Danyelle Womack
Baltimore,MD
Summary
Motivated and dependable professional with years of experience and expertise in fast paced environments utilizing excellent Customer Relations and Service Satisfaction. Strategic and Creative Thinker with solid background in delivering decisive, action driven leadership. Demonstrates expert insight and proficiency teaching, coordinating, monitoring, evaluation and communicating with clients. Performance driven team player with excellent interpersonal skills and attention to detail, optimally utilizing all channels of communication to assist operations.
Overview
12
12
years of professional experience
Work History
Resolution Team Lead
Express Scripts Cigna
11.2021 - 05.2024
- Promoted open communication channels among team members that fostered collaborative problem solving.
- Enhanced team productivity by implementing effective resolution strategies and streamlining communication processes.
- Established clear goals and expectations for team members, fostering a results-driven work environment.
- Take ownership of escalations to ensure resolution and follow-up.
- Assist PCA's with questions and system navigation when applicable.
- Work efficiently and effectively with other departments.
- Adhere to quality production standards while complying with safety guidelines.
- Work offline cases when permitted.
- Managed multiple group Chats to assist PCA's when call volume was high.
- Ability to be a critical thinker in complex situations.
Patient Care Advocate
Express Scripts Cigna
08.2021 - 11.2021
- Developed strong relationships with local pharmacies to expedite prescription refills and prevent gaps in medication therapy.
- Upheld confidentiality requirements and regulatory compliance guidelines.
- Demonstrated empathy toward diverse patient populations, building trust through compassionate interactions.
- Enhanced patient satisfaction by addressing concerns and providing clear communication on treatment plans.
- Provided excellent customer service
- Provided clear explanation on benefits available for different plans.
- Provided expert listening techniques to provide excellent service to patients.
- Identified and empathetically addressed patient concerns and if necessary escalated to appropriate support.
Prior Authorization Specialist
Cigna Healthspring
10.2014 - 08.2020
- 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.
- Analyzed medical records and other documents to determine approval of requests for authorization.
- Verified eligibility and compliance with authorization v-requirements for service providers.
- Verified and answered questions about medical products and services.
- Process driven
- Demonstrated the ability to build and maintain professional working relationships with others and contributed as an effective team player.
- Implemented Medicare and Medicaid managed care policies and regulations to align with the Centers for Medicare and Medicaid.
Program Specialist
Covance, Inc.
06.2014 - 10.2014
- Received incoming phone calls and contact form submissions and provided timely responses to inquiries.
- Improved overall program effectiveness through comprehensive data analysis and evaluation of key performance indicators.
- Conducted thorough needs assessments to identify gaps in service delivery and inform program development efforts.
- Evaluated program operations, successes and deficiencies to identify concerns and recommend strategies to enhance processes and elevate results.
- Respond to request from customers, physicians and pharmacies and distributors.
Customer Service Representative
Hirsch Financial Service Benefits
10.2012 - 08.2013
- Handled customer inquiries and suggestions courteously and professionally.
- Managed high-stress situations effectively, maintaining professionalism under pressure while resolving disputes or conflicts.
- Actively listened to customers, handled concerns quickly and escalated major issues to supervisor.
- Resolved customer complaints with empathy, resulting in increased loyalty and repeat business.
- Assist participants with their medical flexible spending accounts.
- Processed medical claims for participants to get a-reimbursements.
- Assisted participants via telephone and through email in regards to inquiries about their medical account or insurance questions.
Education
Business
Baltimore City Community College
Baltimore, MD06.2001
Skills
- Team Management
- Motivational Abilities
- Goal Setting and Achievement
- Client Retention Strategies
- Conflict Resolution
- Customer Service
- Patient care
- Claims Management
- Time Management
- Quality Assurance
- Medical Terminology
- Reports and Documentation
- Attention to Detail
- Microsoft Office
Timeline
Resolution Team Lead
Express Scripts Cigna
11.2021 - 05.2024
Patient Care Advocate
Express Scripts Cigna
08.2021 - 11.2021
Prior Authorization Specialist
Cigna Healthspring
10.2014 - 08.2020
Program Specialist
Covance, Inc.
06.2014 - 10.2014
Customer Service Representative
Hirsch Financial Service Benefits
10.2012 - 08.2013
Business
Baltimore City Community College