Jamaecia Brooks
16670 Harlow ,MI
Summary
Dynamic customer service professional with extensive experience at Centene Corporation, excelling in claims processing and health insurance policies. Proven ability to resolve complex issues and enhance customer satisfaction through effective communication. Skilled in electronic health records and adept at managing escalated inquiries, ensuring timely resolutions and fostering strong client relationships.
Overview
21
21
years of professional experience
1
1
Certification
Work History
Customer Service Representative
Centene Corporation
Detroit, Michigan
10.2020 - Current
- Provided customer support through phone and email communication channels.
- Resolved customer inquiries regarding health insurance policies and services.
- Assisted clients with claims processing and benefit explanations.
- Handled escalated issues while ensuring timely resolutions for customers.
- Answered customer inquiries and provided accurate information regarding products and services.
- Resolved complex problems by working with other departments to provide solutions that meet customer needs.
- Assisted providers with enrollment and credentialing processes.
- Answered incoming calls from clients and routed them to appropriate personnel for further assistance.
- Communicated with providers to clarify claim discrepancies and gather information.
- Utilized claims management software to track and manage outstanding claims.
- Worked closely with providers to resolve pending claim issues and disputes.
- Evaluated claim denials or underpayments and took corrective action as needed.
- Maintained professional relationships with healthcare providers.
Medical Assistant
Medical Foot and Ankle
Livonia, Michigan
10.2004 - 10.2020
- Assisted patients with foot and ankle examinations and procedures.
- Prepared examination rooms and maintained sterile environments for treatments.
- Coordinated patient scheduling and managed appointment reminders efficiently.
- Documented patient histories and recorded vital signs accurately.
- Educated patients on post-treatment care and preventive measures effectively.
- Managed medical supplies inventory and ensured availability for procedures.
- Responded to patient inquiries, providing compassionate support and information.
- Kept examination rooms clean, stocked with necessary supplies and prepared for incoming patients.
- Administered injections, medications and treatments as directed by the physician.
- Adhered to HIPAA regulations regarding safeguarding confidential patient information at all times.
- Relayed messages from patients to physicians about concerns, condition updates or refill requests to facilitate treatment.
- Documented notes during patient visits.
- Answered phones, scheduled appointments and managed patient flow while greeting visitors in a professional manner.
- Maintained accurate medical records through filing, charting, transcription and data entry into electronic health record system.
- Assisted surgeons during procedures by providing necessary instruments and supplies.
- Maintained sterile environment by preparing and sterilizing surgical tools and equipment.
- Documented surgical procedures and maintained accurate patient records for compliance.
- Extensive knowledge of medical terminology, EMR, quality, safety, OSHA, JCAHO, and Department of Defense (DOD) regulations governing medical, clerical and administrative issues
Education
Certificate - Medical Billing And Coding
Absolute Coding Insitute
Online 07-2024
High School Diploma -
Southfield-Lathrup High School
Southfield, MI05-2001
Skills
- Claims processing
- Health insurance policies
- Electronic health records
- Customer support
- Appointment scheduling
- Insurance dispute resolution
- Issue escalation
- Effective communication
- Order fulfillment
- Call center experience
- Call escalation
- Customer relations
- Microsoft PowerPoint
- Excel spreadsheets
- Assist podiatrists in examining patients by developing and exposing X-rays, and providing initial analysis
- Proficient in using systems to assist providers in reviewing claims and authorizations, such as Cenpas, TruCare Cloud, Amisys Advance, and MicroStrategy
- Assist in team chats with questions regarding the health plan as Chat Ambassador
Certification
see attachment
Timeline
Customer Service Representative
Centene Corporation
10.2020 - Current
Medical Assistant
Medical Foot and Ankle
10.2004 - 10.2020
Certificate - Medical Billing And Coding
Absolute Coding Insitute
High School Diploma -
Southfield-Lathrup High School
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