LaDrika Portee
Sumter,SC
Summary
Highly-motivated employee with desire to take on new challenges. Strong work ethic, adaptability, and exceptional interpersonal skills. Adept at working effectively unsupervised and quickly mastering new skills.
Overview
1
1
Certification
10
10
years of professional experience
Work History
Patient Access Repesentative
Colonial healthcare
Sumter, SC
11.2023 - Current
- Coordinated patient appointments and managed scheduling for healthcare providers.
- Collaborated with medical staff to ensure efficient patient flow during visits.
- Facilitated communication between healthcare providers and patients via telephone or email.
- Supported billing processes by verifying insurance information and eligibility.
- Coordinated care between multiple providers, including physicians, specialists, pharmacists and other healthcare professionals.
- Maintained confidentiality of all patient information according to HIPAA guidelines.
Claims Representative
Principle Solutions Group
Omaha, Nebraska
04.2026 - 06.2026
- Reviewed policy provisions to determine claim eligibility and compliance standards.
- Provided clear explanations of benefits, eligibility requirements, and applicable laws when communicating with customers.
- Handled escalated complaints with professionalism and empathy to ensure resolution.
- Delivered fast, friendly, and knowledgeable service for routine questions and service complaints.
- Delivered product knowledge to customers, guiding them through purchasing decisions.
Referral Management Clerk
Epic Government
Shaw AFB, SC
07.2023 - 11.2023
- Processed physician referrals and ensured timely communication between providers and patients for coordinated care.
- Confirmed patient eligibility and submitted pre-authorization requests to insurance companies, facilitating accurate benefits navigation.
- Processed referrals from front desk and directed patients to appropriate departments, maintaining efficient workflow.
- Scheduled patient appointments for treatment or new healthcare providers, facilitating access to care.
- Referred new patients to clinic and provided essential information, ensuring smooth transitions into care programs.
- Updated the clinic's patient database, maintaining accurate records for care team coordination.
Claims Speaclist CSR I
The HArtford Insurance company
Remote
07.2022 - 07.2023
- Processed STD, LTD, ADA, FMLA, and Personal LOA claims, achieving accuracy and timeliness in claim handling.
- Reviewed claim submissions and verified information to ensure thorough documentation and effective case management.
- Used a consultative approach to determine customer needs, build rapport, and provide solutions based on current products and service offerings.
- Prepared claim forms and related documentation, maintaining organized records for administrative tasks.
- Managed daily interactions with 20-35 accounts to ensure client satisfaction., showcasing strong multitasking and time management abilities.
Patient Access Representative
Prisma Health Tuomey Hospital
Sumter, SC
08.2021 - 06.2022
- Applied knowledge of payer requirements and utilized online eligibility systems to verify patient coverage and policy limitations.
- Processed insurance-determined patient responsibility estimates at pre-registration, clearly communicating financial obligations to patients.
- Collected fees at time of service while communicating financial obligations to patients, enhancing customer service experience.
- Verified demographics and insurance information for patient registrations in computer systems, ensuring accurate data entry.
- Assembled registration paperwork and placed identification bands on patients, supporting accurate patient identification.
- Applied HIPAA privacy and security regulations while handling patient information, ensuring confidentiality and compliance.
Customer Service Advocate II, Cobra Coordinator
Blue Cross Blue Shield
Columbia, SC
03.2016 - 08.2021
- Serviced insurance policies and provided guidance on Fixed Indemnity, Wellness plans, and COBRA, enhancing member benefits navigation.
- Processed SDS forms and COBRA applications/payments, ensuring organized records for efficient administrative support.
- Followed outlined guidelines when quoting plan details, ensuring accurate communication with members.
- Offered specialty products to staffing agencies, demonstrating effective customer service and product knowledge.
Education
Basic -
Crestwood High School
Sumter, SC05-2005
Skills
- HIPAA Compliance
- Patient Confidentiality
- Insurance Plan Verification
- Coverage and Authorizations
- Medical Records
- Healthcare Administration
- Patient Communication
- Policyholder Communication
- Time Management
- Multitasking
- Problem-Solving
- Attention to detail
- Customer Service
- Motivational Interviewing
- Patient Advocacy
- Effective communication
Certification
Certified Phlebotomy Technician
Timeline
Claims Representative
Principle Solutions Group
04.2026 - 06.2026
Patient Access Repesentative
Colonial healthcare
11.2023 - Current
Referral Management Clerk
Epic Government
07.2023 - 11.2023
Claims Speaclist CSR I
The HArtford Insurance company
07.2022 - 07.2023
Patient Access Representative
Prisma Health Tuomey Hospital
08.2021 - 06.2022
Customer Service Advocate II, Cobra Coordinator
Blue Cross Blue Shield
03.2016 - 08.2021
Basic -
Crestwood High School