Summary
Overview
Work History
Education
Skills
References
Timeline
Generic

CH A Q U E T I A B O Y D

Buford,Georgia

Summary

Intake Specialist with a track record of high productivity and rapid task execution. Proficient in client assessment, data entry, and case management, leading to streamlined intake processes. Strong communication and problem-solving abilities enhance client and team interactions, ensuring optimal service delivery. Demonstrated success in collaboration and managing high-pressure situations, focused on improving operational efficiency and client outcomes.

Overview

31
31
years of professional experience

Work History

Intake Specialist II

CareSource
Dayton, OH
09.2019 - Current
  • Responsible for the intake of all authorization requests received via various methods into the Utilization Management department.
  • Served as lead point of contact for all intake-related inquiries, ensuring timely and accurate responses.
  • Handle incoming requests from providers, assists with reviewing authorization details, requirements or update
  • Processes all requests into our systems for medical review as well as contacting the provider/member if additional and or clinical information is required
  • Convert information obtained from providers/members, (received via fax, phone, provider portal or mail) into electronic records while verifying member eligibility, provider network status, and benefit coverage
  • Review requests and send fax back for ineligible members, duplicate requests and items not covered by medical benefit
  • Place prior authorizations when approval is appropriate per SOP into the medical management systems
  • Facilitate the authorization of benefits for participating and out-of-network providers including completion of appropriate forms that are distributed to physicians' offices, provider relations and the generation of approval letters
  • Communicate with providers regarding prior authorization requests and troubleshoot issues from providers
  • Initiate process for routing prior authorizations requiring medical necessity review by clinical care reviewer
  • Assist Clinical team as directed to ensure requests for authorization that require clinical review are received and processed timely

Customer Services Representative

Wright&Filippis-Prosthetics And Orthotics
Sterling Heights, MI
06.2018 - 06.2019
  • Data Entry
  • Developed and maintained strong knowledge of multiple products and varying levels of benefits within each product.
  • Take inbound calls and make outbound calls.
  • Schedule appointments.
  • Verify health insurance.
  • Greeted all customers that called and walked in.

Owner

New Beginning Family Services
Sterling Heights, MI
03.2008 - 04.2019
  • Implemented a comprehensive outreach program that expanded our services to over 100 new families within the first year of operation.
  • Led a team of 10 professionals in providing high-quality support services, improving overall family outcomes by [number]% as measured by client feedback surveys.
  • Developed partnerships with local community organizations, which enhanced resource availability and increased service utilization by 50% over 5 months.
  • Provided transportation
  • Provided in home/childcare services
  • Provided housekeeping

Team Leader

Chrysler Assembly Plant
Warren, MI
05.1994 - 03.2003
  • Assisted supervisor in daily duties.
  • Mentored and guided employees to foster proper completion of assigned duties.
  • Cross-trained and provided backup support for organizational leadership.
  • Demonstrated knowledge of company mission and goals and mentored employees in reaching objectives aligned with company core values.
  • Lead a team of ten when needed.

Education

High School Diploma - General Studies

Martin Luther King Jr High School
Detroit, MI
05.1990

No Degree - Social Work

Oakland Community College
Bloomfield Hills, MI

Skills

  • Data entry and management
  • Utilization management
  • Customer relationship management
  • Conflict resolution
  • Verbal and written communication
  • Problem solving
  • Team collaboration
  • Pressure resilience
  • Patient assessment expertise
  • Healthcare knowledge
  • Confidentiality compliance
  • Self-motivation
  • Time management
  • Health insurance verification

References

References available upon request.

Timeline

Intake Specialist II

CareSource
09.2019 - Current

Customer Services Representative

Wright&Filippis-Prosthetics And Orthotics
06.2018 - 06.2019

Owner

New Beginning Family Services
03.2008 - 04.2019

Team Leader

Chrysler Assembly Plant
05.1994 - 03.2003

High School Diploma - General Studies

Martin Luther King Jr High School

No Degree - Social Work

Oakland Community College

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