Lisa Hammond
La Vergne,TN
Summary
Proven professional with extensive experience in public transit and healthcare management, notably with United Health Group and WeGo Public Transit. Excelled in safe driving, customer relations, and analytical thinking, achieving significant improvements in operational efficiency and customer satisfaction. Skilled in mentoring teams and enhancing service delivery through effective communication and dispute resolution.
Overview
18
18
years of professional experience
Work History
Bus Operator
WeGo Public Transit
Nashville, TN
11.2017 - Current
- Ensure safe and timely transportation of passengers while adhering to traffic laws and company policies.
- Deliver courteous customer service by addressing inquiries, and providing essential route and schedule information.
- Conduct routine inspections of transit buses to maintain operational standards.
- Operate accessibility features for passengers with disabilities to ensure secure boarding and deboarding procedures.
- Adhered to strict time requirements for bus route scheduling and reported delays to dispatch.
- Cleaned and sanitized bus interiors to lessen germ spread.
- Collected fares and provided route updates and schedule information.
- Notified dispatch personnel whenever a scheduled stop is missed due to traffic congestion or other unforeseen circumstances.
- Train new hires on bus routes and operational protocols.
Managed Care Specialist III
State of Tennessee
Nashville, TN
11.2014 - 11.2017
- Led a team and served as the primary contact for inquiries, ensuring timely responses and issue resolution.
- Maintained accurate documentation of all claims processing activities.
- Processed EOG inquiries, high-priority escalations, timesheets, and leave requests, while monitoring work productivity and addressing issues proactively.
- Provided quarterly training for new hires and refresher sessions for existing staff, created operational manuals, and audited case reports for accuracy.
- Interpreted health plan benefits, contracts, and regulations to determine coverage and reimbursement levels.
- Coordinated with other departments to resolve complex claim issues in a timely manner.
Associate Provider Installation Specialist
United Health Group
Richardson, TX
07.2013 - 09.2014
- Managed the installation and administration of provider contracts, including the database loading of contracts and amendments, ensuring accuracy and compliance with organizational standards
- Conducted thorough audits and quality checks on provider data, encompassing billing setups, fee schedules, demographics, credentialing, and contracts, to maintain high standards of data integrity and adherence to quality measures
Clinical Administrative Coordinator
United Health Group
Richardson, TX
10.2011 - 07.2013
- Conducted nonclinical coverage determinations in alignment with employer group contracts and federal and state mandates
- Prepared cases for clinical review, facilitating efficient evaluation by nurses and Medical Directors
- Verified accurate use of ICD-9 and CPT coding by providers and ensured timely communication of benefit determinations to providers and members
Inpatient Coordinator
United Health Group
Richardson, TX
11.2009 - 10.2011
- Identified member needs and coordinated with Care Coordinators for risk validation, ensuring timely communication of benefit determinations to providers and members within regulatory timeframes
- Served as a departmental resource by mentoring and coaching peers to enhance team effectiveness and service delivery
Intake Coordinator
United Health Group
Richardson, TX
02.2007 - 10.2009
- Delivered exceptional customer service to providers and enrollees, efficiently processing network considerations for out-of-network physician specialties or facilities for relevant products
- Supported departmental operations by assuming Team Lead responsibilities in their absence and offering mentorship and coaching to peers
Education
Associate of Arts - Sociology
College County Community College
Plano, TX, USA01.2015
Skills
- Safe driving skills
- Route planning
- Mobility support
- Customer relations skills
- Effective communication skills
- Analytical thinking
- Dispute resolution
- Inbound and outbound calling
Timeline
Bus Operator
WeGo Public Transit
11.2017 - Current
Managed Care Specialist III
State of Tennessee
11.2014 - 11.2017
Associate Provider Installation Specialist
United Health Group
07.2013 - 09.2014
Clinical Administrative Coordinator
United Health Group
10.2011 - 07.2013
Inpatient Coordinator
United Health Group
11.2009 - 10.2011
Intake Coordinator
United Health Group
02.2007 - 10.2009
Associate of Arts - Sociology
College County Community College
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