LeCola Fonville
Hayes,Virginia
Summary
A seasoned customer service professional with over 15 years of experience, demonstrating strong leadership and team management skills through roles as a Team Lead and Subject-Matter Expert (SME). Proven expertise in resolving complex customer issues, staff training, and ensuring high customer satisfaction by leading, by example, while maintaining detailed documentation and
proficiency in healthcare billing systems, including claims processing, ICD-10/HCPC codes, and eligibility verification tools.
Overview
14
14
years of professional experience
1
1
Certification
Work History
Patient Support Specialist IV
PAN FOUNDATION
Washington, DC
08.2022 - Current
- Achieved a 95% customer satisfaction rate by strictly following call scripts and SOPs, enhancing patient trust and loyalty.
- Enhanced patient satisfaction by managing inbound and outbound follow-up calls weekly within a high-volume call center, ensuring timely resolutions.
- Improved patient eligibility determination by 12% within 3 months by effectively answering inquiries and streamlining program processes via phone and online portals.
- Analyzes claim documents, identifies claims processing issues, and inaccurate claim payments, and provides solutions.
- Mentored and trained new hires on customer service protocols, resulting in an increase in patient satisfaction ratings through effective knowledge transfer.
- Activated debit cards for patients enhance their access to healthcare and enable smoother transportation to appointments.
- Resolved customer inquiries regarding denials and account balances within 24 hours.
- Provided customer service to patients and their families, responding to inquiries in a timely manner.
- Handled billing related activities focused on medical specialties.
Team Lead/Customer Service Advocate III
Blue Cross Blue Shield CareFirst Community Health
Washington, DC
08.2020 - 08.2022
- Oversaw training and development programs to enhance team skills and knowledge.
- Ensured satisfactory customer service for enrollees, vendors, and providers.
- Demonstrated ability to identify and understand issues, resolve customer inquiries, and develop appropriate solutions quickly and effectively.
- Coach and mentor teammates to ensure customer service interactions.
- Create and manage various reports related to team performance.
- Delegating tasks, discovering training needs, and providing coaching.
- Listen to team members' feedback, and resolve any issues or conflicts.
- Provided training on how to use the equipment, and the proper scripts to use.
- Reissue enrollee ID cards as requested.
- Obtain and update demographic information.
- De-escalated customer complaints.
- Send the Explanation of Benefits about paid or denied claims to providers via email or fax.
- Direct providers to the appropriate internal departments for further assistance.
- Confirm eligibility and PCP assignments to providers and contracted vendors.
- Educate providers on internal processes for claims, authorization, and appeal/grievance submission.
Order Processor
Canon USA (Engage Partners Temporary Assignment
Arlington, VA
04.2017 - 03.2019
- Process customer orders of products and services by entering orders into the computer system, and ensuring that orders are filled correctly and on time.
- Collecting customer information, including payment options.
- Maintained daily production logs and reports for management to review weekly.
- Place calls and return phone calls or emails in a timely manner.
- Looks up customer orders/invoices pertaining to order/invoice dates, totals, shipment dates, etc.
- Take inbound calls from sales agents to validate customers' home addresses for services available.
Customer Service Call Center Representative
Mygrant Glass
Lanham, MD
04.2014 - 04.2016
- Actively listened to each customer's inquiry in order to provide an appropriate response in a timely fashion.
- Handled incoming customer calls efficiently.
- Place phone calls to customers regarding incomplete orders, back orders, or other issues that may delay the fulfillment of the order.
- Proficiently and professionally responded to customer and sales representatives’ questions pertaining to orders, product availability, backorders, prices, products and services, procedures, and policy.
- Process return orders while compiling reports of the reasons and circumstances surrounding the return.
- Processed credit card payments for orders and managed account receivables.
Customer/Credit Representative
Royal Glass
Capitol Heights, MD
08.2010 - 05.2013
- Assisted customers by telephone, email, and in person with inquiries.
- Performed routine audits of customer accounts to identify any inaccuracies or inconsistencies.
- Assisted customers in opening accounts and updated personal information for new and existing customers.
- Responsible for collecting a portfolio of customers with balances greater than 30 days old.
- Collection calls, reconciling customer problems, following up on open issues, documenting customer notes, handling incoming calls from internal and external customers, and all other assigned daily credit and collection programs.
Education
Associates - Paralegal
Parks College
Arlington, VA04.2006
Skills
- Adaptability
- Communication skills
- Strong Work Ethic
- Team Leadership
- Healthcare industry
- Data entry proficiency
- Follow-up coordination
- Medical terminology
- Patient confidentiality
- Escalation management
- Policy adherence
- Dispute handling
- Detail-oriented
- Problem-solving abilities
- Proficient in AI Applications
Certification
- Difference Maker
- 02/2022 - 02/2022 Blue Cross & Blue Shield
Affiliations
Difference Maker • 02/2022 - 02/2022
Blue Cross & Blue Shield
Accomplishments
Employee Spotlight Program•10/2024
PAN Foundation
Timeline
Patient Support Specialist IV
PAN FOUNDATION
08.2022 - Current
Team Lead/Customer Service Advocate III
Blue Cross Blue Shield CareFirst Community Health
08.2020 - 08.2022
Order Processor
Canon USA (Engage Partners Temporary Assignment
04.2017 - 03.2019
Customer Service Call Center Representative
Mygrant Glass
04.2014 - 04.2016
Customer/Credit Representative
Royal Glass
08.2010 - 05.2013
Associates - Paralegal
Parks College
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