DEVILAWN EVANS-HEGGS
Hillside,USA
Summary
Conscientious, personable and energetic Case Manager, experienced in working in a fast-paced environment, while also paying close attention to detail. Team player who enjoys working with others but capable of working individually. Multi-tasker with organization skills to handle a variety of assignments while still delivering results in a timely matter. Strong work ethic, with a yearning to learn new things that correlate to my area of expertise. Seeking a position within a company that I can help reach and maintain the company goals.
Overview
11
11
years of professional experience
1
1
Certification
Work History
Clinical Specialists
Visionworks
Woodbridge, NJ
04.2023 - Current
- Established and maintained effective communication with staff, physicians and community organizations to promote high quality.
- Control the schedule weekly and annually for appointment's.
- Call patent to get insurance and updated benefits, before scheduled appointment, Call insurance provider to verify benefits.
- Pretest patients preparing them for the doctor’s visit.
- Order and sale contacts and glasses
Customer Service Representative
AmeriHealth Caritas
NJ
06.2022 - 03.2023
- Managed insurance company inquiries and resolved service problems,ensuring compliance with healthcare regulations.
- Documented customers request and finalized policy adjustments,maintaining accurate records in healthcare management systems
- Assisted with resolving customer complaints and provided support through inbound call and call transfers
- Processed Cash Posting and EOBs(Explanation of Benefits),ensuring accurate claims resolutions.
- following up with insurance payors on claims and and maintained up to date knowledge of insurance of insurance plan policy updates, including authorization and medical .
CLERK COORDINATOR
OPTUM RX
01.2019 - 03.2022
- Scan medication and pack in boxes for mail order customers
- post labels and mail posting label on boxes for postal deliveries of
- Receiving medication into pharmacy inventory
- Conduct morning meetings with staff to assure that customers will receive their mail-ordered medication with out issues ina timely fashion
- Maintaining a clean and safe workplace for the employees utilizing Optum Rx standards.
CASE MANAGER
New Community Corporation
Newark,NJ
12.2014 - 09.2021
- Assist members within their community and their work sites
- Provide Maternal Group Home residents (prenatal and post partum) with direct care.
- Assisting with parenting classes,GED programs referrals for anger management, counseling and assistant living
- Collect weekly reports and ISP plan
CUSTOMER CARE COORDINATOR
ONE CALL CARE DIAGNOSTICS, INC.
09.2017 - 12.2018
- Call workmen’s compensation members to schedule doctors appointments for X-rays, MRI ans CT scans for the insurance company, verify and confirm with the provider.
- Maintain high volume inbound and outbound calls, verifying insurance benefits,
- Daily commination with adjusters, completing accurate noted and em ails in type systems.
Education
High School Diploma -
Columbia High School
Skills
- Outstanding Communication skills
- Highly Organized
- Flexible and Adapts quickly
- Resourceful problem solver
- Detail Oriented
- Team Player
- Computer Proficient
Certification
- CPR CERTIFICATION
- PREVENTING ABUSE AND NEGLECT CERTIFICATION
- OVERVIEW DDD CERTIFICATION
- PERSON CENTERED THINKING CERTIFICATION
- LEAD AND ABATEMENT 40 HOUR CERTIFICATION
Timeline
Clinical Specialists
Visionworks
04.2023 - Current
Customer Service Representative
AmeriHealth Caritas
06.2022 - 03.2023
CLERK COORDINATOR
OPTUM RX
01.2019 - 03.2022
CUSTOMER CARE COORDINATOR
ONE CALL CARE DIAGNOSTICS, INC.
09.2017 - 12.2018
CASE MANAGER
New Community Corporation
12.2014 - 09.2021
High School Diploma -
Columbia High School