LaCreisha Parham
Winder,GA
Summary
Dedicated Senior Customer Service Op with 12.37 years of experience in providing superb customer service. Passionate and professional Representative sometimes assist with outreach efforts, strategic direction and day-to-day function management. Proven talent at building relationships and influencing others to gain support and commitment. Excellent presentation and communication skills and comfort working in fast-paced environment.
Overview
15
15
years of professional experience
1
1
year of post-secondary education
Work History
Sr. Rep Customer Service Op
Cardinal Health
, GA
01/11/14 - Current
- Assisted customers by answering questions, addressing concerns and providing current account information.
- Managed customer conflicts and challenging situations by staying calm and accessing internal knowledge bases to develop strategic solutions.
- Delivered fast, friendly and knowledgeable service for routine questions and service complaints.
- Memorized company products and services to answer customer questions quickly and capitalize on upsell opportunities.
- Monitored customer accounts to track outstanding issues and implement new solutions.
- Improved customer satisfaction and retention by proactively reviewing new customer accounts and reaching out to offer assistance.
- Met and exceeded performance goals.
- Reduced customer complaints by 30% with introduction of new service management and sales follow-up processes.
Billing/Coding/Prior Authorization Specialist
Uromed
Suwanee, GA
03.2011 - 01.2014
- Performed detailed medical reviews of prior authorization request, following established criteria and protocols.
- Contacted insurance carriers to obtain authorizations, notifications and pre-certifications for patients.
- Contacted insurance companies to obtain necessary preauthorizations needed for upcoming tests and procedures.
- Provided accurate information to all parties, including patients, insurance providers, healthcare staff and office personnel by using effective written and verbal communication skills.
- Applied knowledge of Medicare, Medicaid and third-party payer requirements utilizing on-line eligibility systems to verify patient coverage and policy limitations.
- Coordinated resolutions for issues and appealed denied authorizations.
- Maintained files for referral and insurance information, entering referrals into system.
- Identified reasons behind denied claims and worked closely with insurance carriers to promote resolutions.
- Updated reference materials with Medicare, Medicaid and third-party payer requirements, guidelines, policies and list of accepted insurance plans.
- Maintained confidential patient documentation to prevent data compromise and comply with HIPAA regulations.
- Maintained positive working relationship with fellow staff and management.
- Granted, modified, denied, or terminated assistance based on key information and eligibility determination.
- Informed applicants of other agencies providing useful or related assistance.
Education
Healthcare
Everest Institute
Suwanee, GA 08.2011 - 02.2012
Bachelor of Science - Psychology
South Carolina State University
Orangeburg, SC12.2005
Skills
- Credit Card Processing
- Order Fulfillment
- Team Monitoring
- Cross-Functional Collaboration
- Database Research
- Database Management
- Database Maintenance
- Staff Training
- SOP Writing
- Membership Renewals
- Process Optimization
- Complaint Resolution
- Account Management
- Documentation Review
- Customer Support
- Quality Assurance
Languages
English
Professional
Accomplishments
- Exceeded QA and STATS goals by average of 100% in 2019-2023.
- Recognized as Employee of the Month for outstanding performance and team contributions.
- Assisted in creating an highly effective new program which would significantly impact efficiency and improve operations.
Timeline
Healthcare
Everest Institute
08.2011 - 02.2012
Billing/Coding/Prior Authorization Specialist
Uromed
03.2011 - 01.2014
Sr. Rep Customer Service Op
Cardinal Health
01/11/14 - Current
Bachelor of Science - Psychology
South Carolina State University