DIANA LEWIS

• Provides service among the customers and business partners while responding in a professional, efficient, and timely manner to enhance member and provider satisfaction and retention. Must exercise tact, patience, and professionalism at all times in responding to internal/external customers.
• Documents, researches, interprets and responds to inquiries from internal and external customers, business partners and special groups concerning our products, services and policies in accordance with MTM, NCQA, HIPAA, NYSDOH, CMS and other legislative requirements.
• By utilizing appropriate resources, resolves customer inquiries accurately & efficiently resulting in acceptable quality, First Contact Resolution, and performance.
• Provides outreach related to claims, onboarding, effectuation, retention, provider inquiries, and any other complex inquiry.
• Demonstrates willingness to adapt and be flexible to changes and business needs while taking ownership and accountability for issue identification and resolution.
• Ongoing participation in meetings, training, and skill development to support career path and individual development plans.
• Is knowledgeable and enthusiastic about the company and our products and/or services.
• Identifies and follows through on issues impacting the Health Plan and customer experience.

• Greeted patients and visitors in a professional and friendly manner.
• Scheduled patient appointments, answered incoming calls, and assisted with inquiries.
• Managed medical records using an electronic health record system.
• Followed HIPAA guidelines to ensure confidentiality of patient information.

• Was responsible for the accurate and timely entry of physician charge documents and archiving of backup information from both the Accounts Receivable and Accounts Payable departments

• In this Per Diem assignment, I came into the department to reorganize the nurse credentialing documentation and took on additional responsibilities
• Added duties were collection, scanning and placement of files such as temperature logs and tracers, along with administration of service analysis reports, booking analysis spreadsheets, first available reports, and other various clerical tasks as needed in the department
• Full list of competencies available upon request

GPA: 3.8

Relevant Coursework: Medical Terminology, Medical Office Management