Summary
Overview
Work History
Skills
Timeline
AssistantManager

Chakoya Sims

DeSoto,TX

Summary

Passionate about promoting lasting customer satisfaction by delivering quality service and unparalleled support. Proficient in customer service best practices and related options. Enthusiastic about helping patients get necessary medical support by obtaining authorizations, scheduling procedures and coordinating paperwork. Detail-oriented and proactive with good relationship-building skills, a hardworking nature and an adaptable approach. Skilled at coordinating busy offices and maintaining professionalism in stressful situations.

Overview

9
9
years of professional experience

Work History

DSNP Navigator

United Healthcare Group
02.2023 - Current
  • Skilled at working independently and collaboratively in team environment.
  • Proven ability to learn quickly and adapt to new situations.
  • Maintained confidential patient, employee and company information in compliance with company policies and regulatory requirements.
  • Gathered information, assessed and fulfilled callers' needs and educated on important policies and procedures.
  • Handled customer inquiries and suggestions courteously and professionally.
  • Supported accounts receivable operations within assigned functions
  • Identified, analyzed and researched systemic issues and made recommendations for resolution.
  • Managed patient registration process, confirming data accuracy and completeness.

Documentation Specialist

Adapt Health
02.2022 - 03.2023
  • Maintained organized and efficient document flows by using excellent planning and multitasking skills.
  • Prepared digital files, physical documents and work requests in compliance with company guidelines.
  • Evaluated current document processes, suggested methods for change and implemented successful improvements.
  • Researched and resolved billing discrepancies to enable accurate billing.
  • Worked effectively with medical payers such as Medicare, Medicaid, commercial insurances to obtain timely and accurate payments.
  • Maintained strong knowledge of basic medical terminology to better understand services and procedures.

Senior Customer Service Representative

Lincare
07.2018 - 09.2022
  • Resolved customer service issues using company processes and policies and provided updates to customers.
  • Responded to customer calls and emails to answer questions about products and services.
  • Learned and maintained in-depth understanding of product and service information to offer knowledgeable and educated responses to diverse customer questions.
  • Escalated issues to proper supervisors when standard processes were not effective.
  • Trained and directed new employees in call script use, conflict resolution, and data entry practices to boost customer satisfaction ratings.
  • Processed, scheduled and executed customer orders for new and established customers.

Benefit Recovery Specialist

Conduent Business Services
08.2014 - 05.2018
  • Maintained client confidentiality and adhered to HIPAA guidelines.
  • Documented case management activity for accurate, reliable records.
  • Assessed individuals' needs and planned bespoke recovery programs to achieve personalized goals.
  • Reviewed accounts and provided recommendations regarding repossession actions.
  • Performed administrative duties by verifying documentation, researching facts and contacting other parties involved to determine fault percentages and minimize potential losses.
  • Generated, posted and attached information to claim files.
  • Checked documentation for accuracy and validity on updated systems.

Skills

  • Data Evaluation
  • Microsoft PowerPoint
  • Financial Documentation
  • Logistics Documentation
  • Complex Problem-Solving
  • Multitasking Skills
  • Reviewing Patient Information
  • HIPAA Regulations
  • Data Integrity
  • Pre-Authorizations
  • Medicaid and Medicare
  • Policy and Procedure Adherence
  • Insurance coding (ICD-9 and CPT)
  • Medical terminology

Timeline

DSNP Navigator

United Healthcare Group
02.2023 - Current

Documentation Specialist

Adapt Health
02.2022 - 03.2023

Senior Customer Service Representative

Lincare
07.2018 - 09.2022

Benefit Recovery Specialist

Conduent Business Services
08.2014 - 05.2018

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Chakoya Sims