Summary
Overview
Work History
Education
Skills
Timeline
Generic

ANTOINETTE BROWN

Austell,GA

Summary

Motivated and dependable professional with 10+ years of experience in a demanding environment, excelling in Customer Relations and Service Satisfaction. Proficient in job execution with a proven history of success in compliance, office management, process improvement, and leadership. A strategic and creative thinker with a solid background in delivering decisive, action-driven leadership. Demonstrates expert insight and ability in teaching, coordinating, monitoring, evaluating, and communicating with clients. Purposeful professional with proven ability to manage and coordinate operations and administrative support, using initiative, resourcefulness, and good judgment. Performance-driven collaborator with excellent people skills and diligence, optimizing all channels of communication to aid operations. Skilled in medical abstracting and escalation response, with proficiency in EMR Systems (Portico, Omni, EPIC).

Overview

8
8
years of professional experience

Work History

Escalation Response Specialist II

Centene Corporation
Clayton, MO
01.2024 - Current
  • Provide timely and appropriate resolutions to escalated issues from various communication channels
  • Serve as a liaison to maintain relationships between departments for timely issue resolution
  • Support documentation, tracking, and resolution of complaints and inquiries
  • Coordinate with contact center team to research underlying facts of escalated inquiries
  • Review complaint trends and develop recommendations to enhance member and provider experience
  • Maintain knowledge of products and services to provide accurate support to customers
  • Conduct basic claims payment error research and make appropriate adjustments.

Customer Service Representative

Peach State Health Plan
Atlanta, GA
01.2019 - 12.2023
  • Provide efficient and courteous service to internal and external customers concerning claims investigation and resolution
  • Respond to inquiries from members and providers about benefits, coverage, payment, and coding
  • Research and analyze recurring trends, problems, and complaints to determine root causes
  • Conduct and investigate claims, interpret laws and regulations, and provide insurance decisions
  • Maintain compliance with department of insurance and state regulations.

Medical Records Abstractor

Piedmont Atlanta Hospital
Atlanta, GA
09.2021 - 10.2023
  • Maintain patient confidentiality and compliance with security regulations
  • Retrieve patient medical record information and distribute reports to physicians and departments
  • Prepare, scan, perform quality control, and index documents into electronic clinical systems
  • Process requests for medical information according to office standards.

Customer Service Representative (Temp)

Aerotek: Recruiting and Staffing
Marietta, GA
07.2018 - 01.2019
  • Provide exceptional listening skills to address inquiries from callers
  • Document all information accurately and review complaints and petitions
  • Develop staffing plans and aid in candidate selection and training.

Medicare Customer Service Representative

Alorica
Kennesaw, GA
04.2016 - 06.2018
  • Provide exceptional customer service to Medicare and Medicaid accounts
  • Process prescriptions and documents for patients, payers, and providers
  • Maintain and update patient records and files.

Education

High School Diploma -

Edison Job Corp. Academy
Edison, NJ
03-2003

Skills

  • Office Health Records Preparation
  • Verbal and Written Communication
  • Records Scanning
  • EMR Systems (Portico, Omni, EPIC)
  • Multitasking and Prioritization
  • Efficient and Meticulous
  • Understanding Customer Needs
  • Issue and Complaint Resolution
  • Data Entry and Maintenance
  • Upbeat and Positive Personality
  • High Call Volume and Quality Metrics
  • Claims Management (Amisys)

Timeline

Escalation Response Specialist II

Centene Corporation
01.2024 - Current

Medical Records Abstractor

Piedmont Atlanta Hospital
09.2021 - 10.2023

Customer Service Representative

Peach State Health Plan
01.2019 - 12.2023

Customer Service Representative (Temp)

Aerotek: Recruiting and Staffing
07.2018 - 01.2019

Medicare Customer Service Representative

Alorica
04.2016 - 06.2018

High School Diploma -

Edison Job Corp. Academy
ANTOINETTE BROWN