Camille Brown-Gant
Summary
Capable Patient Representative dedicated to providing superior support for patients in need of reliable information regarding insurance coverage, finance options and documentation requirements. Well-versed in scheduling and database management functions for streamlined communication and reduced correspondence backlogs. Excels at identifying client needs and concerns to improve engagement strategies and overall service. Adequate at handling abundant calls on a daily basis via incoming and outgoing being able to handle any issue quickly and smoothly. This exposure has allowed me to build sound internal and external relationships to support customers and the organization's goals. Looking to contribute to the continued growth and profitability of an organization that can benefit from the services of a dedicated and hardworking professional.
Overview
10
10
years of professional experience
Work History
Social Services/Patient Advocate
East Liberty Family Health Care Center
09.2023 - Current
- Responded to patient concerns and questions with compassionate and knowledgeable service.
- Monitored patient progress and provided emotional support.
- Provided emotional support to patients and families during challenging medical situations, fostering trust and rapport.
- Educated patients on available resources and community programs, increasing their access to needed services.
- Entered details into computer systems and managed database of information.
- Facilitated communication between patients, families and healthcare providers to support comprehension.
- Negotiated payment plan arrangements with medical billing departments on behalf of the patients experiencing financial hardship.
- Assisted patients in navigating complex insurance processes, leading to successful claim resolutions and reduced financial burdens.
Managed Care Coordinator
Patriot Home Health Care
02.2023 - 10.2023
- Collaborated with departments across the organization on projects related to managed care initiatives.
- Created and maintained spreadsheets tracking managed care activities such as contract expiration dates, renewals.
- Responded promptly to inquiries from providers regarding eligibility verification or other issues concerning managed care operations.
- Processed prior authorizations from insurance companies for medical services.
- Coordinated with insurance companies to ensure accurate patient coverage information is on file.
- Maintained up-to-date records of all managed care contracts and related correspondence.
- Explained policies, procedures and services to patients.
- Communicated with patients with compassion while keeping medical information private.
Patient Service/ Benefits Verification
UPMC
01.2020 - 12.2022
- Verify patient insurance eligibility and benefit package via phone or web for specific services (diagnostic and fertility services)
- Entered patient demographic and insurance information in Epic system
- Counsels patients regarding coverage and expected financial liability
- Collects and records patient payments including co-payments, co-insurance, and deductibles on the day of service
- Generates and completes all applicable forms and necessary communications
- Obtains applicable signature for consent to treat and financial responsibility, along with signatures on any required forms, while following all HIPAA rules and regulations and maintaining patient confidentiality
- Schedule and confirm appointments
Customer Service Technician
Grane Pharmacy
06.2019 - 03.2020
- Speak with nurses in long term care and hospices facilities regarding residents medication orders and refills
- Review incoming prescriptions to verify that all information is correct to member in the system and triage to correct pharmacist
- Enroll new residents with information received via phone and fax
Provider Service Representative
United HealthCare
08.2018 - 05.2019
- Speak with providers (Doctors & Hospitals) regarding members insurance information
- Initiate authorizations for members surgery's typically not covered under a members insurance
- Review claims that have been billed by the providers for accuracy and process claims ifneeded assist providers with any corrections needed to process the claim.
Patient Case Coordinator
Mindlance, Amerisource Bergen
08.2017 - 10.2017
- Answer basic clinical and program inquiries
- Coordinates access to therapies, schedules and conducts appropriate follow-up, and facilitates access to appropriate support services
- Facilitates access to appropriate support services, including reimbursement counseling, nursing hotline, and support
- Processes incoming enrollment forms for program and follows up via phone, mail, and/or fax for missing enrollment information.
Customer Service Associate
Gentech Staffing Solutions/Gateway Health Systems
12.2016 - 04.2017
- Engaged Medicare and Medicaid recipient inquiries in a confident and compelling manner,performing a full range of customer service duties and responsibilities, as assigned;
- Resolved customer concerns in a single interaction via telephone or written communication
- Responded to a diverse set of customers with an equal level of confidence regardless of theissue at hand
- Routinely responded to customers with an in-depth product knowledge achieved through acontinuously improving set of listening, analysis, quality focus, problem solving, anddocumentation skills;
- Consistently exceeds results for internal adherence, efficiency, and inquiry timeliness.
Customer Service Representative
PNC Bank
08.2015 - 11.2016
- Exercise sound judgement while tactfully and effectively resolving customer inquiries relatedto financial transactions and account information
- Responded to a heavy volume of customer inquiries via incoming calls and email; averagedapproximately 160 calls/inquiries per day while adhering to all company metrics for performanceefficiency
- Recognized for superior leadership skills and performance excellence; chosen to be amember of a group of Subject Matter Experts (SME's) assigned to mentor and assist in thetraining of employees of a contractor who was chosen to handle various customer bankingissues
Customer Service Specialist
CVS Specialty Pharmacy
06.2014 - 07.2015
- Working within an assigned disease state and with assigned insurance carriers, responsiblefor verifying the existence of applicable insurance coverage and satisfaction of precertificationissues related to specialty medication orders...included contact with medical providers, freightcarrier representatives, and patient/policyholder to address related issues.
Education
Child Care Certification -
ForbesTechnology
Certificate, Child Care -
Community College of Allegheny County
Pittsburgh, PA06.2011
H.S. Diploma - General Studies
Penn Hills Jr. & Sr. High School
Pittsburgh, PA06.2009
Skills
- Verbal and Written Communication
- Highly Skilled in Microsoft Office and Epic
- Problem Resolution
- Friendly, Positive Attitude
- Critical Thinking
- Care Delivery
- Medicare Compliance
- Patient Education and Counseling
- Patient Advocacy
- Medicaid knowledge
- Relationship Building
- Financial Counseling
Timeline
Social Services/Patient Advocate
East Liberty Family Health Care Center
09.2023 - Current
Managed Care Coordinator
Patriot Home Health Care
02.2023 - 10.2023
Patient Service/ Benefits Verification
UPMC
01.2020 - 12.2022
Customer Service Technician
Grane Pharmacy
06.2019 - 03.2020
Provider Service Representative
United HealthCare
08.2018 - 05.2019
Patient Case Coordinator
Mindlance, Amerisource Bergen
08.2017 - 10.2017
Customer Service Associate
Gentech Staffing Solutions/Gateway Health Systems
12.2016 - 04.2017
Customer Service Representative
PNC Bank
08.2015 - 11.2016
Customer Service Specialist
CVS Specialty Pharmacy
06.2014 - 07.2015
Child Care Certification -
ForbesTechnology
Certificate, Child Care -
Community College of Allegheny County
H.S. Diploma - General Studies
Penn Hills Jr. & Sr. High School
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