Brinesha Calvin
Houston,TX
Summary
Analytical professional with technical knowledge and critical thinking skills to thrive in data-driven environments. Tackles challenges with positivity and drive to overcome. Works great alone or with others and consistently exceeds expectations.
Overview
9
9
years of professional experience
Work History
Team Lead Insurance Verification
Acaria Health Specialty Pharmacy
Houston, Texas
05.2022 - Current
- Obtained informed consent and payment documentation from patients and filed in system.
- Collaborated with clinical and administrative staff to meet patient needs.
- Maintained accurate records of all patient care activities using electronic health record systems.
- Identified discrepancies in patient's insurance coverage or benefits, ensuring accuracy of data entered into system.
- Checked documentation for appropriate coding, catching errors and making revisions.
- Provided leadership and guidance to team members, ensuring that tasks were completed on time and to a high standard.
- Resolved escalated customer complaints or queries promptly and efficiently.
- Reviewed completed work to verify consistency, quality and conformance.
- Fostered positive employee relationships through communication, training, and development coaching.
Patient Care Coordinator Team Lead
Acaria Health Specialty Pharmacy
Houston, Texas
02.2016 - Current
- Handle inbound calls from patients, physician’s offices, and/or insurance companies
- Input patients’ insurance information verify eligibility and fax and submit prior authorizations
- Assist and maintain all related pharmacy records (prescriptions logs, care plans, medication profiles, and any other related files) as determined by the pharmacist
- Perform over 100 inbound and outbound calls on a daily basis
- Reach out to new patients and introduce them to service and products via telephone
- Run test claims to determine patient’s copays, schedule delivery of medications after all patients’ needs are addressed
- Received patient inquiries or complaints and directed to appropriate medical staff members.
- Provided ongoing communication with patients, families, and other healthcare providers regarding treatment plans and progress.
- Complete call audits for a team 18 or more.
- Collaborated with clinical and administrative staff to meet patient needs.
Team Lead Customer Service Representative (SME)
Sutherland Global Service
Houston, TX
04.2015 - 02.2016
- Managed a team of 20 agents to ensure quality and great customer service
- Made appointments for the veterans with a community provider
- Faxed authorizations and medical documentation
- Resolved escalated calls
- Timekeeping/Attendance tracker
- One on one coaching with agents on call performance and skill
- Other duties as assigned.
Customer Service Representative
Xerox
Houston, TX
- 04.2015
- Support sales representatives in opening new accounts and upgrading existing service
- Quickly and effectively salve customer challenges
- Maintain quality control/satisfaction records, constantly seeking new ways to improve customer service.
Client Support Representative
DaVita Dialysis
Houston, TX
02.2009
- Implements progressive mobility guidelines
- Ambulating, turning and repositioning patients
- Uses patient handling equipment in the tasks of lifting, transferring, repositioning and transporting patients
- As needed, may also transport patients within the medical center and deliver and pick up specimen sand prescriptions
- Assisting with activities of daily living, including, but not limited to: feeding, bathing, toileting, providing water, answering the phone, and oral care.
Education
Graduate - Medical Assistant
Everest Institute
05.2014
High School Diploma -
Lufkin High School
Lufkin, TX05-2005
Skills
- Schedule Management
- Performance Improvement
- Complaint Resolution
- Resource Allocation
- Quality Control
- Documentation and Reporting
- Team Supervision
- Quality Improvement
- Coaching
- SOP Adherence
- Call Center Operations
- Overseeing Daily Activities
- Onboarding and Orientation
- Staff Training
Timeline
Team Lead Insurance Verification
Acaria Health Specialty Pharmacy
05.2022 - Current
Patient Care Coordinator Team Lead
Acaria Health Specialty Pharmacy
02.2016 - Current
Team Lead Customer Service Representative (SME)
Sutherland Global Service
04.2015 - 02.2016
Client Support Representative
DaVita Dialysis
02.2009
Customer Service Representative
Xerox
- 04.2015
Graduate - Medical Assistant
Everest Institute
High School Diploma -
Lufkin High School
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