Chevanique Black
Pembroke Pines
Summary
Detail-oriented and compassionate professional with 6+ years of combined experience in healthcare operations, insurance coordination, and customer service. Proven expertise in Medicare/Medicaid collections, referral processing, and medical benefits verification. Adept at ensuring regulatory compliance, identifying billing discrepancies, and coordinating care delivery across cross-functional teams. Technically proficient in Microsoft Office, SAP, and healthcare coding systems including CPT, HCPC, and ICD-10. Committed to improving the patient experience through proactive communication, accuracy, and operational excellence. Resourceful professional in administrative management known for high productivity and efficient task completion. Possess specialized skills in workflow coordination, staff supervision, and process improvement. Excel in communication, leadership, and problem-solving to enhance team performance and achieve organizational goals.
Overview
7
7
years of professional experience
Work History
Medicare/Medicaid Collections Coordinator & Refund Request Specialist
VITAS Healthcare
04.2023 - Current
- Managed timely billing and collection of Medicare and Medicaid claims in compliance with federal and state regulations.
- Entered and maintained accurate admission and claims data within billing systems.
- Reviewed Medicare accounts to ensure all required documentation and claim information were complete and compliant.
- Responded to technical assistance letters and resolved claim discrepancies promptly.
- Corrected and adjusted claims as necessary to prevent denials and delays in reimbursement.
- Monitored daily Medicaid admissions for eligibility verification and third-party payer information.
- Reviewed Medicaid Pending Reports regularly and conducted follow-up to resolve outstanding issues.
- Collaborated with clinical teams and medical records departments to obtain required documentation for billing.
- Maintained organized records to support prompt and accurate billing and collections.
- Communicated with state agencies regarding claim status, eligibility, and reimbursement matters.
- Conducted weekly follow-up on denied or suspended claims through Medicaid Remittance reviews and implemented necessary corrections.
- Posted applied income amounts, updated financial classifications, and made billing adjustments as appropriate.
- Analyzed Aged Trial Balance (ATB) reports to track collection progress and identify problem accounts.
- Coordinated with hospice providers to obtain Medicaid numbers for patients in pending status.
- Identified uncollectible accounts and recommended them for supervisory review and resolution.
Customer Service/ Sales Associate
Verizon Wireless
08.2022 - 06.2023
- Provided consumers clear disclosures for policies and procedures by supporting customer and partner inquiries.
- Improved company earning by establishing an average $227 value gain per hour.
- Created and drove change amongst team through virtual platforms, encouraging a positive, goal-oriented, and focused team.
- Consulted and assisted customers with billing, product, service, and account inquiries.
- Gathered and documented customer and product information for filing and processing insurance claims.
- Detected and troubleshot devices, processed replacements, identified and documented product issues through found through investigating product software and devices.
- Provisioned devices and services into company network by completing initial set up and activation.
- Deescalated customers ensuring first contact resolution and customer satisfaction thereby repairing company brand.
- Took ownership of assigned workload following established procedures after full training.
- Managed and prioritized daily workload for assigned group customers, meeting customer demands.
- Read, interpreted, and communicated eligibility requirements following plan guidelines.
- Practiced advanced follow-up skills with internal and external parties to ensure group customer expectations were met.
- Conducted independent research and gain knowledge of new products and services.
Pharmacy Technician
Walgreens
Pembroke Pines
11.2020 - 08.2022
- Serve as the primary contact for all enrollment tasks for an assigned book of business, managing multiple group customers.
- Maintain high levels of customer satisfaction through superior service and meticulous attention to detail in various responsibilities.
- Answer member, provider, and group customer phone calls, consistently meeting department expectations for responsiveness and providing friendly customer service.
- Utilize established procedures to maintain enrollment data in applicable systems based on customer requests, electronic files, or internal reports.
- Seek guidance from superiors for non-standard enrollment inquiries, ensuring accurate and compliant processes.
- Responded to provider and pharmacy inquiries regarding prior authorizations, formulary processes, and overrides.
- Reviewed and audited pharmacy and override requests to ensure compliance with company and state guidelines.
- Analyzed utilization trends and costs to support pharmacy management decisions.
- Resolved provider and member complaints related to pharmacy network issues.
- Supported Provider Relations through provider education on pharmacy policies and processes.
- Assisted with pharmacy utilization review, reporting, and quality improvement meeting preparation.
- Ensured adherence to organizational policies and performance standards.
Customer Experience Specialist
Best Buy
Pembroke Pines
11.2018 - 11.2020
- Handled cash and cashless transactions.
- Maintained and updated customer information ensuring accurate and current data.
- Drove store sales and promoted company offers and promotion.
- Prepared online orders and ship-to-home packages.
- Conducted returns, exchanges, and trade-ins.
- Resolved customer inquiries ensuring resolution of all past, present, and future issues.
- Investigated and documented cashflow shortages and overages.
- Calculated and reported store profits, losses and product shrink.
Education
High School Diploma -
Glenmuir High School
Jamaica06-2018
Associate of Science -
Broward College
Fort Lauderdale, FLSkills
- Excellent Listening and Communication
- Microsoft Office/ Word/ Excel
- Medicare billing
- Customer relationship management
- Problem solving
- Attention to detail
- Team collaboration
- Record keeping proficiency
- Verbal and Written Communication
- Management Skills
- Problem-Solving Administrative
- Contract Negotiation
- Customer Retention & De-escalation
- Research Analytical
- Critical Thinking
- Teamwork orientation
Timeline
Medicare/Medicaid Collections Coordinator & Refund Request Specialist
VITAS Healthcare
04.2023 - Current
Customer Service/ Sales Associate
Verizon Wireless
08.2022 - 06.2023
Pharmacy Technician
Walgreens
11.2020 - 08.2022
Customer Experience Specialist
Best Buy
11.2018 - 11.2020
High School Diploma -
Glenmuir High School
Associate of Science -
Broward College