BREEZY MCCORMICK
DURHAM,US
Summary
Healthcare Professional experienced in patient care and claims processing. Enhanced patient outcomes through effective communication and collaboration with healthcare teams while managing high caseloads in high-pressure environments. Focused on innovating healthcare services to improve patient satisfaction and operational efficiency.
Overview
2
2
years of post-secondary education
18
18
years of professional experience
Work History
Case Manager Pharmacy Shipping Specialist
Johnson & Johnson
Pittsburgh, Pennsylvania
03.2025 - Current
- Provided case management services including intake, assessment, crisis intervention, advocacy, referral and monitoring of families.
- Assessed client needs, developed tailored service plans, and monitored progress to achieve individual goals.
- Coordinated client care plans to ensure compliance with health regulations and enhance service delivery.
- Conducted assessments to determine client needs and service eligibility.
- Advocated for client needs within multidisciplinary teams and organizations.
- Collaborated with healthcare professionals to develop treatment strategies.
- Educated clients on resources and support services to empower informed decision-making.
REIMBURSEMENT CASE MANAGER
Trail Card
Morrisville, NC
10.2019 - 03.2025
- Collaborated with various healthcare providers to facilitate delivery of services.
- Assessed treatment effectiveness for individuals and families, contributing to tailored care strategies.
- Determined and coordinated level of care to meet individual patient needs.
- Determined and coordinated an appropriate level of care to meet individual patient needs.
- Compiled and submitted documentation adhering to payer guidelines, ensuring compliance and timely processing.
- Confirmed clients' insurance claims coverage through coordination with providers, facilitating patient access to necessary services.
- Reviewed effectiveness of treatment for individual and family situations.
- Documented patient progress during treatment sessions.
CUSTOMER SERVICE PROFESSIONAL IPP HOST
Blue Cross And Blue Shield Of North Carolina
Durham, NC
07.2018 - 10.2019
- Reviewed administrative guidelines to resolve questions during claims processing.
- Based the payment or denials of medical claims upon well-established criteria for claims processing.
- Stayed current on HIPAA regulations, benefits claims processing, medical terminology, and other procedures.
- Followed up with insurance carriers in an effort to obtain details regarding denials.
- Followed up with insurance carriers to obtain details on claim denials.
- Monitored physician expiration dates and notified practitioners in advance.
- Reviewed documentation and accounts to gain a full picture.
- Presented and clearly explained insurance policy options to clients based on their needs and goals.
INBOUND SALES REPRESENTATIVE
Spectrum Center
Morrisville, NC
12.2017 - 07.2018
- Met or exceeded sales objectives on a regular basis.
- Took daily inbound calls and key-entered orders, faxes, backorders and credit memos for assigned accounts and clients.
- Practiced customer interaction scripts to improve communication skills. to enhance customer interactions.
- Achieved quality and productivity objectives through strong organizational and communication skills.
- Utilized active listening to identify customer preferences and financial limits.
- Managed daily inbound calls from customers to address inquiries and key-entered orders, faxes, backorders and credit memos for assigned accounts and clients.
CUSTOMER SERVICE SPECIALIST
Duke Energy
Raleigh, NC
05.2015 - 10.2017
- Confirmed appropriate changes to resolve customer problems.
- Answered customer inquiries and addressed complaints in person and via phone, ensuring satisfaction.
- Provided effective and timely account support in handling inbound customer requests.
- Confirmed that appropriate changes were made to resolve customer problems.
- Built customer confidence by actively listening to their concerns and giving appropriate feedback.
- Proactively identified and solved problems that impacted management and business direction.
- Handled up to 100 calls daily from merchants, providing technical assistance to resolve performance issues.
BILLING AND ENROLLMENT SPECIALIST
ACS
Cary, NC
01.2013 - 06.2015
- Enhanced client retention by delivering high-quality service and consistent follow-through.
- Prepared necessary paperwork to process insurance sales and renewals.
- Applied agency policies accurately by reviewing, classifying, coding, and rating applications.
- Finalized and maintained all types of personal lines insurance policies within the agency.
- Facilitated communication between patients and physicians to clarify treatment plans and improve patient understanding.
- Evaluated accuracy and compliance of all documentation and reports.
- Revised policies and procedures in accordance with changes in local, state and federal laws and regulations.
CUSTOMER SERVICE REPRESENTATIVE
Sports Endeavors Inc. (SEI)
Hillsborough, NC
05.2012 - 04.2013
- Recommended and located merchandise aligned with customer needs, enhancing shopping experience.
- Developed empathetic client relationships, consistently exceeding sales goals and fostering customer loyalty.
- Collaborated with customer service team members to give exceptional service throughout the entire shopping and purchasing experience.
- Communicated information to customers about product quality, value and style.
- Handled merchandise returns efficiently at the customer service desk. and exchanges.
- Sourced special products and services to fulfill unique customer requests, ensuring satisfaction.
- Generated sales and inventory reports in Excel with data from a variety of sources, maintaining a 100% accuracy rate.
NURSING ASSISTANT
Carillon Assisted Living of Hillsborough
Hillsborough, NC
02.2011 - 01.2013
- Monitored advances in medicine, diagnostic and treatment equipment, data processing technology, government regulations, health insurance changes and financing options to ensure compliance and enhance care delivery.
- Established and refined quality care systems and standards by creating and improving medical protocols and guidelines, enhancing patient safety and care outcomes.
- Developed and maintained quality care systems and standards, including but not limited to, creating and improving medical protocols/guidelines.
- Assessed facility activities and data to identify risk management opportunities and implement service improvements.
- Analyzed facility activities and data to properly assess risk management and improve services.
MED TECH
Wynwood of Chapel Hill
Chapel Hill, NC
08.2008 - 04.2010
- Ensured cleanliness and sterilization of instruments, maintaining strict hygiene standards to prevent infection.
- Delivered primary resident care and assisted with daily living activities to enhance overall resident well-being.
- Conducted screening, diagnostic treatment, and rehabilitative services as the senior nurse on a primary health care team.
- Developed and maintained quality care systems and standards, creating and refining medical protocols and guidelines to improve patient outcomes.
- Cleaned and sterilized medical instruments in a clinical setting to ensure safety and hygiene standards. and disposed of contaminated supplies.
Education
BACHELOR - Healthcare Administration
Southern New Hampshire University
Hooksett, NH 01.2025 - 09.2026
Bachelor of Science - BUSINESS ADMINISTRATION
Johnson C Smith University
Charlotte, NCBachelor of Science - BUSINESS ADMINISTRATION
Saint Augustine's University
Raleigh, NCSkills
- Healthcare (Expert), Customer Service (Expert), Claims Processing (Expert), HIPAA (Expert), Medical Billing (Expert), Patient Care (Expert), Healthcare Sales, Clinical Data Review, Care Coordination, MS Office (Expert), Time Management (Expert), Documentation (Expert), Insurance (Expert), Medicare (Expert), Service Quality Improvement
- Resource Allocation
- MS Office (Expert)
- Time Management (Expert)
- Customer Service (Expert)
- Effective communication
- Service Quality Improvement
- Documentation skills
- HIPAA adherence
- Patient care
- MS Office
- Resource Allocation
- Utilization management
Personal Information
Title: Healthcare Professional
Timeline
Case Manager Pharmacy Shipping Specialist
Johnson & Johnson
03.2025 - Current
BACHELOR - Healthcare Administration
Southern New Hampshire University
01.2025 - 09.2026
REIMBURSEMENT CASE MANAGER
Trail Card
10.2019 - 03.2025
CUSTOMER SERVICE PROFESSIONAL IPP HOST
Blue Cross And Blue Shield Of North Carolina
07.2018 - 10.2019
INBOUND SALES REPRESENTATIVE
Spectrum Center
12.2017 - 07.2018
CUSTOMER SERVICE SPECIALIST
Duke Energy
05.2015 - 10.2017
BILLING AND ENROLLMENT SPECIALIST
ACS
01.2013 - 06.2015
CUSTOMER SERVICE REPRESENTATIVE
Sports Endeavors Inc. (SEI)
05.2012 - 04.2013
NURSING ASSISTANT
Carillon Assisted Living of Hillsborough
02.2011 - 01.2013
MED TECH
Wynwood of Chapel Hill
08.2008 - 04.2010
Bachelor of Science - BUSINESS ADMINISTRATION
Johnson C Smith University
Bachelor of Science - BUSINESS ADMINISTRATION
Saint Augustine's University