LINDA THAMES
Federal Way,WA
Summary
Highly motivated and dedicated healthcare professional with extensive experience delivering exemplary customer service. Proven problem solver and excellent communicator with strong organizational skills. Well-versed in data collection, documentation, explanation of benefits and scheduling while adhering to strict HIPAA regulations. Committed to providing top-notch care and ensuring patient satisfaction through effective communication and attention to detail.
Overview
11
11
years of professional experience
Work History
Clinical Administrative Coordinator
United Healthcare, UHG
2023.02 - Current
- Outreached patients post hospital scheduling assessments, local community resources, and care team while documenting interaction.
- Completed DSNP Core Assessment. Ensuring critical NCQA time frame requirements are met.
- Collaborate with healthcare providers, care team and staff to address patient concerns and improve the overall patient experience while meeting in-home needs.
- Delegated follow up tasks with Community Health Worker or Care Navigator to assist members with additional needs under the Case Management program.
- Participated in regular team meetings discussing process improvements, leading to more effective workflows within the clinic setting.
Providers Office Support
VSP Global
2020.05 - 2022.12
- Managed high volume of concurrent cases, prioritizing tasks based on urgency while maintaining keen attention to detail throughout the pre-authorization process.
- Resolved complex customer inquiries through careful research, maintaining excellent relationships with clients.
- Developed strong relationships with external partners such as suppliers or service providers to ensure seamless operations within the office setting.
- Improved customer satisfaction by providing timely and accurate information on claim status and resolution.
- Reduced denials and appeals by ensuring accurate documentation and timely submission of authorization requests.
Customer Service Sales Supervisor
Innovative Marketing Solutions
2017.01 - 2020.04
- Increased sales revenue by developing and implementing effective sales strategies.
- Led a successful sales team by providing motivational coaching and performance-based incentives.
- Consistently met or exceeded quarterly sales targets through diligent effort and persistence in closing deals.
- Facilitated cross-functional communication between sales, marketing, and product development teams to ensure cohesive efforts towards shared goals.
- Supported talent acquisition efforts by screening resumes, scheduling interviews, and performing reference checks for prospective candidates.
Pharmaceutical Customer Support
CVS Caremark - Aetna Med D
2013.08 - 2016.10
- Managed high-volume inbound calls, providing exceptional service to customers in need of assistance.
- Maintained detailed records of customer interactions, identifying trends to inform continuous improvement efforts.
- Increased patient satisfaction by providing accurate and efficient pharmaceutical support.
- Efficiently processed insurance claims for patients, facilitating seamless transactions and minimizing out-of-pocket expenses for customers.
Skills
- Clinical Documentation
- Claim Assessment
- HIPAA Compliance
- Patient Scheduling
- Telephone Customer Support
- Medical Database Expertise
- Medical Terminology
- Explanation Of Benefits
- De-Escalation Techniques
- Insurance Verification
- Medical Billing Experience
- Sales expertise
Timeline
Clinical Administrative Coordinator
United Healthcare, UHG
2023.02 - Current
Providers Office Support
VSP Global
2020.05 - 2022.12
Customer Service Sales Supervisor
Innovative Marketing Solutions
2017.01 - 2020.04
Pharmaceutical Customer Support
CVS Caremark - Aetna Med D
2013.08 - 2016.10
Similar Profiles
Abraham Testa MD MScAbraham Testa MD MSc
Regional Medical Director West Region at United Healthcare, UHGRegional Medical Director West Region at United Healthcare, UHG
Jade GreenJade Green
Customer Service Representative (Contract) at United Healthcare, UHGCustomer Service Representative (Contract) at United Healthcare, UHG
Tanisha SimpsonTanisha Simpson
Care Navigator at United Healthcare, UHGCare Navigator at United Healthcare, UHG