Giana Cooks
Covington,GA
Summary
Detail-oriented healthcare professional experienced in supporting patients and providers across diverse healthcare environments. Skilled in managing sensitive information and competing priorities while delivering effective solutions to complex needs. Proven ability to enhance service experiences by navigating healthcare systems efficiently.
Overview
1
1
Certification
9
9
years of professional experience
Work History
Provider Services Representative
CVS HEALTH CORPORATION
Atlanta, Georgia
01.2025 - Current
- Research claims, billing concerns, and account information to identify issues and determine resolutions.
- Assists healthcare providers with inquiries regarding benefits, referrals, authorizations, and coverage requirements.
- Navigates multiple electronic systems to review information and ensure accurate case documentation.
- Handles complex provider inquiries in a high-volume environment while safeguarding sensitive healthcare information.
Leasing Consultant
Ambling Management
Fairburn, Georgia
01.2025 - 12.2025
- Guided prospective residents through the leasing process by conducting property tours and explaining application requirements.
- Processed rental applications, background checks, and credit checks to ensure compliance with policies and protect resident privacy.
- Coordinated move-ins, move-outs, inspections, and maintenance requests to enhance resident satisfaction and streamline operations.
- Utilized Onesite property management software to track availability, maintain resident information, and organize application records.
Provider Services Representative II
Caresource Health Plan
Atlanta, Georgia
11.2021 - 01.2025
- Managed denied-claim appeals by gathering required documentation and coordinating with providers, achieving a 75% success rate in overturning denials.
- Verified Medicaid eligibility and assisted members and providers with benefits, claims, and coverage inquiries to ensure access to necessary services.
- Navigated electronic eligibility and state healthcare systems/portals to research member information and confirm coverage requirements.
- Clarified healthcare benefits, referral requirements, and available resources while maintaining confidentiality and delivering professional service to enhance member understanding.
Customer Service Representative
Centene
Sandy Springs, Georgia
09.2018 - 11.2021
- Investigated member accounts and benefits to deliver precise information and effectively resolve customer concerns.
- Facilitated member understanding of healthcare benefits, claims, eligibility, and services during high-volume inbound interactions.
- Applied company policies, procedures, and applicable requirements when reviewing and addressing member issues.
- Recorded customer interactions and ensured confidentiality while managing sensitive member information.
Patient Access Representative
WellStar North Fulton Hospital
Alpharetta, Georgia
03.2018 - 09.2018
- Conducted face-to-face patient interviews to accurately collect and verify demographic, insurance, and medical information for efficient registration.
- Facilitated patient scheduling, pre-registration, pre-certification, and prior authorization to streamline processes for physicians, office staff, and patients.
- Coordinated appointment requests from physician offices and effectively communicated scheduling details to enhance patient experience and support staff operations.
- Collected copays and other patient payments while maintaining patient confidentiality and HIPAA compliance.
Education
Associate of Science - Nursing
Atlanta Technical College
Atlanta, GA05-2028
Skills
- Pharmacy Operations Support
- Insurance Verification
- Medicaid Eligibility
- Benefits & Coverage Verification
- Patient & Provider Relations
- Claims & Billing Support
- Referrals & Prior Authorizations
- Medical Terminology
- Healthcare Documentation
- Electronic Records & Data Entry
- Confidential Information Handling
- Customer & Patient Service
- Problem Resolution
- Microsoft Office
- HIPAA Compliance
Certification
- Pharmacy Technician Registration- In Progress
Timeline
Provider Services Representative
CVS HEALTH CORPORATION
01.2025 - Current
Leasing Consultant
Ambling Management
01.2025 - 12.2025
Provider Services Representative II
Caresource Health Plan
11.2021 - 01.2025
Customer Service Representative
Centene
09.2018 - 11.2021
Patient Access Representative
WellStar North Fulton Hospital
03.2018 - 09.2018
Associate of Science - Nursing
Atlanta Technical College