Cara Grimes
Medical Consultant Specialist
Topeka,KS
Summary
Solution-focused Medical Consultant with progressive 9-year career history in various customer service settings. Collaborative team player adept at creating and implementing strategic plans. Detail-oriented team player with strong organizational skills. Ability to handle multiple projects simultaneously with a high degree of accuracy.
Overview
9
9
years of professional experience
4
4
years of post-secondary education
Work History
Medical Consultant Specialist
Blue Cross Blue Shield Of Kansas
08.2022 - Current
- Collaborated with multidisciplinary teams to ensure optimal patient care and effective communication among healthcare providers.
- Maintained detailed documentation of patient interactions, treatments, and outcomes for accurate record-keeping purposes.
- Oversaw monthly case review costs and managed invoices for multiple external companies.
- Prepared prior authorization and claim review requests for review, as well as assisting in the preparation of fraud and abuse reviews.
- Consistently enforced time management to ensure review request were completed in a timely manner
- Collaborated with multiple areas of the company and consultants simultaneously to provide quick and satisfying case results.
Customer Experience Representative
Blue Cross Blue Shield Of Kansas
02.2020 - 08.2022
- Elevated overall customer satisfaction ratings with a focus on providing prompt assistance and empathetic support during interactions.
- Increased repeat business with exceptional follow-up efforts that nurtured ongoing relationships with customers.
- Continuously refined personal communication skills, adapting to various customer personalities and preferences for optimal rapportbuilding.
- Facilitated smooth issue resolution by maintaining clear lines of communication between customers and relevant departments.
- Streamlined communication channels for improved efficiency in handling customer inquiries.
- Analyzed customer feedback data, identifying areas for improvement and implementing necessary changes.
- Investigated and resolved accounting, service and delivery concerns.
- Met customer call guidelines for service levels, handle time and productivity.
Optometrist Technician
Smart Family Vision
1 2019 - 02.2020
- Maintained sanitary work environment by disinfecting equipment, disposing of used supplies and cleaning exam rooms
- Conducted inventory of supplies such as trial contacts and various office necessities and maintained stock levels by submitting orders and disposing of expired items
- Conducted pretesting as well as gathering ocular and medical history
- Performed administrative tasks such as processing insurance information, setting appointments and preparing prescriptions and other documents to be signed by Optometrist
- Supervised production planning while using appropriate tools and analysis for smooth production output
- Investigated and resolved customer complaints to foster satisfaction
- Established and maintained productive working relationships with staff to resolve operational difficulties and to promote interdisciplinary, collaborative approach to customer service provision
- Controlled digital access, used confidential waste bins and shredders, and locked document storage cabinets to protect confidential files, reports and fiscal data
- Operated with high integrity, built trust, and earned sustained credibility with internal and external clientele
- Identified and resolved process issues to encourage smoother procedures, more efficient workflow and overall business growth
- Welcomed visitors to office, communicated arrival to team and managed visit expectations
Certified Pharmacy Technician
Walmart
11.2015 - 01.2019
- Consulted with insurance company representatives to complete claims processing, resolve concerns and reconcile payments
- Helped pharmacist clear problematic prescriptions and address customer questions to keep pharmacy efficient
- Set up and modified patient profiles in [System] to include current information such as medications and insurance details
- Restocked pharmacy shelves with current merchandise to drive consistent peripheral sales
- Stocked, labeled and inventoried medication to keep accurate records
- Assisted in preparation, distribution, and storage of pharmaceuticals
- Resolved non-routine issues like third-party billing, computer system and customer service issues
- Completed paperwork, entering prescription and insurance or billing information into patient profiles
- Collected co-payments or full payments from customers
- Worked with computerized and automated systems for dispensing medications and editing new patient profiles
- Answered incoming phone calls and addressed questions from customers and healthcare providers
- Communicated directly with doctors offices via telephone, fax, and email
Customer Service Associate
Walmart
02.2015 - 11.2015
- Improved customer satisfaction ratings by addressing issues and fostering timely resolution
- Reported to work early, checked low inventory, learned sales or special offerings, and became aware of store issues
- Assisted with price verifications and implemented adjustments for discounts or promotions
- Compiled customer feedback and recommended service delivery improvements to management
- Issued receipts and processed refunds, credits, or exchanges
- Offered advice and assistance to customers, paying attention to special needs or wants
- Greeted customers entering store and promoted sales or special programs
Education
High School Diploma -
Topeka High School
Topeka, KS 08.2010 - 05.2014
Skills
Time Management
Timeline
Medical Consultant Specialist
Blue Cross Blue Shield Of Kansas
08.2022 - Current
Customer Experience Representative
Blue Cross Blue Shield Of Kansas
02.2020 - 08.2022
Certified Pharmacy Technician
Walmart
11.2015 - 01.2019
Customer Service Associate
Walmart
02.2015 - 11.2015
High School Diploma -
Topeka High School
08.2010 - 05.2014
Optometrist Technician
Smart Family Vision
1 2019 - 02.2020
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