Giana Cooks
Atlanta,GA
Summary
Customer service professional with extensive experience supporting members, patients, providers, and clients in fast-paced environments. Skilled in resolving complex inquiries, explaining benefits and policies, handling claims and billing concerns, and delivering clear, empathetic solutions. Strong background in healthcare operations, eligibility, authorizations, appeals, documentation, and compliance. Known for strong communication, problem-solving, attention to detail, and the ability to build trust while handling challenging customer interactions with professionalism.
Overview
9
9
years of professional experience
Work History
Provider Service Representative
CVS Healthcare
Remote, US
01.2026 - Current
- Conduct interviews by phone with claimants, representatives and advocates to explain the full range of Benefits and related programs.
- Managed high-volume inbound calls to triage patient questions regarding authorizations, referrals, and claim status.
- Explained coverage limitations and referral requirements to patients by phone, enhancing appointment preparedness.
- Resolved billing disputes with payers by researching claims and submitting corrected documentation.
- Review claims cases to assure all issues have been addressed, apply and interpret laws, existing statutes and procedures, precedent rulings and state law in the adjudication process.
- Utilize various electronic data processing systems to input data for processing claims and generating automated correspondence.
Leasing Consultant
Ambling Management
Fairburn, US
01.2025 - 12.2026
- Greeted prospective tenants daily, conducted property tours, and closed lease agreements with clear move-in timelines.
- Processed rental applications with background and credit checks to streamline approval cycle for applicants.
- Coordinated move-ins and move-outs, conducted unit inspections, and documented maintenance requests to ensure timely repairs.
- Tracked vacancy and renewal rates in spreadsheet reports, identifying units for targeted marketing efforts to enhance occupancy.
- Utilized on-site property management software (Onesite) to track apartment availability and manage resident data.
Provider Services Representative II
Caresource
Remote, US
11.2021 - 01.2025
- Handled provider inquiries about billing and claims status, clarifying payer requirements and routing complex issues to specialty teams.
- Provided information on benefits to providers, enhancing understanding of coverage options and facilitating smoother claims processing.
- Conducted thorough eligibility checks for patients, utilizing advanced verification tools to ensure accurate and timely process.
- Managed the appeals process for denied claims, effectively communicating with providers to gather required documentation and achieving a 75% success rate in overturning denials.
- Mentored and onboarded new hires through hands-on training and structured job shadowing.
Customer Service Representative I
Centene Inc.
Sandy Springs, US
09.2018 - 11.2021
- Resolved inquiries for members and providers regarding Medicaid claims, benefits, and eligibility, ensuring accurate, customer-focused service.
- Managed a high volume of inbound calls while meeting quality, productivity, and customer service performance standards.
- Educated members on plan benefits, claim processes, and available resources, helping them navigate healthcare services with confidence.
- Managed appeals process for denied claims, communicating with providers to gather required documentation and overturning 75% of denials.
- Maintained compliance with HIPAA, Medicaid regulations, and company policies while handling sensitive member information.
- Documented customer interactions and maintained accurate records, ensuring compliance with company policies and regulatory requirements.
- Mentored and onboarded new hires through hands-on training and structured job shadowing.
Patient Access Representative
WellStar
Atlanta, Georgia
04.2018 - 09.2018
- Maintained confidentiality of patient information in accordance with WellStar policy and HIPAA regulations.
- Facilitated scheduling, pre-registration, pre-certification, and prior authorizations for physicians, office staff, and patients to enhance appointment efficiency.
- Coordinated appointment requests from physicians and arranged pre-admission logistics, effectively communicating available dates to office staff and patients.
- Collected co-pays and other payments from patients at time of service.
- Conducted face-to-face patient interviews to gather demographic, insurance, and medical information for accurate registration.
Education
Associate of Science - Nursing
Atlanta Technical College
Atlanta, GA05-2027
Skills
- Claims Processing
- Salesforce
- Onesite
- Data Entry
- Attention to Detail
- Problem Solving
- Time Management
- Customer Service
- Active Listening
- Conflict Resolution
- Empathy
- Team Collaboration
- Adaptability
- Interpersonal Skills
- Sales
- Integrity
Timeline
Provider Service Representative
CVS Healthcare
01.2026 - Current
Leasing Consultant
Ambling Management
01.2025 - 12.2026
Provider Services Representative II
Caresource
11.2021 - 01.2025
Customer Service Representative I
Centene Inc.
09.2018 - 11.2021
Patient Access Representative
WellStar
04.2018 - 09.2018
Associate of Science - Nursing
Atlanta Technical College