Artensia Lee
Chicago,IL
Summary
Highly motivated individual seeking a position with a growth oriented company where I can utilize my customer service and people skills.
Professional Referral Specialist with track record of delivering impactful results. Adept at coordinating referrals, navigating complex systems, and ensuring seamless communication between parties. Strong focus on team collaboration, adaptability, and achieving desired outcomes. Known for problem-solving skills, reliability, and maintaining high standards in all tasks.
Overview
11
11
years of professional experience
1
1
Certification
Work History
Referral Specialist I
Elevance
04.2024 - Current
- Promoted clear communication between primary care providers and specialists through detailed documentation and follow-up calls.
- Developed strong relationships with external healthcare facilities, fostering a collaborative approach to patient care coordination.
- Maintained accurate records on in-progress and completed referrals, ensuring full data integrity throughout process.
- Managed high-volume referral requests by prioritizing tasks and maintaining organized records.
- Obtained prior authorization for PAC
- Supported healthcare team members by providing detailed patient information for seamless transitions between providers.
- Contributed to the development of referral policies and procedures, enhancing departmental operations.
- Assisted with completion of referral forms and verified data accuracy and completion
- Prepared and processed patient referrals and transfer requests.
Referral Specialist
Centene
09.2021 - 12.2023
- Called insurance companies to get precertification and other benefits information on behalf of patients.
- Collaborated with healthcare providers to ensure accurate and complete referral information, improving patient care coordination.
- Streamlined referral processes for increased efficiency, resulting in timely appointments for patients.
- Verified insurance benefits and eligibility for procedures before referring clients.
- Obtained prior authorization for procedures.
- Answered telephone calls to offer office information, answer questions, and direct calls to staff.
- Processed referral requests from patients, doctors and other health care professionals.
Billing Liaison
Byram Healthcare
01.2021 - 09.2021
- Responds to customers concerns in a professional and friendly manner
- Take over 60 inbound calls a day
- Processing payments from customers
- Adding, ending and updating customer insurance
- Review explanation of benefits to confirm customer copay
- Apply credits to account for over payments
- Send emails to have claims we submit or resubmitted to customer insurance
Customer Service Representative
Ingenio Rx / CVS Health
02.2019 - 03.2021
- Receive inbound calls from members
- Provide customer service helping members do first time orders, refills and making sure they have the correct dosages, quality and day supply of the medication
- Go over billing, payments and any insurance information
- Run insurance for payments collect forms of payments such as credit debit and checks
- Assist with adding copay information or helping members get started with getting any kind of copay assistance that may be available
- Reach out to health care providers to obtain new Rx or any copay information
- Promoted from CVS over to Ingenious account
- Complete New Patients enrollment with the members
- Send out any emails needed to the correct department to get any issue fix with patients insurance payments or any problems that can be resolved right away
- Manage members records
- Perform customer service surveys
- Provide policy and service information
- Assist members with a warm and professional attitude
- Answer general questions
- Resolve members issues and or complaints
Letter Carrier
United States Postal Service
10.2014 - 02.2019
- Set up mail for the day that will be delivered on route assign
- Delivered mail and packages to residents and business on route
- Provided customer service to customers
- Secured packages and mail that’s been delivered to the customer
Education
High school - General studies
Perspectives Charter High School
Chicago, ILSkills
- Call Center
- Customer Care
- Customer Service
- Microsoft Office (10 years)
- Windows (10 years)
- Data Entry (8 years)
- Sales Experience (9 years)
- Insurance Verification (1 year)
- Insurance (1 year)
- Pharmacy Technician Experience (Less than 1 year)
- Client Services (9 years)
- Dispatch
- Scheduling
- Excel
- Microsoft Excel
- Communications
- Typing
- Problem solving
- Loss Prevention
- Computer Operation
- Security
- Upselling
- Surveillance
- Cash Handling
- Office Experience
- Computer Skills
- Microsoft Outlook
- Microsoft Word
- Phone Etiquette
- HIPAA
Certification
- Security Guard
- PERC Card
- Pharmacy Technician
- December 2019 to December 2022
- December 2019 to December 2021
- Pharmacy Technician Certification
- PTCB Certification
Timeline
Referral Specialist I
Elevance
04.2024 - Current
Referral Specialist
Centene
09.2021 - 12.2023
Billing Liaison
Byram Healthcare
01.2021 - 09.2021
Customer Service Representative
Ingenio Rx / CVS Health
02.2019 - 03.2021
Letter Carrier
United States Postal Service
10.2014 - 02.2019
High school - General studies
Perspectives Charter High School
Additional Information
- Highly motivated individual with excellent written and communication skills
- Excellent customer service skills
- Ability to work in a fast pace environment
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