Summary
Overview
Work History
Education
Skills
Additional Information
Certification
Timeline
Generic

Dominique Luten

Davison,MI

Summary

Professional in healthcare administration with strong background in managing authorization processes. Adept at ensuring compliance, streamlining workflows, and mitigating risks. Consistent track record of fostering team collaboration and achieving results in dynamic environments. Skilled in navigating complex systems, prioritizing tasks, and maintaining high standards of accuracy and efficiency.

Overview

18
18
years of professional experience
1
1
Certification

Work History

Senior Customer Service Representative

OptumRx
02.2023 - Current
  • Established strong rapport with customers, fostering long-term relationships and repeat business.
  • Resolved customer service issues using company processes and policies and provided updates to customers.
  • Delivered exceptional customer service to every customer by leveraging extensive knowledge of products and services and creating welcoming, positive experiences.
  • Increased efficiency of call handling by utilizing available resources such as scripts, FAQs, or knowledge base articles when assisting customers.
  • Demonstrated flexibility by adapting swiftly to changes in product offerings or company procedures, minimizing disruption to the customer experience.
  • Maintained thorough knowledge of insurance plan requirements, facilitating accurate and timely completion of authorization forms.
  • Provided prior authorization support for physicians, healthcare providers and patients in accordance with payer guidelines.

Medical Assistant and Phlebotomist

Placement Management Center
01.2007 - 02.2023
  • Obtain client medical history, medication information, symptoms and allergies.
  • Direct patients to exam rooms, fielded questions and prepared for physician examinations.
  • Collect and document patient medical information such as blood pressure and weight.
  • Perform clerical duties, such as word processing, data entry, answering phones and filing.
  • Call and fax pharmacies to submit prescriptions and refills.
  • Schedule appointments, register patients and distribute sample pharmaceuticals as prescribed.
  • Verified eligibility and compliance with authorization requirements for service providers.
  • Reached out to insurance carriers to obtain prior authorization for testing and procedures.
  • Input all patient data regarding claims and prior authorizations into system accurately.

Information Call Center Agent & Warehouse Processor

Superior Technical Resource-Stericycle
06.2010 - 01.2011
  • Delivered exceptional customer service to every customer by leveraging extensive knowledge of products and services and creating welcoming, positive experiences.
  • Helped large volume of customers every day with positive attitude and focus on customer satisfaction.
  • Adhered to company policies and scripts to consistently achieve call-time and quality standards.
  • Analyzed and escalated complaints, issues and grievances to designated departments for investigation and response.
  • Recommended products to customers, thoroughly explaining details.
  • Responded to customer requests for products, services and company information.

Education

Associate of Applied Science - Registered Nurse

Medtech College
Greenwood, IN
10.2013

Certificate of Technical Studies - Patient Care, Phlebotomist, And EKG Technician

Genesee CNA Academy
Flint, MI
04.2005

High School Diploma -

Central High School
Flint, MI
06.2003

Skills

  • Patient Relations
  • Conflict Resolution Techniques
  • Pharmacy Relations
  • Pharmacy Benefit Management
  • Multi-Line Telephone System Operation
  • EMR Systems
  • HIPAA Compliance Knowledge
  • Documentation Procedures Expertise
  • Electronic Health Records Proficiency
  • Customer Account Management
  • Customer Data Confidentiality
  • Data Entry and Maintenance
  • Inbound and Outbound Calling
  • ICD-10 Coding Proficiency
  • Medical Appeals Handling
  • Leadership Qualities
  • Proficiency in Rx Claims
  • Medical Terminology
  • Benefit Coverage
  • Insurance Claims and Verification Expertise
  • Medicare and Medicaid Knowledge
  • Strong Organization
  • Effective Communication Skills
  • Documentation Skills
  • Drug Utilization Review Experience
  • Issue Research
  • Training and Mentoring
  • Prior Authorization Knowledge
  • Customer Relationship Management

Additional Information

  • Awards and Accomplishments: , Volunteer Appreciation Certificate from Red Cross of America, 2002. Certified Nurses Aide, 2005. Patient Care Technician, 2005. Certified EKG Technician, 2005. Certified Phlebotomist Technician, 2005.

Certification

  • First Aid Certification
  • CPR/AED Certification
  • Registered Nurse License (RN) - State Board of Nursing.
  • Patient Care Technician Certification (CPCT/A) - National Healthcareer Association (NHA).
  • EKG Technician Certification (CET) - National Healthcareer Association (NHA).
  • Certified Phlebotomy Technician (CPT) - National Healthcareer Association (NHA).
  • Certified Nursing Assistant (CNA)
  • Michigan Driver's License

Timeline

Senior Customer Service Representative

OptumRx
02.2023 - Current

Information Call Center Agent & Warehouse Processor

Superior Technical Resource-Stericycle
06.2010 - 01.2011

Medical Assistant and Phlebotomist

Placement Management Center
01.2007 - 02.2023

Associate of Applied Science - Registered Nurse

Medtech College

Certificate of Technical Studies - Patient Care, Phlebotomist, And EKG Technician

Genesee CNA Academy

High School Diploma -

Central High School

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