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
02.2023 - 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
05.2020 - 12.2022
- 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
01.2017 - 04.2020
- 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
08.2013 - 10.2016
- 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
02.2023 - Current
Providers Office Support
VSP Global
05.2020 - 12.2022
Customer Service Sales Supervisor
Innovative Marketing Solutions
01.2017 - 04.2020
Pharmaceutical Customer Support
CVS Caremark - Aetna Med D
08.2013 - 10.2016
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