Summary
Overview
Work History
Education
Skills
Certification
Timeline
Generic

Delonta Garner

Knightdale,NC

Summary

Motivated Team Lead possessing excellent leadership and planning abilities. Focused on delivering high-quality products on tight schedules. Monitors, trains, and encourages employees to improve skills and meet demanding targets. History of successfully developing and managing strong teams through proactive training and issue management.

Overview

9
9
years of professional experience
1
1
Certification

Work History

Program Supervisor

Mercalis
Morrisville, NC
01.2024 - Current
  • Reviewed data reports related to program outcomes and objectives.
  • Coordinated training sessions for staff members.
  • Ensured compliance with all applicable laws, regulations, standards and codes of practice.
  • Assessed community needs in order to identify areas of improvement.
  • Provided leadership, guidance and supervision to staff members.
  • Maintained accurate records of program activities and results.
  • Coached staff members on how best to use available resources effectively.
  • Facilitated team meetings to discuss progress on projects and initiatives.
  • Helped team members improve productivity and performance through hands-on coaching in order to achieve company objectives.
  • Analyzed program effectiveness to optimize workflows.
  • Led team meetings to communicate updates, gather feedback, and align on goals.
  • Consulted with staff on resolution of complex service issues.
  • Keep track of attendance and approving time.

Fraud Investigator

Capital One
McLean, VA
12.2022 - 04.2024
  • Responsible for moderately complex research and analysis of customer relationships through multiple channels of investigation to assess levels of risk related to wire transactions.
  • Take appropriate mitigating action to eliminate exposure.
  • Focus on providing exceptional customer experience at all times throughout the investigation process.
  • Maintained detailed records regarding investigations, including evidence collected and investigative techniques used.
  • Provided recommendations for improvements in existing anti-fraud systems and processes.
  • Developed strategies to identify, prevent, and mitigate instances of fraud.
  • Reviewed customer accounts for evidence of fraudulent activity.

Team Lead

Mercalis
Morrisville, NC
06.2022 - 01.2024
  • The Team Lead will be responsible for leading an assigned team of Patient Experience Specialists
  • A Team Lead's effectiveness is determined by the success of their direct reports' overall performance, quality and compliance scores, adherence and overall professionalism
  • As a part of the management team, the Team Lead is expected to manage in accordance with all TrialCard policies and procedures and display professionalism at all times.

Care Coordinator

Mercalis
Morrisville, NC
12.2022 - 05.2023
  • The case manager will serve as an expert on reimbursement issues and be responsible for handling the day-to-day activities within reimbursement services.
  • Manage high-volume inbound calls from patients and providers to answer inquiries and resolve affordability options.
  • Inbound/Outbound phone calls and data entry.
  • Complete medical and/or pharmacy benefit investigations, identify and facilitate submission of required documentation for payer/plan review for prior authorization, step edit identification, and appeals according to program standard operating procedures.
  • Knowledge and understanding of the different types of major payers
    including private/commercial and government (Medicare, Medicaid, VA,
    DoD)
  • Understand the health and disease states of patients in the programs/promotions.
  • Responsible for assisting members and third-party representatives with a high level of integrity.

Reimbursement Manager

Mercalis
Morrisville, NC
06.2022 - 12.2022
  • Reimbursement Case Manger will also answer calls, handle verification and identification of covered and non-covered medications, as well as necessary follow up with families, health care providers and payors regarding referral issues, authorization questions, insurance eligibility issues and copay assistance programs.
  • Operate in Compliance with HIPAA within program guidelines.
  • Ensure all SOPs are followed with consistency and conducted miscellaneous tasks or projects as assigned.
  • Developed and maintained internal policies for reimbursement of expenses.
  • Maintained patient profiles, including allergies, current medications, and other pertinent information.
  • Resolved any customer complaints or issues quickly and professionally.

Army National Guard

Army National Guard
Smithfield, NC
10.2015 - 09.2022
  • Operate weapons and equipment in ground combat operations
  • Duties include operating and maintaining weapons, such as rifles, machine guns, mortars, and hand grenades; locating, constructing, and camouflaging infantry positions and equipment; evaluating terrain and recording topographical information; operating and maintaining field communications equipment; assessing need for and directing supporting fire; placing explosives and performing minesweeping activities on land; and participating in basic reconnaissance operations.

Insurance Specialist

McKesson
Scottsdale, AZ
11.2021 - 03.2022
  • Performs research, analysis, documentation, and interpretation for the provider reimbursement programs for an organization that provides health insurance
  • Update, maintain, and review fee scheduling and pricing structures
  • Ensure contracted rates and reimbursement policies are priced and applied accurately
  • Make reimbursement policy and process recommendations and ensure compliance with government regulations
  • Analyze provider reimbursement patterns and trends.

Amazon Delivery Driver

Foghorn Delivery Services, LLC
Durham, NC
05.2021 - 11.2021
  • Daily on my feet for at least 10 hours
  • Deliver packages to business and customers homes
  • Lifting up to 50lbs daily
  • Responsible for optimizing customer satisfaction by transporting and delivering goods, merchandise, and/or other items in a safe and timely manner
  • The job description entails picking up, transporting, and dropping off packages and small shipments within a local region or urban area.

Probation and Parole Officer

North Carolina Department of Public Safety
Raleigh, NC
04.2020 - 05.2021
  • Parole and probation officers usually meet offenders at state or county office buildings and offenders' homes and site of employment
  • They write reports, conduct background investigations, and recommend probation or jail sentences for offenders
  • Supervise offenders' activities in the community and ensure their compliance with court orders
  • Respond to offender behavior and non-compliance; intervene in crises and make arrests
  • Counsel offenders; make decisions regarding treatment that offenders need
  • Evaluate what offenders need to successfully complete probation or parole successfully
  • Respond to offender behavior and non-compliance; intervene in crises and make arrests.

Mental Health Technician

Carolina Dunes Behavioral Center
Leland, NC
09.2019 - 03.2020
  • In-person and telephone communication, professional awareness and boundaries are observed
  • Safely and accurately performs vital signs, electrocardiograms, body weight and input/outputs
  • Proactively prepares self and assigned patients to transitions, group structure and adheres to program schedule
  • Ensures the confidentiality of patient records and disclosures
  • Observes and assists assigned mental health patients and helps with daily living activities, therapeutic activities, and socialization
  • Responsible for the overall maintenance of a therapeutic environment in the psychiatric unit and to ensure the safety of patents and staff.

Education

Bachelor's - Criminal Justice

Fayetteville State University
Fayetteville, NC
06.2019

High school or equivalent -

Rocky Mount High School
Rocky Mount, NC
06.2014

Skills

  • Microsoft Office
  • Customer Service
  • Typing
  • Active Listening
  • Security
  • Medical Records
  • Law Enforcement
  • Performance monitoring
  • CCTV
  • Surveillance
  • Military Experience
  • Help Desk
  • Windows
  • Troubleshooting
  • Leadership
  • Live chat
  • Customer support
  • HIPAA
  • Communication skills
  • Time management
  • Problem Solving
  • Motivation

Certification

  • Driver's License
  • CPR Certification
  • First Aid Certification
  • Secret Clearance

Timeline

Program Supervisor

Mercalis
01.2024 - Current

Care Coordinator

Mercalis
12.2022 - 05.2023

Fraud Investigator

Capital One
12.2022 - 04.2024

Reimbursement Manager

Mercalis
06.2022 - 12.2022

Team Lead

Mercalis
06.2022 - 01.2024

Insurance Specialist

McKesson
11.2021 - 03.2022

Amazon Delivery Driver

Foghorn Delivery Services, LLC
05.2021 - 11.2021

Probation and Parole Officer

North Carolina Department of Public Safety
04.2020 - 05.2021

Mental Health Technician

Carolina Dunes Behavioral Center
09.2019 - 03.2020

Army National Guard

Army National Guard
10.2015 - 09.2022

Bachelor's - Criminal Justice

Fayetteville State University

High school or equivalent -

Rocky Mount High School

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Delonta Garner