Lashonda Issac
Miami,FL
Summary
Knowledgeable patient representative offers demonstrated skills in case management and service coordination. Expertly handles complaints, inquiries and service questions to meet patients' access needs and correct problems related to care. Well-versed in policies, procedures and standards.
Overview
10
10
years of professional experience
1
1
Certification
Work History
Patient Care Advocate
Accredo Health Group / Express Scripts / Cigna
Miami , FL
10.2023 - 02.2024
- Provide patients and caregivers with the support and education they need so they can make their own decisions about their next steps
- Process refills, process payments, process claims, and manage prescription drug benefits for clients ranging from health insurers and Medicare Part D drug plans to large employers.
- Maintained accurate documentation of all interactions with patients in accordance with HIPAA regulations.
- Developed strong and trusting rapport with patients to facilitate smooth, quality care.
Customer Service Advocate II
UnitedHealthcare
Miami , FL
08.2022 - 03.2023
- Assist the state of Florida Medicaid/Medicare members with benefit information, finding a provider, claim information, or any other resources that may be needed
- Resolve members' complaints, maintain accurate medical records, apply ICD-10 and CPT coding, obtain pre-authorizations and referrals, verify eligibility and benefits, submit insurance claims to Medicare, utilize Rx to coincide with PBM, resolve members' inquiries and complaints, ensure all members' needs are met, provide helpful resources to members to assist them in obtaining the help they need, and ensure members receive the care they need.
- Developed relationships with customers through friendly conversations.
Customer Satisfaction representative/Team Lead
Directv
Miami , FL
04.2014 - 04.2021
- Train new customer service team members, conduct interviews for potential new hires, research and resolve customer issues, provide technical support for products and services, use customer relationship management software (CRM) to document customer interactions, respond to 50 emails and chats per day, monitor average call length and overall team volume, have knowledge of quality control standards used while evaluating calls, listen to individual calls to ensure quality, handle customer inquiries both over the phone and by email, research required information using available resources, manage and resolve customer complaints, provide customers with product and service information, document all call information according to standard operating procedures, and make product recommendations or services to customers based on their needs and preferences.
Education
College Degree in Criminology -
Miami-Dade Community College
04.2003
Skills
- Microsoft Outlook
- Customer support
- Communication skills
- Medical terminology
- Computer skills
- Windows
- Microsoft Excel
- Microsoft Word
- Microsoft Office
- Medical Insurance Knowledge
- Medical Coding And Billing
- Hipaa Protocol Adherence
Certification
pharmacy tech
certified correctional officer
Timeline
Patient Care Advocate
Accredo Health Group / Express Scripts / Cigna
10.2023 - 02.2024
Customer Service Advocate II
UnitedHealthcare
08.2022 - 03.2023
Customer Satisfaction representative/Team Lead
Directv
04.2014 - 04.2021
College Degree in Criminology -
Miami-Dade Community College
pharmacy tech
certified correctional officer
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