Lynnette Blakely
Sumter,SC
Summary
Professional with strong background in Medicaid eligibility determination and case management. Proven ability to navigate complex regulations and ensure compliance. Strong focus on team collaboration and achieving results. Known for reliability and adaptability in dynamic environments. Expertise in data analysis, client communication, and process improvement.
Overview
15
15
years of professional experience
Work History
Medicaid Eligibility Specialist
State of South Carolina
10.2022 - 10.2024
- Review patient information and documentation to determine eligibility for Medicaid programs
- Collect and verify necessary documents, such as income statements and identification
- Enter patient data into the system accurately and efficiently
- Communicate with patients to gather additional information or clarify any discrepancies
- Collaborate with healthcare providers and insurance companies to ensure accurate eligibility determinations
- Maintain confidentiality and adhere to all HIPAA regulations
CSA 1
Blue Cross Blue Shield
05.2023 - 09.2023
- Operated auto dialer systems to efficiently manage high volumes of outbound calls, connecting with members to address inquiries and resolve issues
- Provided excellent customer service by answering questions related to insurance policies, benefits, claims, and coverage options
- Processed and documented interactions with members, ensuring accuracy and compliance with company policies and industry regulations
- Assisted members in navigating the online portal and utilizing digital resources for self-service options
- Escalated complex issues to appropriate departments, ensuring prompt resolution and member satisfaction
- Maintained confidentiality and adhered to HIPAA regulations while handling sensitive member information
- Participated in regular training sessions to stay updated on product knowledge, policy changes, and customer service best practices
- Contributed to team goals by consistently meeting or exceeding performance metrics, including call volume, response time, and member satisfaction scores
Front Desk Receptionist
Physicians Footcare
01.2021 - 02.2023
- Serves patients by greeting and helping them, scheduling appointments, and maintaining records and accounts
- Welcomes patients and visitors in person or on the telephone, and answering or referring inquiries
- Optimizes patients' satisfaction, provider time, and treatment room utilization by scheduling appointments in person or by telephone
- Keeps patient appointments on schedule by notifying provider of patient's arrival, reviewing service delivery compared to schedule, and reminding providers of service delays
- Comforts patients by anticipating patients' anxieties, answering patients' questions, and maintaining the reception area
- Ensures availability of treatment information by filing and retrieving patient records
- Maintains patient accounts by obtaining, recording, and updating personal and financial information
Production Worker
Pilgrims Pride
06.2018 - 02.2020
- Received live poultry and placed it in a moving line in a humane manner
- Used various tools and equipment to clean, trim and cut meat
- Sorted and sectioned the carcasses for further processing
- Weighed, packed, and labeled meat according to specification
- Maintained and followed USDA standards for raw meat handling
Retail Sales Associate
Kmart
01.2012 - 01.2018
- Serving customers
- Dealing with customer queries and complaints
- Handling payments
- Displaying products
- Helping with special promotions
- Ordering stock
- Cash Handling
- Cash Register operations
Customer Service Rep / Customer Support Agent
Sykes Enterprises
01.2010 - 01.2016
- Provided high-quality and accurate resolutions to customers under stipulated policies and procedures, by answering general inquiries and offering solutions, to make sure that objectives set by the client are met successfully
- Experienced high call/chat volume while providing excellent customer service
- Referred unresolved customer grievances to designated escalation departments for further investigation
- Meet established individual and team performance targets, including customer service, productivity, and quality assurance standards
Education
Associate of Science -
Ultimate Medical Academy
Clearwater, FL11-2020
Skills
- Application processing
- Eligibility determination
- Policy interpretation
- Medicaid
Timeline
CSA 1
Blue Cross Blue Shield
05.2023 - 09.2023
Medicaid Eligibility Specialist
State of South Carolina
10.2022 - 10.2024
Front Desk Receptionist
Physicians Footcare
01.2021 - 02.2023
Production Worker
Pilgrims Pride
06.2018 - 02.2020
Retail Sales Associate
Kmart
01.2012 - 01.2018
Customer Service Rep / Customer Support Agent
Sykes Enterprises
01.2010 - 01.2016
Associate of Science -
Ultimate Medical Academy
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