Qiyama Moore

Dallas,US

Summary

Healthcare professional with 15+ years of experience supporting patients and members across clinical, administrative, and managed care settings. Proficient in CRM and EHR systems, with strong knowledge of medical terminology and healthcare workflows. Skilled in streamlining interactions, maintaining accurate documentation, and resolving complex issues with empathy. Experienced in training staff, coordinating care between patients and providers, and improving processes to enhance efficiency and patient satisfaction.

Overview

years of professional experience

Work History

Member Service Representative / Team Lead

Coordinated Care

Tacoma, WA

10.2018 - 05.2026

Facilitated member understanding of healthcare benefits with patience and empathy, enhancing overall satisfaction during difficult periods.
Determined member eligibility for healthcare services and programs, ensuring compliance with payer requirements and facilitating timely access to necessary care.
Coordinated communication between patients and healthcare providers to ensure seamless service delivery.
Partnered with cross-functional teams to improve member satisfaction, resolve escalated issues, and deliver timely, member-centered solutions in a high-volume call center environment.
Provided day-to-day leadership, coaching, and performance support to team members by answering questions, reinforcing policies, sharing best practices, and promoting high-quality member service.
Coached team members through performance reviews, identifying areas for growth and development while setting achievable goals in alignment with organizational objectives.

Care Coordinator

Superior Health

Dallas, TX

02.2016 - 06.2018

Coordinated care for members by assessing healthcare needs, identifying barriers to care, and connecting members with appropriate clinical and community resources.
Conducted outbound telephonic outreach to engage members, provide health education, and encourage participation in care management programs.
Assisted members in scheduling preventive screenings, specialist appointments, and primary care visits to help close gaps in care.
Documented member interactions, care plans, referrals, and follow-up activities accurately within electronic health record and care management systems.
Used motivational interviewing and active listening techniques to support members in achieving personalized health goals and overcoming barriers to care.
Built trusting relationships with members through compassionate communication, advocacy, and problem-solving to improve overall member experience.

Medical Receptionist

Arlington Premier Health Clinic

Grand Prairie, TX

12.2014 - 02.2016

Coordinated patient scheduling, check-in, check-out and payments for billing using electronic health record systems.
Operated multi-line phone systems with excellent phone etiquette to answer inquiries and direct calls appropriately.
Verified insurance coverage and perform insurance eligibility and benefits verification to facilitate seamless billing processes.
Manage patient records by updating medical information, reviewing documentation for completeness, and maintaining confidentiality in accordance with HIPAA regulations.
Assisted healthcare providers with administrative tasks, enabling them to focus on quality patient care.

Patient Care Advocate

Health Net

Sacramento, CA

06.2011 - 11.2014

Advocated for members by resolving healthcare concerns, educating them on available services, and coordinating with providers to ensure timely access to quality care.
Served as a liaison between members, medical vendors, and providers to coordinate healthcare services, monitor order status, and facilitate timely delivery of care.
Motivated members to adhere to prescribed care plans through health education, goal setting, and regular follow-up to support positive health outcomes.
Conducted telephonic outreach and health coaching to members to support quality improvement, regulatory and contractual requirements.
Conducted face-to-face education with the member and their family, in the provider's office, about care gaps identified, and barriers to care.

Education

Associate of Science - Health Administration

University of Phoenix

Phoenix, AZ

06.2018

Skills

Leadership
Training and Development
Care Coordination
Member Outreach
Medical Terminology
Empathy and Active Listening

Patient Advocacy
Relationship Building
Customer Service
Conflict Resolution
Analytical Thinking
EHR Systems

Timeline