Jasmine Birmingham
Sacramento,CA
Summary
Analytical and practical Healthcare Professional knowledgeable about diverse procedures, medication contraindications and healthcare protocols. Remains present and focused throughout procedures to make timely adjustments and protect patients.
Diligent Claims Processor versed in insurance processes and claims procedures. Offers great attention to detail and time management abilities to successfully handle large volume of claims. Highly accurate and thorough with focus on completing error-free work in line with processing guidelines.
Detail-oriented, organized and meticulous employee. Works at fast pace to meet tight deadlines. Enthusiastic team player ready to contribute to company success.
Overview
11
11
years of professional experience
1
1
Certification
Work History
Crisis Counselor
WellSpace Health
02.2024 - Current
- Reduced crisis response times by streamlining communication protocols and implementing efficient triage procedures.
- Enhanced client support by conducting thorough assessments and developing personalized intervention plans.
- Provided timely assistance to individuals in crisis, utilizing active listening skills and empathy to establish rapport quickly.
- Collaborated with multidisciplinary teams to create comprehensive care plans, addressing clients'' mental health, social, and emotional needs.
- Improved overall client satisfaction by maintaining a high level of professionalism and adhering to confidentiality guidelines at all times.
- Developed resources for clients in need, connecting them with community services and programs that best suited their situation.
- Prevented further escalation of crises by effectively deescalating intense situations through skilled verbal interventions.
TSR Advise and Appointment
Kaiser Permanente
04.2023 - Current
- Handles continuous inbound telephone volume
- Identifies the purpose of the members call and processes the call according to the appropriate script
- Provides facility and provider information and some laboratory results, makes and cancels appointments, transfers members to Advice Nurses, intakes information from members, and composes messages for providers
- Resolves problems with facility teleservice teams
- Effectively processes calls in a systematic and organized manner following Call Center scripts, policies and procedures
- Processes calls accordingly from hearing-impaired members
- Receives and relays information regarding appointment cancellations
- Records instructions from provider in PARRS
- Updates member demographics
- Works collaboratively with members and staff across all service lines
- Functions as a team member to achieve Call Center goals
- Identifies and/or proposes ways to improve customer service
- Demonstrates an awareness and sensitivity to patient/family rights
- Handles inquiries and complaints pursuant to procedure.
Customer Service Representative
Magellan Healthcare
01.2023 - 03.2023
- Answered calls
- Provided information
- Documented each encounter
- Researched prescription errors and collaborated with pharmacies.
Claims Analyst
Centene - Remote
06.2022 - 09.2022
- Review and adjudicated claims
- Processed over 200 claims daily.
CDA customer service agent II
California Dental Association - Remote
09.2021 - 01.2022
- Answered provider calls to help register online accounts
- Created tickets for tech issues
- Scheduled follow-up appointment for providers.
Technical Support Engineer
Phillips - Sacramento, CA
10.2020 - 08.2021
- Answer calls and provide customers with code keys for software updates
- Create work orders for any system maintenance
- Manage the closure and request needed documents for closure of cases
- Dispatch field service workers to physical locations to complete work or upgrades
- Respond to a functional email box and give feedback to customers.
Customer Service Representative II
Eyefinity/VSP - Rancho Cordova, CA
11.2019 - 02.2020
- Support Optometrists and Ophthalmologists and staff with product
- Troubleshoot and set up new customers with eyefinity product
- Assisted with compatible software and hardware.
Customer care representative claim representative
Blue Shield of California El Dorado Hills California - El Dorado Hills, CA
01.2016 - 01.2019
- Consistently provide members with exceptional customer service
- Assist internal and external customers via incoming telephone calls
- Actively listen to customers and respond appropriately
- Investigate and resolve member inquiries for correspondence and through computer research can contribute to the team effort to meet or exceed service production and quality goals
- Consistently provide members with exceptional customer service
- Assist internal and external customers via incoming telephone calls
- Actively listen to customers and respond appropriately
- Investigate and resolve member inquiries with correspondence and computer research can contribute to the team effort to meet or exceed service production and quality goals
- Meets timeframes for performance while balancing the need to produce high quality work related to complex and sensitive member issues
- Ensures integrity of departmental database by thorough, timely and accurate entry
- Submit verbal and written notification to members and provider
- Remained knowledgeable regarding company policies and procedures and current developments within operational departments
- Provided outreach for additional information for appeal and Grievance's
- Reduce grievances and arbitration needs by educating frontline managers of techniques for enhancing interaction between labor and leadership
- Accountable for investigation and response of all issues, including collection of appropriate data, preparation and presentation of documents to decision makers.
Customer service representative
HealthNet Rancho Cordova California - Rancho Cordova
01.2015 - 01.2016
- Identified analyze and resolve variety of scheduling issues to find veterans earliest doctors appointments
- Determined healthcare eligibility by gathering patients status and appropriate authorization
- Extensive knowledge of health insurance portability and accountability (HIPPA) laws
- Medical reimbursement claims
- Documents transactions and authorization system and communicated via written correspondence to the veterans administration as required
- Ranked 'Top Agent' based on cost center metrics from three site offices.
VP and department staff
Advanced Call Center
01.2013 - 01.2015
- Handled over 500 mortgage customer calls weekly
- Coached new agents on call flow system and company policies daily
- Efficiently documented nature of calls and transferred to appropriate department
- Processed payments using Western Union and Speed Pay electronic payment systems
- Chaired weekly calibration conference calls with the company VP and department staff
- Acted as a supervisor and made crucial decisions to guarantee customer satisfaction
- Effectively managed escalated calls to ensure highest quality of service was provided to customers.
Education
Associate of Science - Biology
Cosumnes River College
Sacramento, CA01.2026
High school diploma -
Valley High School
01.2006
Skills
- Microsoft Excel
- Microsoft Word
- Microsoft Office
- Microsoft Outlook
- Medical Scheduling
- Medical Terminology
- HIPAA Compliant
- Software Troubleshooting
- Help Desk
- Technical Support
- Desktop Support
- Calibration
- Microsoft Windows
- Operating Systems
- Network Support
- Computer Networking
- Time management
- Remote access software
- DNS
- Active Directory
- Microsoft Windows Server
- Information Security
- Sales
- Conflict management
- Customer support
- Internet of things
- VPN
- IT support
- DHCP
- Salesforce
- Medical terminology
- Medical records
- Troubleshooting
- LAN
- Citrix
- CLAIMS (3 years)
- COACHING (3 years)
- MEDICAL CLAIMS (3 or more years )
- TELEPHONE SKILLS ( 10 years or more)
- Referral Coordination
- Grief counseling
- Youth engagement
- Alliance Building
- Patient confidentiality
- Elderly Care
- Crisis handling
- Mental Health Assessment
- Behavioral Health
- Psychosocial Support
- Treatment Planning
- System Configuration Changing
- Software Updates
- Debugging
- Technical Documentation
- Technical Troubleshooting
- Project Management
- Document Management
- Information Collection
Certification
CompTIA A
Training
- Medical Claims Training- 2019
- Complaint Resolution Training - 2013
- Coaching a Service Team Training - 2013
- Manage Customer Expectations Training - 2014
- Telephone skills "Inbound and Outbound" Training - 2011
Knowledge
- Grievance Handling
- Policy interpretation
- Insurance Knowledge
- Grievance MS Word, Excel, Power Point, Access, Mainframe
- Timely case resolution
- Compliance with state and federal regulations, laws and accreditation
Assessments
- Customer service, Proficient, 01/01/22, Identifying and resolving common customer issues
- Work motivation, Proficient, 08/01/21, Level of motivation and discipline applied toward work
- Call center customer service, Proficient, 09/01/22, Demonstrating customer service skills in a call center setting
- Protecting patient privacy, Proficient, 01/01/22, Understanding privacy rules and regulations associated with patient records
Timeline
Crisis Counselor
WellSpace Health
02.2024 - Current
TSR Advise and Appointment
Kaiser Permanente
04.2023 - Current
Customer Service Representative
Magellan Healthcare
01.2023 - 03.2023
Claims Analyst
Centene - Remote
06.2022 - 09.2022
CDA customer service agent II
California Dental Association - Remote
09.2021 - 01.2022
Technical Support Engineer
Phillips - Sacramento, CA
10.2020 - 08.2021
Customer Service Representative II
Eyefinity/VSP - Rancho Cordova, CA
11.2019 - 02.2020
Customer care representative claim representative
Blue Shield of California El Dorado Hills California - El Dorado Hills, CA
01.2016 - 01.2019
Customer service representative
HealthNet Rancho Cordova California - Rancho Cordova
01.2015 - 01.2016
VP and department staff
Advanced Call Center
01.2013 - 01.2015
Associate of Science - Biology
Cosumnes River College
High school diploma -
Valley High School