Dominique King
Katy
Summary
Dedicated Remote Customer Care Advocate with expertise in patient advocacy, customer service, and medical documentation. Enhanced customer satisfaction through effective issue resolution and strong communication in high-pressure environments. Committed to fostering team collaboration and adapting to evolving work conditions.
Overview
10
10
years of professional experience
Work History
Customer Care Advocate (CCA)
Excellus BCBS
Houston, TX
01.2021 - Current
- Resolved customer inquiries accurately & efficiently resulting in acceptable quality, first contact resolution/provider satisfaction, and performance.
- Provided outreach related to claims, onboarding, effectuation, retention, provider inquiries, and any other complex inquiry.
- Uphold strict confidentiality standards while managing sensitive patient information according to HIPAA regulations.
- Provide service for customers and business partners while responding in a professional, efficient, and timely manner to resolve issues and enhance member & provider satisfaction/retention.
- Document, research, interpret and respond to inquiries from internal and external customers, business partners and special groups concerning our products, services and policies in accordance with LOS, NCQA, HIPAA, NYSDOH, CMS and other legislative requirements.
- Oversee business operations, financial planning, and contract negotiations.
Remote Healthcare Customer Service Representative
Conduent
Houston, TX
01.2017 - 01.2021
- Responded to inbound inquiries regarding dental benefits, eligibility, claims, appeals, grievances, and provider searches for both Commercial and Medicare plans.
- Provided uniform interpretation and clarification of dental benefits, policies, and procedures to members, providers, and employer groups.
- Resolved member or provider concerns by investigating issues, contacting appropriate parties, and documenting all interactions accurately within the billing system.
- Investigated verbal complaints regarding billing, claims, or services rendered; escalated service failures to appropriate internal departments for follow-up and resolution.
- Retrieve and send written correspondence, including plan brochures, provider directories, and other printed materials as needed.
- Maintain current and thorough knowledge of all Member Services policies, procedures, and dental plan updates.
Education
Bachelor of Science - Business Communication
Sam Houston State University
Huntsville, TX05-2028
High School Diploma -
Booker T. Washington High School
Houston, TXSkills
- Healthcare administration
- HIPAA compliance
- Claims processing
- Data entry
- Medical billing
- Data management
- Client communication
- Customer service
- Multitasking skills
- Problem resolution
- Efficient documentation
- Attentiveness
Additional Highlights
- Delegated by RNs to administer and document medications safely.
- Knowledgeable in state and federal guidelines for medication handling.
- Recognized for exceptional accuracy, professionalism, and patient advocacy.
- Experienced in collaborating with healthcare teams to ensure optimal resident care.
Timeline
Customer Care Advocate (CCA)
Excellus BCBS
01.2021 - Current
Remote Healthcare Customer Service Representative
Conduent
01.2017 - 01.2021
Bachelor of Science - Business Communication
Sam Houston State University
High School Diploma -
Booker T. Washington High School