Conita Barrett
Columbus,OH
Summary
Knowledgeable and dedicated customer service professional with extensive experience in customer success. Solid team player with outgoing, positive demeanor and proven skills in establishing rapport with clients. Motivated to maintain customer satisfaction and contribute to company success. Specialize in quality, speed and process optimization. Articulate, energetic and results-oriented with exemplary passion for developing relationships, cultivating partnerships and growing businesses.
Overview
14
14
years of professional experience
1
1
Certification
Work History
Prior Authorization Specialist
CVS HEALTH CORPORATION
10.2023 - Current
- Collaborated with physicians to obtain necessary clinical information for prior authorization submissions.
- Maintained thorough knowledge of insurance plan requirements, facilitating accurate and timely completion of authorization forms.
- Verified eligibility and compliance with authorization requirements for service providers.
- Analyzed medical records and other documents to determine approval of requests for authorization.
- Responded to inquiries from healthcare providers regarding prior authorization requests.
- Evaluated clinical criteria for approval or denial of services requiring pre-authorization.
- Achieved high success rate in obtaining authorizations by effectively demonstrating medical necessity through comprehensive documentation and clear communication with insurance companies.
- Obtained and logged accurate patient insurance and demographic information for use by insurance providers and medical personnel.
- Reviewed appeals for prior authorization requests and communicated with payers to resolve issues.
Member Service Representative
AmeriHealth Caritas
12.2022 - 10.2023
- Updated patient records with accurate, current insurance policy information.
- Complied with HIPAA guidelines and regulations for confidential patient data.
- Maintained strong knowledge of basic medical terminology to better understand services and procedures.
- Managed high-volume insurance verifications within pressured timeframes for productive medical operations.
- Assured timely verification of insurance benefits prior to patient procedures or appointments.
HR Administrator
Chipotle
05.2022 - 09.2022
- Coordinated implementation of people-related services, policies and programs through departmental staff.
- Completed human resource operational requirements by scheduling and assigning employees.
- Managed payroll and timekeeping to track hours and accurately pay employees.
- Collaborated with managers to identify and address employee relations issues.
- Answered employee inquiries regarding health benefits and 401k options.
Senior Customer Service Specialist
Kruger Inc
11.2018 - 12.2021
- Resolved 96% of customer service issues using company processes and policies and provided updates to customers on timely basis
- Greeted customers and listened closely to problems described to determine solutions over calls
- Coached new team members on new service techniques and provided scoring through quality assurance programs
- Promoted to team lead of customer service for displaying outstanding enthusiasm and remaining calm in extremely trying and repulsive situations
- Trained new personnel regarding company operations, policies and services Improved sales abilities and product knowledge
- Continuous basis by 39% providing optimal service and achieving quotas.
Customer Service Representative
Grid One Solutions
02.2014 - 11.2018
- Facilitated gas/electric orders and completed accurate goals to meet, aggressive deadlines Assessed caller accounts to determine BG&E benefits
- Identify service needs and resolve issues
- Answered average of 60 to 90 calls, emails, and faxes per day
- Addressing customer inquiries, solving problems, and providing product information Served at internal helpdesk, accepting, and resolving calls
- Delegating more severe issues to supervisor
- Explained technical information in clear terms to non- technical individuals to promote better understanding
- Performed troubleshooting and repaired peripheral devices such as printers, scanners etc.
CNA - Certified Nursing Assistant
Neighbourly Home Care
11.2010 - 01.2018
- Worked in a Senior citizen and home environment
- Provided caring, intimate, hands-on healthcare for residents Monitored vital signs
- Delivered residents' medication Handled minor wound care
- Assisted with feeding residents Three meals per day
- Took care of approximately 3 elderlies, disabled and hospice patients daily
- Assisted with bathing residents.
Customer Service Representative/File Clerk
Community action Agency
03.2013 - 04.2016
- Answer the phones and exchange extensions document clients for intake department
- File all client's payments made and payments due for agency
- Greet clients as they enter the building and assist with which rep to meet with in intake.
Education
Bachelor of Science - Behavioral Sciences
Kaplan University
Broomall, PA05.2025
Skills
- Time Management
- Senior customer service
- Member Relations
- Appointment Scheduling and Confirmation
- Member Retention
- Microsoft Office
Expert in resolving 96% of customer service issues using company processes and policies and providing updates to customers on timely basis
- Administrative and Office Support
- Customer Account Management
- Prior Authorization Process
- Medical Appeals Handling
- Medicare and Medicaid knowledge
- Medical terminology knowledge
Certification
- Certified nurse assistant,
- Certified AmeriHealth Caritas Ohio - Quality Improvement
- Corporate Compliance
- Medicare Model of Care
- HIPAA Security Awareness
- CC_MS_New Hire Training
Timeline
Prior Authorization Specialist
CVS HEALTH CORPORATION
10.2023 - Current
Member Service Representative
AmeriHealth Caritas
12.2022 - 10.2023
HR Administrator
Chipotle
05.2022 - 09.2022
Senior Customer Service Specialist
Kruger Inc
11.2018 - 12.2021
Customer Service Representative
Grid One Solutions
02.2014 - 11.2018
Customer Service Representative/File Clerk
Community action Agency
03.2013 - 04.2016
CNA - Certified Nursing Assistant
Neighbourly Home Care
11.2010 - 01.2018
Bachelor of Science - Behavioral Sciences
Kaplan University
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