CRYSTAL LAMERCE
Health Care Administration
Miami,FL
Summary
Highly trained professional with a background in verifying insurance benefits and creating appropriate patient documentation. An established Insurance Verification Specialist known for handling various office tasks with undeniable ease.
Overview
10
10
years of professional experience
7
7
Health Care Customer Support
3
3
Claims
Work History
Customer Care
Elevation Connect
04.2022 - 12.2022
- Elevation Connect
- Handled complaints, provided appropriate solutions and alternatives within appropriate timeframes and followed up to achieve resolution.
- Organized daily workflow and assessed appropriate staffing to provide optimal service.
- Performed duties and provided service in accordance with established operating procedures and company policies.
- Built client relationships by responding to inquiries, identifying and assessing clients' needs, resolving problems, and following up with potential and existing clients.
Ostomy Specialist
ABC Medical
08.2019 - 02.2022
- Accurately load patient information into working system, generating all delivery paperwork for sales, rental & service orders, provide a high level of customer service to patients, referral & pay sources
- Responsible for maintaining a strong working knowledge of products & services, funding sources and company policies & procedures
- Responsible for maintaining record integrity through assembling, compiling, filing, retrieving and tracking all confidential patient records
- Proficiency in claims history and ensuring accuracy of billing, and member responsibility
- Medical terminology, scans and organizes medical records for scanning and indexing
- Develops and maintains a strong relationship with the New Patient Enrollment team
- Adheres to all HIPAA guidelines/regulations
- Maintained strong knowledge of basic medical terminology to better understand services and procedures.
- Maintained confidentiality of patient finances, records, and health statuses.
- Provided advice to customers regarding claims, rights and insurance processes to prevent disputes.
- Carried out administrative tasks by communicating with clients, distributing mail, and scanning documents.
- Resubmitted claims after editing or denial to achieve financial targets and reduce outstanding debt.
- Posted payments to accounts and maintained records.
- Collected premiums and issued accurate receipts.
- Notified insurance agents and accounting departments of policy cancellations and changes.
Program Assistant
House of Hope
06.2016 - 02.2019
- Office administrative work, client program intake, responsible for pantry to meet USDA standards
- Data entry, referrals to community assistant programs such as 211, food pantries, shelters and community outreach programs
- Provide quality customer service by giving assistance, information, and technical support to internal and external customers
- Responsible for screening and assessing clients to determine their needs and arrange for appropriate services.
- Directed automation of office procedures such as correspondence management, recordkeeping and online communications.
- Answered and managed incoming and outgoing calls while recording accurate messages for distribution to office staff.
- Prepared clearly written and formatted documents and reports.
- Recorded and tracked operational expenses to identify and eliminate wasteful spending.
- Developed and implemented strategies to streamline office operations.
- Assisted clients with daily living needs to maintain self-esteem and general wellness.
- Trained and supervised employees on office policies and procedures.
- Performed wide-ranging administrative, financial and service-related functions.
- Volunteered to help with special projects of varying degrees of complexity.
- Followed detailed directions from management to complete daily paperwork and computer data entry.
- Created and updated records and files to maintain document compliance.
- Supported planning and coordination of project hope program and associated activities.
- Managed both digital and physical filing systems and retrieved documents as required.
- Conducted research to assist with routine tasks and special projects.
Education
Bachelor of Science - Organizational Management-Health Care Management
Southern New Hampshire University
Hooksett, NH12.2024
Skills
- Fraud Detection
- Inputting Claims
- Estimate Preparation
- Electronic Authorization Processing
- Information Gathering
- Complex Problem-Solving
- Insurance Terminology
- Work Organizing and Prioritizing
- Insurance Coverage Limits
- Claims
- Billing Statements
- Confidential Records Management
- Online Chat
- Microsoft Excel
- Active Listening
Work Availability
monday
tuesday
wednesday
thursday
friday
saturday
sunday
morning
afternoon
evening
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Quote
There is a powerful driving force inside every human being that, once unleashed, can make any vision, dream, or desire a reality.
Tony Robbins
Timeline
Customer Care
Elevation Connect
04.2022 - 12.2022
Ostomy Specialist
ABC Medical
08.2019 - 02.2022
Program Assistant
House of Hope
06.2016 - 02.2019
Bachelor of Science - Organizational Management-Health Care Management
Southern New Hampshire University
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