Kamishala Rumph
El Paso,Texas
Summary
Hardworking and passionate candidate who is detailed-oriented, organized and dependable successful at managing multiple priorities with a positive attitude. With a willingness to take on added responsibilities to meet team goals. Ability to handle multiple projects simultaneously with a high degree of accuracy and efficiency.
Overview
24
24
years of professional experience
1
1
Certificate
Work History
Patient Advocate, UDP Claims Representative
Elevate PFS
The Woodlands, TX
09.2022 - Current
- Resolve accounts as quickly and accurately as possible, obtaining maximum reimbursement
- Review and research insurance claims to determine possible payment sources
- Coordinate with payors to ensure appropriate filing guidelines are met for reimbursement
- Pursue first party payers for reimbursement of hospital claims
- Answer incoming telephone calls, make out-bound calls, and track via Accelerate
- Navigate a variety of hospital system and user interfaces i.e (Epic, Meditech and AS400)
- Entered details into computer systems and managed database of information.
- Facilitated communication between patients, families and healthcare providers to support comprehension.
- Educated patients and families on healthcare options and financial support resources.
- Assisted patients in understanding individual rights and responsibilities in regards to care, coverage, and payment.
- Responded to patient concerns and questions with compassionate and knowledgeable service.
- Participated in team projects, demonstrating an ability to work collaboratively and effectively.
- Worked well in a team setting, providing support and guidance.
Founder/Executive Director
Bag Lady
El Paso, TX
07.2020 - Current
- Collaborate with the board members to identify, create and implement strategic plans to actualize business objectives
- Develop the organization culture and promote transparency and collaboration through the organization
- Identify potential risks and opportunities withing the organization and its environment to protect business interest
- Identify potential sources of investments and organize fundraising efforts
- Represent the company at social and corporate events in way that strength the brand and communicates the company’s message
- Developed strong partnerships with other businesses to allow for collaboration and more significant opportunities for growth.
- Created organization's mission and vision statements for use by employees.
- Secured sufficient funds to cover business obligations by tracking expenses and budgeting accurately.
Adjuster
USAA
San Antonio, TX
07.2015 - 07.2022
- Provides Auto/Casualty claims service via internal channels (phone/email/fax/mail/other electronic channels) to members and third-party customers
- Adjusts low to moderately complex auto claims
- Acquires and applies basic knowledge of P&C insurance industry products, services, and processes to include P&C insurance policy contracts and coverage’s and the USAA claim handling process and procedures
- Seeks guidance from team members to resolve issues and to identify appropriate issues for escalation
- Partners and/or directs vendors and internal business partners to facilitate claims resolution
- Contributes to business goals and performance metrics, and effectively uses tools & technology
- Supports workload surges and/or Catastrophe operations as needed to include working significant overtime during designated CAT's.
- Examined claims forms and other records to determine insurance coverage.
- Investigated and assessed damage to property and reviewed property damage estimates.
- Reviewed police reports, medical treatment records, and physical property damage to determine extent of liability.
- Analyzed information gathered by investigations to report findings and recommendations.
- Established relationships with clients and insurance companies to foster timely claims resolution.
- Negotiated with policyholders and claimants to reach mutually satisfactory resolutions.
- Mitigated risks and increased profitability with well-developed strategies for reducing future claims and costs.
Team Manager
Sykes Enterprises
Fayetteville , NC
06.2014 - 07.2015
- Manage a team of 20 to 25 members service representatives
- Gather, evaluate and distribute reports on a daily, weekly, monthly basis
- Make adjustments accordingly
- Be visible to answer questions and collect feedback from the team
- Take escalated calls and be available when a representative appears to need assistance
- Monitor queue and track inbound calls
- Keep agents aware of inbound calls, calls waiting, abandonment rate, utilization and occupancy rate, etc
- Motivate and encourage representatives through positive communication and feedback
- Attend product update meeting and provide new product information to the representatives
- Monitor calls and perform coaching using quality assurance methodologies
- Attend daily meetings with other departments to review service center operations
- Produce performance reviews
- Create effective channels of agent feedback
- Coordinated team collaboration to share ideas and build best practices.
- Evaluated employee performance and coached and trained team members, increasing quality of work and employee motivation.
- Delivered regular team meetings for aligned work towards common goals.
Member Services Representative
Sykes Enterprises
Fayetteville, NC
03.2013 - 06.2014
- Works under general supervision and is accountable for delivering superior customer service in performing a variety of basic banking services though phone contact
- Resolves customer issues and/or complaints in a professional manner; collaborates with team members to resolve issues and to identify appropriate issues for escalation and seeks management assistance as needed
- Uses established procedures and job experience to carry out moderately complex work assignments
- Responds to and directs customer inquiries on product features and services
- Recognizes and refers potential product needs and self-service opportunities
- Maintains and adheres to all policies, regulations, guidelines, and procedures applicable to Member Service Representatives
- Met customer call guidelines for service levels, handle time and productivity.
- Followed up with customers about resolved issues to maintain high standards of customer service.
- Promptly responded to inquiries and requests from prospective customers.
- Trained new personnel regarding company operations, policies and services.
- Maintained up-to-date knowledge of product and service changes.
CSI Representative
AT&T Internet Services
El Paso, TX
06.2008 - 12.2011
- Offers alternative solutions where appropriate with the objective of retaining customer’s business
- Handles business transactions in connection with activation of new customer accounts on a computer terminal
- Communicates with customers using web-based tools and demonstrates the associated proficiency in typing and grammar
- Answers customer/client requests or inquiries concerning services, products, billing, equipment, claims, and reports problem areas
- Worked in one or multiple queues/skill sets over various customer contact channels
- Acting manager in his/her absence
- Greeted customers warmly to set tone of customer experience and provide welcoming and friendly atmosphere.
- Handled customer complaints quickly and professionally to restore customer confidence and prevent loss of business.
Logistics Technician
United States Army, Army Reserve
Fort Gordon, GA
09.1999 - 10.2007
- Receive, inspect, inventory, load, unload, segregate, store, issue, deliver and turns-in organization and installation supplies and equipment
- Operate unit level computers and perform general clerical duties
- Prepare all unit/organizational supply documents
- Maintain automated supply system for accounting of organizational and installation supplies and equipment
- Issue and receive small arms
- Secure and control weapons and ammunition in security areas
- Schedule and perform preventive and organizational maintenance on weapons
- Inspect completed work for accuracy and compliance with established procedures
- Post transactions to organizational and installation property books and supporting transaction files
- Determine method of obtaining relief from responsibility for lost, damaged and destroyed supply items
- Assisted in development and implementation of logistics policies and procedures to provide roadmap for daily operations.
- Prepared and documented shipment activities and cargo movements to enable tracking history and maintain accurate records.
- Coordinated shipping requests for expedited delivery and documented accurately to achieve correct billing.
DSL Technical Support Representative
Calltech Communications
Columbia, SC
08.2005 - 10.2006
- Walked customers through configuring email clients, installing antivirus software and PC checks
- Talking customers through a series of actions to resolve a problem
- Following up with clients to ensure the problem is resolved
- Replacing or repairing the necessary parts
- Resolving network issues.
- Assisted customers in identifying issues and explained solutions to restore service and functionality.
- Documented support interactions for future reference.
Correctional Officer
Georgia Department of Corrections
Oglethorpe, GA
09.2001 - 08.2003
- Builds and maintains rapport with inmates
- Controls disruptive behavior by appropriate verbal orders and or appropriate use of physical force
- Uses verbal and listening skills to determine potential inmate problems, such as suicide risk, intoxication, drug usage, behavior, etc
- Informs and explains institutional rules to inmates
- Communicates information regarding security, safety and operations through the chain of command
- Monitors inmates, watching closely for unusual behavior, improper conduct or signs of conflict
- Writes narrative reports describing events that have happened, such as confidential reports, incident reports, disciplinary reports, special observation reports, etc
- Reads and writes short notes in a logbook as a means of posting information about daily events from one shift to another, such as inventory logs, post logs, narrative logs, etc
- Uses portable two-way radio.
- Searched cells of inmates to identify and confiscate contraband and other prohibited items.
- Escorted inmates to and from cells, court, hospitals, and medical appointments.
- Observed and supervised inmates throughout visits, meal time, recreation, phone calls, and showers.
- Conducted routine and emergency head counts.
Education
Master of Information Technology Management - Information Security
Keller Graduate School of Management
Graduate Certificate - Information Security
Keller Graduate School of Management
MBA - Health Service Management
Keller Graduate School of Management
Bachelor of Science - Business Administration With Concentration in Health Service Management
DeVry University
Associate of Arts - Healthcare Administration
University of Phoenix
Skills
- Software - Microsoft Office Applications 97/2013, Windows 95/Windows 07, Macintosh OXS, MS Outlook, Outlook Express, Mac Mail, Netscape, Internet Explorer, Foxfire, Google Chrome, Commax
- Hardware -IBM PC and compatibles, Scanner, Facsimiles, Automated Data Processing Equipment, Linksys, Netgear and D-link routers
- Typing Skills - 40 WPM
- Computerized Maintenance Management Systems
- Reviewing Patient Information
- Technical Assistance
- Large Caseloads
- Benefits Verifications
- Quality Assurance
- Patient Correspondence
- Medicare Knowledge
- Office Supplies and Inventory
- Patient Information Management
- Proactive Problem-Solving
- Verbal and Written Communication
- Trend Tracking
- Word Processing
- Insurance Understanding
- Policy Research
- Health Information Access Management
Certification
United States Army Basic Training Fort Jackson SC. 1999
92Y Unit Supply Specialist Training Fort Lee VA. 2000
Georgia Department of Corrections, Correctional Officer Training 2001
Reaching for Stellar Service 2013
Licenses – Property and Casualty Adjuster
Additional Information
- Awards- Good Conduct Medal Date Awarded October 2000 - United States Army Best in Class Awarded 2009 – AT& T Top Performer- Sykes 2013 Top Performing Team January, February, March, April, May, June 2015- Sykes
Timeline
Patient Advocate, UDP Claims Representative
Elevate PFS
09.2022 - Current
Founder/Executive Director
Bag Lady
07.2020 - Current
Adjuster
USAA
07.2015 - 07.2022
Team Manager
Sykes Enterprises
06.2014 - 07.2015
Member Services Representative
Sykes Enterprises
03.2013 - 06.2014
CSI Representative
AT&T Internet Services
06.2008 - 12.2011
DSL Technical Support Representative
Calltech Communications
08.2005 - 10.2006
Correctional Officer
Georgia Department of Corrections
09.2001 - 08.2003
Logistics Technician
United States Army, Army Reserve
09.1999 - 10.2007
Master of Information Technology Management - Information Security
Keller Graduate School of Management
Graduate Certificate - Information Security
Keller Graduate School of Management
MBA - Health Service Management
Keller Graduate School of Management
Bachelor of Science - Business Administration With Concentration in Health Service Management
DeVry University
Associate of Arts - Healthcare Administration
University of Phoenix
Similar Profiles
Ernestine MabreyErnestine Mabrey
Patient Advocate at Elevate PFSPatient Advocate at Elevate PFS
Shawanda MackShawanda Mack
Claims Representative at Elevate PFSClaims Representative at Elevate PFS
Geetha KuppaniGeetha Kuppani
Managed Care Appeals Analyst at ELevate PFS holdingsManaged Care Appeals Analyst at ELevate PFS holdings
Lishia MartinezLishia Martinez
bilingual Patients Advocate contractor at Elevate PFSbilingual Patients Advocate contractor at Elevate PFS
Christopher A. MendozaChristopher A. Mendoza
Masters Research Assistant at University Of Texas At El Paso - Aerospace CenterMasters Research Assistant at University Of Texas At El Paso - Aerospace Center