Ca’Daja Williams

• Answers telephones, responds to highly complex customer questions, and/or forwards calls to appropriate personnel.
• Researches customer inquiries and responds to appropriate parties promptly.
• Records calls, processes requests, and updates account history with results of inquiry to include proper documentation.
• Processes and distributes incoming and outgoing mail through established service-level agreements for multiple clients.
• Performs data entry and matches documents to appropriate accounts to ensure up-to-date and accurate information.
• Escalate unresolved issues to higher-level support or technical teams.
• Update customer profiles with relevant details such as recent orders, issues, and preferences.
• Log all interactions in the customer management system to ensure continuity and accurate tracking.

• Assist customers in placing, tracking, or modifying orders for medical equipment, medications, or healthcare services.

• Guide patients or healthcare professionals in ordering prescriptions or medical supplies through an online platform or over the phone.

Help patients understand their health insurance coverage, billing statements, co-pays, and deductibles.

• Assist in submitting insurance claims, explaining coverage benefits, and following up on the status of claims or rejections.

• Handle customer inquiries regarding medical bills, billing errors, or payment options.

Explain different healthcare plan options, eligibility criteria, and enrollment processes.

• Inform customers about specific health products or services offered, such as prescription drug programs, wellness programs, or telemedicine services
• Maintain strict confidentiality when handling personal health information, adhering to privacy laws (like HIPAA in the U.S.).
• Assist in ensuring that all customer interactions and records comply with regulatory standards.
• Assist patients in managing their medical records, including retrieving records, updating information, or answering queries related to their history.
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• Help ensure that medical information is accurately documented in the company’s database.
• Deal with sensitive or emotional situations with empathy, especially when addressing issues related to patient health or billing.
  
• Handle inquiries from patients who may be frustrated or anxious about medical services, appointments, or insurance claims.

• Reviewed medical charts, identifying incomplete or inaccurate information, and took prompt actions to address and resolve any issues.
• Utilized effective communication skills via email and phone to liaise with healthcare staff, patients, and insurance companies, ensuring accurate and timely retrieval of medical records.
• Negotiated and facilitated mutually beneficial agreements between involved parties, resolving disagreements and maintaining positive professional relationships.
• Maintained meticulous records of all medical record requests, ensuring accuracy and compliance with regulations.
• Demonstrated exceptional punctuality and reliability, consistently meeting deadlines and maintaining an excellent attendance record.
• Utilized chart finder and datavant vault software to efficiently retrieve and organize medical records.
• Prioritized patient confidentiality and upheld company guidelines and regulations regarding the handling of sensitive information.
• Achieved performance metrics related to record retrieval accuracy and efficiency, contributing to improved operations and customer service.

• Reviewed and assessed Medicaid applications to ensure compliance with state and federal guidelines.
• Determined eligibility based on income, household size, residency, and other criteria.
• Processed and analyzed applications, ensuring complete documentation and timely approval/denial.
• Applicant Assistance & Guidance
• Assisted applicants in completing Medicaid applications, explaining requirements and benefits.
• Provided information regarding eligibility, helping to resolve issues or concerns throughout the process.
• Data Management & Documentation:
• Entered and updated applicant data into Medicaid management systems and maintained accurate records.
• Scanned, filed, and stored all documents in compliance with organizational and regulatory standards.
• Verification & Follow-Up
• Verified income, residency, and other eligibility factors through communication with applicants and external sources.
• Conducted follow-ups with applicants to resolve missing information or documentation delays.
• Compliance & Reporting
• Ensured strict adherence to Medicaid policies and regulations at all stages of the eligibility process.
• Prepared and submitted regular reports tracking applicant status, approvals, and denials.
• Customer Service & Support
• Delivered exceptional customer service by addressing inquiries and providing clear, accurate information to applicants.
• Managed a high volume of cases with a focus on efficiency and accuracy.
• Training & Development
• Participated in ongoing training to stay current with changes in Medicaid eligibility guidelines and procedures.
• Assisted in the onboarding and training of new team members.

• Organized physical files and digitized records so that authorized team members could update and retrieve them quickly.
• Provided expert clerical support by handling a wide range of routine and special requests efficiently.
• Made sure that business records were up to date by updating customer information on a regular basis.
• Implemented a record filing system to improve document organization and management.
• Created electronic file systems and kept track of both electronic and paper files.
• Handled a large volume of internal and external communications, including email and mail, and screened them all.
• Managed a multi-line telephone system and greeted claimants during office visits.
• Planned, scheduled, and organized business and social events, as well as meeting and travel calendars.

• Provided expert clerical support by handling a wide range of routine and special requests efficiency
• Made sure that business records were up to date by updating customer information on a regular basis.
• Was in charge of sorting and distributing office mail as well as keeping track of incoming shipments for corporate records.
• Prepared meeting agendas, provided advance materials, and followed up on meetings and team meetings.
• By reducing downtime and streamlining quality control procedures, I was able to increase profitability and productivity.
• Handled all incoming and outgoing correspondence, made copies, and sent faxes.
• Scheduled staff appointments to keep the office running smoothly and efficient.