LeCola Fonville
PAN FOUNDATION
Hayes,USA
16
years of professional experience
Customer service professional with 15 years of experience in healthcare billing and team leadership. Skilled in resolving complex customer issues, staff training, and expertise in claims processing and patient satisfaction. Proven track record as a subject matter expert and team lead.
Work History
Patient Support Specialist IV / Subject Matter Expert (SME)
4 Years 2 Months- Manage inbound and outbound follow-up calls in a high-volume call center to ensure timely resolutions and patient satisfaction.
- Analyze claim documents to identify processing issues and inaccurate claim payments, providing effective solutions.
- Serve as a subject matter expert to identify areas of improvement in operational processes and procedures.
- Facilitate training sessions for new and existing employees on company policies and procedures.
- Resolve customer inquiries regarding denials and account balances within 24-hour windows.
- Enhance patient access to healthcare by activating debit cards for smoother transportation to appointments.
- Maintain up-to-date records of all transactions related to Subject Matter Expert activities.
Team Lead / Customer Service Advocate III
2 Years- Coach and mentor teammates to ensure high-quality customer service interactions and professional growth.
- Resolve customer inquiries within 24 hours to improve overall customer relations.
- Educate providers on internal processes for claims, authorizations, and appeal/grievance submissions.
- Identify training needs, delegate tasks, and manage various reports related to team performance.
- Ensure satisfactory customer service for enrollees, vendors, and providers while resolving issues or conflicts.
Order Processor
1 Year 11 MonthsCustomer Service Call Center Representative
2 YearsCustomer / Credit Representative
2 Years 9 MonthsEducation
Associate of Arts - Paralegal
GPA: 3.0
Skills
Assisted in processing healthcare claims using ICD-10 and HCPCS codes. Supported billing systems to ensure accurate patient billing. Maintained knowledge of medical terminology and patient confidentiality standards.
Assisted teams in achieving project goals through effective collaboration. Supported employee development through training initiatives. Fostered team cohesion through structured team-building activities.
Assisted in managing customer escalations to resolve disputes effectively. Supported initiatives to enhance patient satisfaction through problem-solving techniques. Collaborated with teams to address customer concerns promptly.
Executed data entry tasks with precision and efficiency across various AI applications.
Assisted teams in utilizing Salesforce CRM software for effective customer relationship management. Supported the implementation of IVR systems to enhance customer service efficiency. Utilized MS Word
MS Office
and Excel to create and manage documentation and reports.
Honors & Accomplishments
Employee Spotlight Program | PAN Foundation (October 2024),
Difference Maker Award | Blue Cross & Blue Shield (February 2022)
Timeline
Patient Support Specialist IV / Subject Matter Expert (SME)
PAN FOUNDATION
2022.08 - CurrentRead More
Team Lead / Customer Service Advocate III
BLUE CROSS BLUE SHIELD CAREFIRST COMMUNITY HEALTH
2020.08 - 2022.08Read More
Order Processor
Canon USA
2017.04 - 2019.03Read More
Customer Service Call Center Representative
Mygrant Glass
2014.04 - 2016.04Read More
Customer / Credit Representative
Royal Glass
2010.08 - 2013.05Read More
Parks College
Associate of Arts from Paralegal
Read More