LaTonya Adams
Kansas City,MO
Summary
Compassionate Case Manager accustomed to treating diverse patient needs while managing dynamic conditions. Collaborative professional possessing excellent clinical knowledge and judgment combined with strong documentation and problem-solving abilities. Well-versed in managing emergent cases with poise.
Overview
15
15
years of professional experience
Work History
Reimbursement Case Manager (Remote)
Aston Carter for Mercalis
Raytown, MO
12.2021 - Current
- Assessed clients' needs, developed service plans and monitored progress towards goals.
- Facilitated communication between clients, families, caregivers, social services and other agencies to ensure client needs were met.
- Counseled clients on available resources within the community that could help meet their needs.
- Provided referrals to appropriate health care providers or other community resources.
- Maintained accurate case records and documentation according to agency guidelines.
- Collaborated with medical professionals to coordinate treatment plans for clients.
- Compiled reports on cases and submitted them to supervisors as required.
- Reviewed and processed reimbursement requests in accordance with company policies and procedures.
- Analyzed patient data to ensure accuracy of reimbursement information.
- Maintained a database of all reimbursements, payments, and other transactions.
- Identified potential areas of cost savings through proactive analysis of billing practices.
- Resolved discrepancies between pharmacy documentation and insurance plan requirements.
Customer Care Representative (Remote)
Aston Carter For Elixer
Raytown, MO
09.2020 - 12.2021
- Answered customer inquiries over the phone and via email.
- Resolved customer complaints promptly and professionally.
- Provided accurate, valid, and complete information to customers.
- Maintained a detailed record of all customer interactions, transactions, comments, and complaints.
- Assisted customers in navigating through website features and functions to locate desired information or products.
- Followed up on customer inquiries not immediately resolved by providing timely updates on the status of their requests.
- Ensured compliance with company policies regarding privacy laws and data protection regulations.
- Adhered strictly to confidentiality guidelines when dealing with sensitive customer information.
- Escalated unresolved issues requiring further investigation or specialized expertise.
- Interacted with customers to provide and process information in response to inquiries, concerns and requests about services and products.
- De-escalated customer issues with proven conflict mediation and problem-solving abilities.
- Kept customer and system account information accurate and current to support timely resolutions for concerns.
- Delivered customer support to high call load each shift.
Debit Card Fraud Specialist
US Bank NA
Overland Park, KS
06.2015 - 11.2019
- Investigated debit card fraud cases, identified patterns and trends in fraudulent activities.
- Analyzed customer accounts and transaction histories to determine suspicious activity.
- Reported incidents of debit card fraud to financial institutions, law enforcement agencies and other relevant organizations.
- Created reports for management on the status of debit card fraud investigations.
- Responded promptly to customer inquiries regarding suspected or confirmed debit card fraud incidents.
- Performed general accounting handling functions such as closing accounts and placing accounts on hold.
- Maintained files, records, databases and prepared routine management reports.
- Prepared detailed reports outlining findings from investigations into suspected cases of debit card frauds.
- Took corrective legal actions against illegal activities by reporting activities to regulatory authorities.
Customer Service Representative
US Bank For Kforce
Overland Park, KS
06.2014 - 06.2015
- Answered customer inquiries and provided accurate information regarding products and services.
- Provided excellent customer service to resolve customer complaints in a timely manner.
- Assisted customers with product selection, ordering, billing, returns, exchanges and technical support.
- Maintained detailed records of customer interactions, transactions and comments for future reference.
- Performed administrative tasks such as filing paperwork, updating databases and generating reports.
- Resolved complex problems by working with other departments to provide solutions that meet customer needs.
- Answered incoming calls and emails, providing frontline customer support or assistance with product and service transactions.
- Answered inbound calls, chats and emails to facilitate customer service.
- Developed strong customer relationships to encourage repeat business.
- Demonstrated excellent communication skills in resolving product and consumer complaints.
Eligibility Specialist
State Of Missouri
Independence, MO
07.2008 - 08.2011
- Maintained comprehensive knowledge of program regulations, policies, and procedures.
- Conducted detailed interviews with applicants to determine their eligibility for assistance programs.
- Processed client applications in accordance with established guidelines.
- Assisted clients with completing forms required for processing applications.
- Verified applicant's identity and other relevant documents such as birth certificates or Social Security cards.
- Reviewed applications for eligibility and determined whether applicants met the criteria to receive benefits.
- Analyzed financial information provided by applicants to verify income levels.
- Provided guidance on how to apply for benefits and answered questions related to the process.
- Communicated regularly with clients regarding their application status or changes in policies or procedures that may affect them.
- Prepared detailed reports outlining the reasons why an individual was denied benefits.
- Ensured compliance with all applicable laws and regulations governing benefit programs.
- Entered client information and files into databases for further review and tracking.
- Performed careful reviews of applicant data to ascertain compliance with eligibility criteria for economic assistance.
- Conducted interviews with applicants, explaining benefits process and which programs were available.
Education
High School Diploma -
Raytown South High School
ElixerRaytown, MO05.1993
Business
Metropolitan Community College - Kansas City
Kansas City, MOSkills
- Care Coordination
- Chronic Disease Management
- Utilization Review
- Regulatory Compliance
- Case Management
- Patient Support
- Referral Coordination
- Resource Management
- Email and Telephone Etiquette
- Records Management
- Data Entry and Analysis
- Documentation Proficiency
- Patient Needs Assessment
- Positive Attitude
- MS Office
- Problem-Solving
- Conflict Resolution
- Organization and Multitasking
Work Availability
monday
tuesday
wednesday
thursday
friday
saturday
sunday
morning
afternoon
evening
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Timeline
Reimbursement Case Manager (Remote)
Aston Carter for Mercalis
12.2021 - Current
Customer Care Representative (Remote)
Aston Carter For Elixer
09.2020 - 12.2021
Debit Card Fraud Specialist
US Bank NA
06.2015 - 11.2019
Customer Service Representative
US Bank For Kforce
06.2014 - 06.2015
Eligibility Specialist
State Of Missouri
07.2008 - 08.2011
High School Diploma -
Raytown South High School
Business
Metropolitan Community College - Kansas City
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