Delina R. Kinder

• • Supervise and guide team members to ensure adherence to program objectives and deliverables, fostering a culture
  of recognition and continuous improvement.
  • Facilitate the onboarding and mentoring of new staff, ensuring seamless integration and effectiveness within the
  team.
  • Conduct assessments to identify proficiency gaps among staff, and develop targeted plans to remediate
  performance issues.
  • Analyze data related to Key Performance Indicators (KPIs) and Service Level Agreements (SLAs), providing
  actionable insights and recommendations to optimize service delivery.
• Delegated work to staff, setting priorities and goals.

• Works closely with program managers, coordinators, directors, and other staff to ensure that the program goals, objectives, and outcomes are met
• Communicates with external partners, stakeholders, and beneficiaries to provide information, feedback, and assistance
• Proficient and knowledgeable about all the services provided on an assigned program and may support multiple client products and programs
• Provided technical assistance to staff members regarding program implementation strategies.
• Produced well-written, comprehensive reports and documents.
• Coordinate the order and transfer of prescriptions based on their degrees of urgency to specialty pharmacies as appropriate
• Be familiar with the market place and the insurance options available for patients
• Creating/Updating training materials, and facilitating trainings for new agents

• • Supervise and guide team members to ensure adherence to program objectives and deliverables, fostering a culture
  of recognition and continuous improvement.
  • Facilitate the onboarding and mentoring of new staff, ensuring seamless integration and effectiveness within the
  team.
  • Conduct assessments to identify proficiency gaps among staff, and develop targeted plans to remediate
  performance issues.
  • Analyze data related to Key Performance Indicators (KPIs) and Service Level Agreements (SLAs), providing
  actionable insights and recommendations to optimize service delivery.

· Coordinate the order and transfer of prescriptions based on their degrees of urgency to specialty pharmacies as appropriate.

· Be familiar with the market place and the insurance options available for patients. Educate patients on the available options as appropriate.

• Responded to and resolve on the first call, customer service inquiries and issues by identifying the topics, and type of assistance the caller needs such as benefits, eligibility and claims, financial spending accounts and correspondence
• Helped guide and educated customers about the fundamentals and benefits of consumer-driven health care topics to include managing their health and well-being by selecting the best benefit plan options, which maximized the value of their health plan benefits and chose a quality care provider
• Interpreted explanation of benefits received to implemented changes to future invoices to facilitate prompt payment and reduce possible denials
• Worked assigned AR (open invoices) using computers and a variety of automated systems to guarantee timely collections
• Recorded in patients charts actions taken, documentation sent and other pertinent notes to the reconsideration process to decrease AR and increase cash collections
• Analyzed explanation of benefits received, denial trends and conferred with customers to determine reasons for denials to facilitate effective collections
• Recorded collections progress of assigned invoices on spreadsheets and within billing system as assigned by manager
• Verified accuracy of billing charges and rejected any invoices using knowledge of medical fee schedules
• Stated specific requirements, payer instructions and compliance requirements
• Answered client account inquiries for billing and collections related questions
• Obtained additional documentation to attach to invoices to facilitate payment and reduce rejections
• Met the performance goals established for the position in the areas of: efficacy, called quality, customer satisfaction, first call resolution and attendance
• Quickly built rapport and responded to customers in a compassionate manner by identifying and exceeding customer expectations (responding in respectful, timely manner, consistently meeting commitments)