Lakeya Burton
Providence
Summary
Dynamic Provider Services Representative with a proven track record at Commonwealth Care Alliance, excelling in claims processing and HIPAA compliance. Adept at resolving complex provider inquiries with empathy and professionalism, enhancing customer satisfaction and loyalty. Strong problem-solving abilities and a goal-oriented mindset drive successful outcomes in high-pressure environments.
Overview
9
9
years of professional experience
Work History
Provider Services Representative
Commonwealth Care Alliance
07.2018 - Current
- Managed provider inquiries and resolved issues efficiently to enhance service quality.
- Enhanced customer satisfaction by efficiently resolving provider inquiries and concerns.
- Coordinated with internal departments on behalf of providers to ensure timely payment resolution for claims disputes or other financial matters.
- Facilitated communication between providers and internal teams to streamline operations.
- Resolved complex inquiries by researching policies and utilizing internal systems effectively.
- Educated providers on billing procedures, coding guidelines, and reimbursement policies for optimal claim submissions.
- Facilitated smoother claims processing by rigorously verifying provider information.
- Managed high-stress situations effectively, maintaining professionalism under pressure while resolving disputes or conflicts.
- Resolved customer complaints with empathy, resulting in increased loyalty and repeat business.
Customer Service Representative
SimpliSafe
07.2016 - 06.2018
- Promoted products and services through effective communication and relationship-building techniques.
- Supported Members with picking best products for the home.
- Developed a comprehensive knowledge of product offerings to better assist customers with informed recommendations.
- Followed up with customers after completed sales to assess satisfaction and resolve technical or service concerns.
- Managed high volume of customer calls, maintaining calm and professional demeanor.
Education
High School Diploma -
Hyde Park High School
Hyde Park, MA06-1999
Skills
- HIPAA compliance
- Claims processing
- Goal-oriented mindset
- Call center experience
- Salesforce CRM
- Insurance verification
- Problem-solving abilities
Timeline
Provider Services Representative
Commonwealth Care Alliance
07.2018 - Current
Customer Service Representative
SimpliSafe
07.2016 - 06.2018
High School Diploma -
Hyde Park High School
Similar Profiles
Katie SorensenKatie Sorensen
Telephonic Triage Nurse at Commonwealth Care Alliance- Primary CareTelephonic Triage Nurse at Commonwealth Care Alliance- Primary Care
GinaMarie VazquezGinaMarie Vazquez
RN at Commonwealth Care Alliance Primary CareRN at Commonwealth Care Alliance Primary Care
Jennifer RossignolJennifer Rossignol
Senior Behavioral Health Clinician at Commonwealth Care AllianceSenior Behavioral Health Clinician at Commonwealth Care Alliance
Jacob NemethyJacob Nemethy
Team Member at McDonald'sTeam Member at McDonald's
Iralma J. RodriguezIralma J. Rodriguez
Customer Service Representative at The Panther Group Inc./ MaximusCustomer Service Representative at The Panther Group Inc./ Maximus