Chalonda Belle
Louisville
Summary
Accomplished Case Manager experienced in managing high caseloads while maintaining quality of care. Delivered effective solutions in high-pressure environments through strong problem-solving skills and collaborative support for team members. Focused on optimizing patient outcomes by recommending appropriate resources and actions.
Overview
2
2
years of post-secondary education
24
24
years of professional experience
Work History
Case Manager, Insurance Specialist, and Sr. Health Associate
RX Crossroads
Louisville
07.2013 - 05.2026
- Contacted insurance payers and pharmacy benefits managers to secure patient coverage for specialty drug therapies, enhancing access to necessary medications.
- Assisted Healthcare Providers in Ophthalmology by securing benefits from Insurance Payers through phone communications.
- Initiated required prior authorizations online using www.Covermymeds.com.
- I spoke with Patients to complete a conference call with the Insurance Payers and Pharmacy Benefits Managers to ensure patients' privacy was protected by Patient giving verbal consent.
- Inputted all findings into the Salesforce operating system Lightning version, to build reports to send back to the Healthcare Providers.
- Over the years trained others on completing successful Benefits Investigations.
- Over the years I have worked with m multiple drug manufacturers such as AstraZeneca, Takeda, Novo Nordisk, MS Lifelines and Genentech Access Solutions.
- I have been working from home the past five years and eight months.
- Facilitated sale transactions between CVS Caremark and McKesson, ensuring adherence to compliance standards and promoting seamless operations.
Membership Enrollment/ Billing Representative
Anthem Wellpoint
08.2012 - 03.2013
Customer Service Representative
SHPS, INC
10.2010 - 01.2012
- Assisted customers with inquiries regarding products and services.
- Resolved customer complaints through effective communication and problem-solving.
- Handled inbound calls from employees and companies to facilitate enrollment in employer benefits during open and new hire enrollment periods.
- Processed orders and managed customer accounts using internal systems.
- Processed claims for health savings accounts, flexible spending accounts, dependent child care accounts, and health reimbursement accounts to ensure timely reimbursements.
Independent Contractor Agent
Liveops, Inc
03.2007 - 01.2012
- Handled customer orders in virtual call center for Papa John's Pizza, ensuring accurate order processing and customer satisfaction.
- Managed inventory for Bare Minerals Essentials Cosmetics and other brands, ensuring product availability and organization.
- Managed product selection for Bare Minerals Essentials Cosmetics, Joan Rivers Great Hair Day, Jack LaLanne Power Juicer, and Monte's Williams Health Master.
Collector Customer Services Representative
Citigroup Inc.
03.2008 - 12.2009
- Managed inbound calls from Sears credit card holders to update accounts and verify purchases.
- Communicated with clients to negotiate payment arrangements and agreements.
- Managed customer accounts and resolved payment issues effectively.
- Managed inbound calls from Sear credit card holders to update accounts and verify purchases.
- Utilized collection software to track account statuses and document interactions.
Patient Account Representative
Fresenius Medical Care
11.2002 - 01.2004
- Approved and posted adjustments into accounting spreadsheet, ensuring accurate account balances and financial reporting.
- Submitted adjustment requests for manager approval and processed approved system adjustments and write-offs on customer and third party payer account balances.
- Prepared and maintained spreadsheets for documentation requests, facilitating timely resolution of outstanding billing issues.
- Compiled bad debt write-off package for review and processing.
- Collected unpaid and underpaid reimbursements on dialysis claims to improve cash flow.
- Responded to correspondence from insurance companies.
- Reviewed claims for unbilled status at end of billing period.
Education
Patient Account - for Hospital Collections
Columbia Patient Account Services
Louisville, KY 01.1997 - 04.1997
Clerical and Computer Training -
Jefferson County Adult Continuing Education
Louisville, KY 01.1994 - 06.1994
Customer Service Training -
Louisville Urban League
Louisville, KY 01.1990 - 06.1990
General Studies -
Jefferson County Adult High School
Louisville, KY 01.1989 - 03.1989
Advanced Typing and Business Machines Class -
Jefferson Community and Technical College
Louisville, KY 01.1986 - 05.1986
Skills
- Case management
- Healthcare Software
- Data Entry
- Microsoft Word
- Critical thinking
- Problem solving
- Multitasking ability
- Independent work
- Communication skills
About Me
True, 1 year
Social Networks - Linkedin
https://Linkedin.com
Timeline
Case Manager, Insurance Specialist, and Sr. Health Associate
RX Crossroads
07.2013 - 05.2026
Membership Enrollment/ Billing Representative
Anthem Wellpoint
08.2012 - 03.2013
Customer Service Representative
SHPS, INC
10.2010 - 01.2012
Collector Customer Services Representative
Citigroup Inc.
03.2008 - 12.2009
Independent Contractor Agent
Liveops, Inc
03.2007 - 01.2012
Patient Account Representative
Fresenius Medical Care
11.2002 - 01.2004
Patient Account - for Hospital Collections
Columbia Patient Account Services
01.1997 - 04.1997
Clerical and Computer Training -
Jefferson County Adult Continuing Education
01.1994 - 06.1994
Customer Service Training -
Louisville Urban League
01.1990 - 06.1990
General Studies -
Jefferson County Adult High School
01.1989 - 03.1989
Advanced Typing and Business Machines Class -
Jefferson Community and Technical College
01.1986 - 05.1986