LaCol Cleare

• Supported our teleheath service approach connecting over the phone virtually with individuals with SMI & SUD (serious mental illness, substance abuse disorder and dementia).
• Successfully engaged with 40-50 patients daily to improve health outcomes and enhance the overall patient experience.
• Provided comprehensive education to connect patients with critical health and social support services with ongoing outreach to patients regarding their treatment plans and medications.
• Coordinated care transitions between providers and facilities to ensure seamless continuity of care.
• Actively participated in team meetings and contributed to process improvement initiatives
• Maintained accurate records of all client interactions, allowing for efficient tracking of progress toward individual goals over time.

• Developed strong relationships with clients through exceptional

customer service and timely responses to inquiries.

• Maintained strict confidentiality of sensitive information, upholding highest standards of professionalism at all times.
• Created welcoming office environment by maintaining clean, organized spaces for staff use.
• Monitored inventory levels of office supplies, placing orders when necessary to prevent stock shortages.

• Provided initial contact between Care Management program and specific identified member conducting (40-50) engagement calls daily to provide information regarding program features, values and explaining available services.
• Gathers and records appropriate member information in accordance with policies and procedures via telephone from hospitals, health plans, physicians, patients, vendors and other referral sources.
• Initiates referrals and manages consults from clinicians for participants registered in Care Management.

• Communicated with customers to resolve complex issues, complaints, disputes, and billing concerns.
• Processed payments, self-pay services, and financial assistance requests.
• Managed collections on accounts receivable and set up payment plans.
• Communicated with customers through various channels acknowledging and resolving complex customer service issues, complaints, disputes, appeals along with general billing concerns.
• Processed payments for self pay services, ordering forms, submissions for internal work orders , and financial assistance requests.
• Managed collection on all accounts receivable for Wellstar patients along with setting up payment plans or processing payments for various delinquent accounts types by phone, mail, visits in person or online via Wellstar Mychart application.

• Enacted as a central point of reference for Georgia Medicaid providers to help with their routine service inquiries, including verifying eligibility and explaining benefits, claims, payments, authorizations and appeal procedures information and status etc.
• Conducted thorough research to provide accurate information and resolve complex issues for customers.
  Serviced product lines for Caresource Georgia Medicaid and Medicare Advantage and Dual Special Needs Plans for Georgia, Ohio, Kentucky, and Indiana.
• Distributes routed calls to support departments including Pharmacy, and Triage, for expedited resolution.
• Assists with non-phone work such as claims processing-through CRM-Facets, incoming faxes and web inquires and perform any other job related instructions, as requested.

• Generated 18% YoY increase in recovering claim awards by

demonstrating exceptional work ethic and dedicated commitment

towards first-class service delivery.

• Managed crew development scheduling to regions nationwide for cellular technology tower builds and maintenance assignments.
• Ensured accuracy, timeliness, and confidentiality for uploading data entry into client project management software
• Invoicing, change orders, crane, and SLAF purchase orders