LaShawna Hayes
Columbus
Summary
Customer Service Representative bringing top-notch skills in oral and written communication, active listening and analytical problem-solving skills. Enhances customer experiences by employing service-oriented behaviors, understanding customer desires and providing customized solutions to build loyalty.
Overview
16
16
years of professional experience
Work History
Patient Care Coordinator
Quantum Health
07.2021 - 07.2023
- Enhanced patient care through administrative support for healthcare staff.
- Streamlined insurance authorizations and resolved discrepancies effectively.
- Executed insurance verifications and claims processing for patient intake.
- Advocated for patients' needs by collaborating with nursing staff.
- Assessed claims for liability, compensability, and due benefits accurately.
- Facilitated efficient claim handling, following up on denied or suspended claims.
Customer Claims Representative
VSP Vision Care
07.2017 - 05.2020
- Enhanced customer satisfaction by resolving complex claims inquiries effectively.
- Verified policyholder details, ensuring accuracy and completeness of information.
- Assisted clients and providers in navigating claims-related issues efficiently.
- Reviewed documentation for coding accuracy, identifying and correcting errors promptly.
- Explained policies and procedures to patients, ensuring clear understanding of services.
- Ensured compliance with HIPAA regulations while managing sensitive patient information.
Customer Solutions Specialist
IGS Energy
05.2012 - 07.2016
- Inbound calls from eye care patients an doctors
- Assist with finding a doctor, enrollments
- Assisted doctors with back end orders and locating patients
- Updated patient records and assisted with claims and explanation of insurance benefits.
- Engaged in conversation with customers to understand needs, resolve issues and answer product questions.
Collections Representative
Discover Financial Services
02.2009 - 05.2012
- Negotiated payment agreements, resulting in significant balance settlements with customers.
- Achieved performance targets by effectively managing irate customer interactions.
- Clarified debtor delinquency through strategic questioning techniques and active listening.
- Processed contracts and payments, ensuring accuracy in customer account management.
- Posted payments promptly to customer accounts, improving record accuracy and efficiency.
- Developed targeted strategies to enhance payment resolution rates for diverse segments.
Claims Representative
Tailored Management/BWC
03.2007 - 01.2009
- Authorized payments by thoroughly investigating questionable claims.
- Verified claim validity through comprehensive data reviews and case management actions.
- Completed thorough evaluations of injury claims by gathering essential information.
- Determined claim acceptability by collecting data from various third parties.
- Interviewed claimants and specialists to extract pertinent claim information.
Education
High School Diploma -
Graduation Alliance (through Zane State College)
Columbus, Ohio12-2025
Skills
- Patient Care Coordination
- HIPAA Compliance
- Claims Processing
- Microsoft Office
- Calm and Effective Under Pressure
- Caring and Empathetic
- Verbal and Written Communication
- Documenting and Recording Information
- Decision Making
- Database Management
- Insurance Claims Review
- Attention to Detail
- Claims Investigation
- Policy Knowledge
- Critical thinking skills
- Organizational skills
- Customer service
- Patient relations
- Insurance verification
- Medical terminology
Timeline
Patient Care Coordinator
Quantum Health
07.2021 - 07.2023
Customer Claims Representative
VSP Vision Care
07.2017 - 05.2020
Customer Solutions Specialist
IGS Energy
05.2012 - 07.2016
Collections Representative
Discover Financial Services
02.2009 - 05.2012
Claims Representative
Tailored Management/BWC
03.2007 - 01.2009
High School Diploma -
Graduation Alliance (through Zane State College)