Donna Franklin

Job Role includes provider's inquiring about current insurance coverage, previous insurance coverage, copays, deductibles, claim questions including claim status, claim payments, claim denials.

Assist providers with insurance inquiries, ensuring accurate and timely information.

Resolve claim issues, improving provider satisfaction and reducing follow-up calls.

Verify coverage details, aiding in efficient patient care and billing processes.

Address copay and deductible questions, enhancing clarity for providers.

Facilitated seamless insurance inquiry resolution, boosting provider satisfaction and operational efficiency.

Address patient concerns, reducing issues and improving satisfaction through effective communication.

Resolve critical issues and educate members on their plans, enhancing understanding and compliance.

Manage inbound and outbound inquiries on eligibility, benefits, claims, and pre-authorizations efficiently.

Enhance patient satisfaction by promptly addressing and resolving 85% of inquiries, demonstrating strong problem-solving skills.

Analyzed claim inquiries to identify patterns, leading to a 20% reduction in recurring issues through targeted member education.

Implemented user-friendly communication strategies, leading to a 15% increase in patient satisfaction scores

• Assisted patients with daily activities, ensuring comfort and safety, improving overall patient satisfaction.
• Assisted patients with daily tasks, enhancing their comfort and care, resulting in a 20% improvement in patient satisfaction scores.

Provided emotional support to patients and their families, fostering a compassionate and reassuring environment.

• Follows control and compliance regulations, Agile Applications, Development,
• For each client of CVS Pharmacy. I am train to perform processing CVS Health clients enrollments and applications, for analyzing, researching, and resolving client issues and making outbound calls to clients when necessary.
  · Experience of Health insurance domain
  · good knowledge of Health Insurance projects
  · Good knowledge of MS Excel, Word, Outlook, PowerPoint.
  · Typing speed 30-40 WPM with 95% Accuracy
  · 1-2 year experience with Out Bound calling

Responsible and Experience in customer service work, including cashier, warehouse laborer, telephone specialist clerk, keyboard data entry, package handling, bookstore clerk and call-center representative protocol.

• Delivered exceptional customer service through acknowledgement, communication and commitment to quality.
• Managed a high volume of customer service operations, supporting issues related to client services.
• Utilized exceptional communication to connect with customers, assess needs and present solutions.
• Politely assisted customers in person and via telephone.
• Strong computer skills and problem solving abilities
  Excellent interpersonal communication skills
  High level of professionalism

Responsible for gathering data and doing research and analyze the results.

• Worked directly with [Capgemini management] to achieve results to demonstrate professional knowledge to ensure that the work products and deliverables are of the highest caliber to ensure client satisfaction. Capgemini Technology Services Group.
• Translate, find, and understand reports or applications to process and improve strategies for management.
• Highly organized, fantastic interpersonal skills
• Responsible for full systems lifecycle from requirements gathering through implementation of data analysis solutions
• Verified data integrity and accuracy.

Core Skills

• Data analysis experience
• Knowledge of research practices

Performed check cashing for customers based on Walmart company policies. Including answering inquiries and obtaining information for general public, customers, visitors, and other interested parties. Received payment by cash, check, credit cards, Wic vouchers, food stamp cards or automatic debits.

• Handled approximately many credit and cash transactions for customers using cash registers.
• Resolved customer complaints and maintained a clean and tidy checkout area.

Responsible for unload merchandise for Walmart company store. Accept delivered packages and ensure proper amount is inside. Stock shelves with unpacked items.

• Stocked and replenished merchandise according to store merchandising layouts.
• Resolved all customer complaints in a professional manner while prioritizing customer satisfaction.