Deanna Stover
Cheektowaga,NY
Summary
Detail-oriented HealthCare Customer Service Representative with 20 years of experience in FACETS/SalesForce. Successful at multitasking with 97% accuracy. Flexible and goal-oriented team player with expertise in scheduling, customer relationship management and document control. Organized and dependable candidate with a positive attitude. Willingness to take on added responsibilities to meet team goals.
Overview
24
24
years of professional experience
Work History
Provider Data Coordinator
Fidelis Care
08.2020 - Current
- Ensured timely completion of projects by efficiently coordinating cross-functional teams involved in data management activities.
- Ensured compliance with industry standards and regulations regarding sensitive information handling protocols, maintaining strict confidentiality where necessary.
- Applied data validation procedures to support and enforce data integrity.
- Located and corrected data entry errors and reported to management.
Service Coordinator, HARP
Fidelis Care
08.2017 - 08.2020
- Accountable for meeting departmental guidelines for timeliness of outreach, and meeting requirements established to ensure adherence to regulatory and departmental policy/procedures.
- Maintains high regard for member privacy in accordance with the corporate privacy policies and procedure.
- Outreach to members for preventive health services and QARR/HEDIS initiatives triggering department goals to exceed.
- Revamped a streamline work approach for training new colleagues for maximum production efficiency.
- Enhanced customer satisfaction by efficiently addressing and resolving service issues.
- Streamlined service coordination processes for improved team productivity and response times.
- Managed a high volume of client requests, ensuring timely and effective service delivery.
- Collaborated with cross-functional teams to optimize service operations and improve client experiences.
- Boosted overall team performance by delivering ongoing training sessions on best practices in customer service and technical skills.
- Played a key role in the successful onboarding of new hires within the Service Coordinator role, offering mentorship and guidance as needed.
- Established strong relationships with clients through regular follow-ups, keeping them informed about progress updates regarding their services requested or concerns raised.
- Introduced innovative solutions to address common challenges faced during the execution of specific tasks assigned or projects undertaken.
- Evaluated and analyzed data to identify trends, uncovering opportunities for process improvements and service enhancements.
- Analyze incoming Crisis Calls to execute immediate barge-in protocol or callback process by a Clinical Professional to triage level of crisis, for possible Emergency Medical Services involvement.
Member Services Associate, Fidelis Care
Imagine Staffing Technology Inc.
12.2015 - 08.2016
- Enhanced member satisfaction by promptly addressing inquiries and providing solutions to concerns.
- Streamlined membership renewal process for increased efficiency and retention rates.
- Assisted in the development of targeted marketing materials, boosting membership growth.
- Exceeded company productivity standards on a consistent basis, handling more than 95% of quota each day.
- Provided exceptional customer service, consistently exceeding expectations and earning positive feedback from members.
Medical Management Associate, Fidelis Care
Imagine Staffing Technology Inc.
10.2015 - 12.2015
- Followed all Medicaid, HIPAA, and private insurance regulations and requirements.
- Maintained a high level of professionalism when speaking to doctors and providers.
- Communicated insurance authorization issues with patients to try to find an effective resolution.
- Skilled at working independently and collaboratively in a team environment.
- Proven ability to learn quickly and adapt to new situations.
- Demonstrated respect, friendliness and willingness to help wherever needed.
Special Claims Representative, BlueCard Program
BlueCross BlueShield of Western New York
05.2000 - 06.2012
- Effectively managed a high-volume of inbound and outbound customer calls approximately 100 calls per day.
- Resolved escalated customer issues quickly to drive client satisfaction.
- Adjust claims 90% of time, using fee schedules and interprets appropriate reference materials to reimburse providers correctly, Requested Medical Records when needed.
- Coded provider/subscriber medical claims, Review claims for all required information to process payment.
- Coded Medicare Part A and B, Dental, Hospital and Medical/Surgical Claims, and COB, Responsible for accuracy of claims.
- Mentor new employees each quarter in procedures and policies in order to maximize team performance.
Education
Associate of Science - Administrative Assistant
Villa Maria College Buffalo
Buffalo, NY1995
Skills
- Microsoft Excel
- Spreadsheet Management
- Data conversion
- Quality Control
- Customer Service
- Team Leadership
- Verbal and written communication
- Complex Problem-Solving
- Staff Development
- Teamwork and Collaboration
- Product and service knowledge
- Team motivation
Timeline
Provider Data Coordinator
Fidelis Care
08.2020 - Current
Service Coordinator, HARP
Fidelis Care
08.2017 - 08.2020
Member Services Associate, Fidelis Care
Imagine Staffing Technology Inc.
12.2015 - 08.2016
Medical Management Associate, Fidelis Care
Imagine Staffing Technology Inc.
10.2015 - 12.2015
Special Claims Representative, BlueCard Program
BlueCross BlueShield of Western New York
05.2000 - 06.2012
Associate of Science - Administrative Assistant
Villa Maria College Buffalo