team player with outgoing, positive demeanor and proven skills in establishing rapport with customers. Motivated to maintain customer satisfaction and contribute to company success. Specialize in quality, speed and process optimization. Articulate, energetic and results-oriented with exemplary passion for developing relationships, cultivating partnerships and growing businesses.
Overview
17
17
years of professional experience
Work History
CSR III (Contract to FTE)
Kaiser Permanente Health Care
08.2021 - Current
- Represent Health Plan by answering and documenting all incoming contacts to determine their nature and to respond to complex calls related to specialized product lines or queues.
- Assist members via phone with benefit inquiries regarding coverage, eligibility, co-pays / co-insurance, and confirming benefit changes.
- Updating of demographic information.
- Executing premium billing inquiries, reinstatement requests, and service reviews.
- Initiating contact with the appropriate Health Plan, medical group, and facility personnel to obtain information relevant to the concerns or inquiries as needed.
- Consistently support compliance and the Principles of Responsibility by maintaining the privacy and confidentiality of information, and adhering to HIPPA laws.
- Handling calls in a professional manner by ensuring first call resolution, complaint resolution compliance, retention, and return contact as warranted.
- Follow established procedures to meet customer needs, documenting contact according to policy, and performing other relevant duties as required by my position.
- Assist providers with referral, eligibility, benefit, Medicare, coordination of benefits and claim inquiries using Epic software and proprietary software.
- Maintain customer satisfaction with forward-thinking strategies focused on addressing customer needs and resolving concerns.
- Assist members daily through email with benefit, claims, billing and Medicare queries.
- Resolve escalated calls through conflict resolution.
- Escalate referrals and securing approvals.
- Account audits for premium and service billing, ordering EOBS and EOPS, faxing to the appropriate parties.
- Outbound calls to services providers to resolve billing issues on behalf of members.
- Chat Captain duties that involve helping with queries, training and development of new hires to navigate systems, benefits, company policies and compliances, as well as leading morning debrief meetings.
- Demonstrated empathy and active listening skills, resulting in a higher rate of customer satisfaction and repeat business.
- Managed high call volumes, maintaining a professional demeanor during peak hours and effectively multitasking in a fast-paced environment.
Clinical Medical Assistant
Summit Spine & Joint Interventional Pain
07.2020 - 12.2020
- Patient intake and workups using eClinicalWorks medical software.
- Taking and recording patient vitals, changes in pain, advanced directives, and conducting depression screenings.
- Checking opioid prescription history in the PDMP database, and updating patient records as needed.
- Urine collection for testing.
- Conducting wound checks and applying new dressings.
- Suture and stitches removal.
- Preparing trigger point injections.
- Preparing sterile trays.
- Making changes to current prescriptions for dosage, frequency, and formula.
- Writing and issuing new prescriptions, and refills.
- Sending prescriptions to pharmacies via MDToolbox and ECW.
- Creating MRI, X-Ray, Physical Therapy, and DME orders using medical codes.
- Medical records requests, preparing paperwork for SCS trials, and discharge letters.
- Retrieving and reading MRI and X-Ray reports.
- Directed patients to exam rooms, fielded questions, and prepared for physician examinations.
Manager/Barista Trainer
Starbucks (Kroger) -Temporary Position
02.2020 - 05.2020
- Implemented and conducted new training protocols with the aim of bringing all current baristas and new hires up to Starbucks standard of operations in regards to beverage routines, equipment maintenance, and health, safety, and sanitation procedures
- Implemented new closing procedures with a focus on accountability for individual tasks performed by introducing a Nightly Closing Procedures checklist with signature
- Provide additional training and coaching for baristas that needed it
- Introduced Playbook Deployment and Locked Positions to ensure a more efficiently run kiosk which resulted in a seven percent drop in waste and loss within my first two months
- Boosted sales of non- food items by sixteen percent within my first two months by reorganizing tumbler and cup display etergers to be more prominently displayed closer to registers, while still adhering to Sirens Eye instructions, to encourage impulse purchases
- Improved weekly Customer Connections surveys by twenty- six percent within my first six weeks
- Inventory management and scheduling for a team of eleven employees
- Created a personal inventory tracking system using Google Sheets to track our best-selling pastry and food items, identify items that need a sales push, as well as how often and how much of each product category to order weekly
- Run weekly loss & sampling, shrink, profit, and ordering reports
- Execute weekly, monthly and seasonal promos according to Sirens Eye directions
- Ensure that all customers are completely happy with their purchases before leaving, and create connections to secure repeat patronage.
Certified Barista Trainer
Starbucks Coffee Company, Barista
03.2013 - 09.2019
- Greeted customers as they arrived at the Starbucks location
- Provided customers with information on popular coffee blends
- Assisted patrons with order placement
- Educated customers about the history of each coffee blend when inquired
- Provided samples of popular coffee blends with a view to creating sales opportunities
- Offered customers demonstrations using brewing equipment
- Brewed coffee per instructions while ensuring that each brew conformed to the standards set by Starbucks
- Ensured that any complaints were entertained in a positive manner with a view to keeping patrons happy and ensure recurring business
- Ensured that Starbucks merchandising and signage standards were followed appropriately
- Made sure that coffee brewing equipment is cleaned, sanitized, and maintained properly on a constant basis
- Made minor repairs to coffee brewing equipment
- Trained all new hires on proper coffee and beverage handling and preparation, Starbucks standards, and health department standards of compliant operation
Contributing Writer
Growth Labs
09.2018 - 06.2019
- Researched, mapped, and wrote on substance abuse trends across various cities in the United States for Rehabhelp.org
- Examined storage facility listings in New York City, Chicago, Philadelphia, Austin, Houston, Dallas, San Francisco, Boise, Tuscan, and Phoenix to find the most pertinent information and then compiled into easy to read blurbs for Storageunits.com
- Researched state and federal regulations in regards to Medicaid and Medicare, as well as other financial programs including low-income assistance and HUD programs available to seniors for the website Payingforseniorcare.com
- Researched states included North and South Carolina, West Virginia, New Jersey, New York, and Philadelphia
- Smaller city-specific research included Palm Beach, West Palm Beach, Jacksonville, and Tallahassee FL, Charleston WV, Westlake OH, Sioux Falls SD, and Boise ID.
Medical/Science Writer
HCP Research Insights
08.2017 - 08.2018
- Medical and science writer and for publications dedicated to healthcare professionals, with a specialization in musculoskeletal degenerative, auto-immunological, and genetically inherited diseases and disorders
- Contributing author of new and experimental treatment protocols for degenerative disease, including clinical trials and new research initiatives
- Proposed content based on current research trends and studies.
Appointment Setter/Medical Assistant
OrthoAtlanta - Temporary Position
06.2016 - 09.2016
- Informed patients of changes in surgery and procedure dates, changes in physicians schedules
- Took and relayed messages from patients, hospitals, physical therapy facilities, home care workers, pharmacies, and other medical professionals to physicians, medical assistants, and physicians assistants
- Reported lab values to medical assistants, physician's assistants, and physicians
- Arranged peer-to-peer consultations
- Procured and verified insurance information and eligibility
- Coordinated with physicians, and PA's to solve whatever urgent post-op, pre-op, and general medical issues as they arose
- Enforced rules of practice discharge, helped to problem solve billing discrepancies
- Assisted patients and physicians with various types of medical research, as they pertained to issues of medication, hospitalization, and billing
- Rearranged patient calendars of fourteen physicians and physician's assistants in the event of emergencies and vacations
- Worked with pharmacies, patients, and physicians to obtain pre-authorizations for procedures and medicines
- Ensured HIPPA compliance.
Evening Assistant
Executansport
01.2008 - 11.2011
- Worked closely with management to provide effective assistance for specific aspects of business operations.
- Responsible for updating and maintaining reports database using Access and functioned as a de facto assistant to resident MIS expert.
- Handled confidential client information including financial information, domestic and international schedules, and other personal information.
- Arranged for in-town, out of town, and overseas ground transportation, organized transport for large events such as the Met Gala and All-Star Games for high-level executives and celebrities.
- Oversaw a nightly team of eight individuals while troubleshooting problems as they arose domestically and internationally.
- Answered incoming phone calls to process requests, transfer calls, or relay messages to appropriate personnel.
- Assisted manager in all aspects of business operations.
- Prepared PowerPoint presentations for senior-level staff with attention to detail.
Education
No Degree - Anthropology
The City College of New York
New York, NYHigh School Diploma -
Erasmus Hall High School
Brooklyn, NYSkills
- Microsoft Office Suite
- Google Suite
- Medical Terminology Knowledge
- Call Triaging
- Customer Account Management
- Report Preparation
- Report Creation
- Customer Relations
- CRM Software
- SaaS
- Staff Training
Timeline
CSR III (Contract to FTE)
Kaiser Permanente Health Care
08.2021 - Current
Clinical Medical Assistant
Summit Spine & Joint Interventional Pain
07.2020 - 12.2020
Manager/Barista Trainer
Starbucks (Kroger) -Temporary Position
02.2020 - 05.2020
Contributing Writer
Growth Labs
09.2018 - 06.2019
Medical/Science Writer
HCP Research Insights
08.2017 - 08.2018
Appointment Setter/Medical Assistant
OrthoAtlanta - Temporary Position
06.2016 - 09.2016
Certified Barista Trainer
Starbucks Coffee Company, Barista
03.2013 - 09.2019
Evening Assistant
Executansport
01.2008 - 11.2011
No Degree - Anthropology
The City College of New York
High School Diploma -
Erasmus Hall High School
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