Malisa Neal
Morgantown,WV
Summary
Highly motivated and results-driven professional with a strong background in healthcare, technical support, and customer service. Skilled in troubleshooting technical issues, providing exceptional remote support, and delivering a positive customer experience. Adept at managing tasks in a fast-paced environment, with a proven ability to adapt to changing technologies and client needs. Demonstrates excellent communication, problem-solving, and multitasking skills, making a valuable addition to any team.
Overview
13
13
years of professional experience
Work History
CSR II
Evolent Health
03.2025 - Current
- Resolved customer inquiries and issues through effective communication and problem-solving techniques.
- Implemented process improvements that increased response times for customer queries.
- Resolved customer inquiries through effective communication and problem-solving strategies.
- Managed high-stress situations effectively, maintaining professionalism under pressure while resolving disputes or conflicts.
- Provided guidance on eligibility requirements, improving client understanding of benefits.
- Coordinated communication between clients and healthcare providers to facilitate service access.
- Resolved discrepancies in member accounts by conducting thorough research and applying appropriate corrective actions as necessary.
- Handled sensitive client information with discretion, adhering to HIPAA privacy regulations at all times.
- Managed a high volume of case files, prioritizing tasks effectively to meet strict deadlines consistently.
- Managed provider inquiries, ensuring accurate and timely responses to enhance satisfaction.
- Increased efficiency by accurately entering provider data into company systems and databases.
- Maintained up-to-date knowledge on company products, services, and industry trends to provide accurate information to providers.
Care Review Processor
Insight Global
02.2025 - 07.2025
- Processed care reviews, ensuring compliance with regulatory standards and organizational policies.
- Evaluated documentation for accuracy, identifying discrepancies to enhance review efficiency.
- Collaborated with interdisciplinary teams to streamline communication and improve care assessment outcomes.
- Reduced potential errors in patient treatment plans by meticulously verifying the accuracy of clinical coding used for billing purposes.
- Supported timely decision-making on case reviews by accurately maintaining case information within the database system.
- Participated in regular team meetings, contributing valuable insights and suggestions for improvements to care review processing workflows and procedures.
- Enhanced the quality of care review processes by updating policies, procedures, and guidelines in accordance with industry best practices.
- Evaluated prior authorization requests for medical procedures, ensuring compliance with policies and regulations.
Technical Support Specialist
Conduent
02.2024 - 02.2025
- Supported customers with computer, phone, tablet and various other electronic support
- Provides a numerous amount of troubleshooting to resolve technical issue these devices may be experiencing
- As a technical support specialist I strive to make sure our customers have a great costumer experience by providing exceptional customer service
- This consists of making sure we show empathy, giving assurance, and making sure there is always some sort of resolution to the issue at hand
- Utilized a multi-line phone system and computerized systems to handle a high volume of incoming calls, ensuring accurate and timely documentation of customer interactions and inquiries
- Resolved technical issues through remote diagnostics and troubleshooting for diverse software applications.
- Resolved 50+ technical support inquiries per day.
- Documented support interactions for future reference.
- Provided remote support for a wide range of software and hardware issues, maintaining strong customer relationships.
- Provided high-level technical support by resolving inquiries by phone, e-mail and web consistent with department and team service levels and goals.
- Walked individuals through basic troubleshooting tasks.
- Managed high-volume ticket queues while maintaining exceptional levels of customer service and satisfaction.
Certified Nursing Assistant
The Village Caregiving
07.2022 - 03.2024
- Demonstrated exceptional patient care by providing assistance with daily living activities, monitoring vital signs, and administering medications under the supervision of registered nurses and medical staff
- Expertly handled medical claims by accurately documenting patient information, verifying insurance coverage, and submitting claims to insurance companies in a timely manner
- Collaborated with the billing department to ensure proper coding and documentation for accurate claim submission, resulting in increased reimbursement rates and reduced claim denials
- Maintained meticulous records of patient interactions, treatments, and medical histories, ensuring compliance with healthcare regulations and facilitating seamless transitions of care
- Acted as a liaison between patients, families, and healthcare providers, effectively communicating patient needs, concerns, and treatment plans to ensure optimal care delivery
Certified Nursing Assistant
Stonerise Rehabilitation and Nursing Facility
06.2017 - 07.2022
- Provided compassionate patient care, ensuring their physical and emotional well-being by assisting with daily living activities, monitoring vital signs, and administering medications with the supervision of registered nurses and medical staff
- Demonstrated expertise in insurance representation by verifying patient insurance coverage, explaining benefits, and assisting patients and their families with insurance-related inquiries, ensuring smooth and efficient claims processing
- Efficiently handled data entry tasks by accurately documenting patient information, medical histories, and treatment plans into electronic medical record (EMR) systems, ensuring comprehensive and up-to-date records for healthcare providers
- Collaborated with the billing department to ensure proper coding and documentation for accurate claim submission, resulting in increased reimbursement rates and reduced claim denials
- Maintained strong attention to detail, ensuring accurate and timely data entry, insurance verification, and claim documentation, resulting in streamlined processes and improved patient care
Customer Service Representative
Teletech
06.2012 - 10.2015
- Assisted patients and their families in navigating healthcare services, providing empathetic and courteous support to address inquiries, resolve issues, and ensure a positive experience
- Effectively communicated with patients, healthcare providers, and insurance companies to verify insurance coverage, explain benefits, and facilitate claims processing, resulting in seamless and efficient service
- Utilized a multi-line phone system and computerized systems to handle a high volume of incoming calls, ensuring accurate and timely documentation of customer interactions and inquiries
- Collaborated with interdisciplinary teams to coordinate patient appointments, referrals, and follow-up care, ensuring continuity of care and patient satisfaction
- Demonstrated exceptional problem-solving skills by addressing and resolving customer complaints and concerns in a timely and professional manner, ensuring high levels of customer satisfaction
Education
High School Diploma -
Certified Nursing Assistant -
Associate Degree in Nursing - Nursing
WVJC
Morgantown, WV12-2023
Skills
- Customer Service Expertise
- Effective Communication Skills
- Problem-Solving Abilities
- 60 WPM Typing Speed & Accuracy
- Attention to Detail
- Critical Thinking
- Decision Making
- Documentation and Reporting
- Collaboration and Teamwork
- Policy Enrollment and Administration
- Benefits Explanation
- Inbound and Outbound Calling
- CRM Software
- Empathy and Sympathy
- Self-Motivation and Independence
- Time Management and Multitasking
- Adaptability and Flexibility
- Organization and Prioritization
- Accountability
- Call Monitoring and Evaluation
- Claims Processing Proficiency
- Patient Care and Assistance
- Medical Record Documentation
- Insurance Verification Skills
- Attention to Healthcare Regulations
- Insurance Product Knowledge
- Policy Sales and Renewals
- Underwriting Understanding
- Client Relationship Management
- Sales and Retention Strategies
- Patient Advocacy
- Medical Terminology Proficiency
- Appointment Scheduling
- Insurance Verification
- HIPAA Compliance
- Electronic Health Records (EHR)
- Prior Authorization Processing
- Billing and Coding Knowledge
- Provider Network Coordination
- Explanation of Benefits (EOB)
- Insurance Renewal Management
- Knowledge of Affordable Care Act
- Technical Support
- Efficient in Microsoft
- Remote desktop services and support
- Application installations
- Hardware upgrades
- Software installation
- Desktop component repair
- Remote support
- Troubleshooting and diagnosing
- Customer support
- Technical troubleshooting
- Problem resolution
- Remote technical assistance
- Technical instruction
- Advanced troubleshooting
- Prior authorization process
- Medical terminology
- Medical appeals handling
- Insurance verification
- Authorizations
- Patient referrals
- Data entry
- Electronic health records proficiency
- Benefit coverage
- Medical office procedures
- Professionalism and ethics
- Insurance procedures
- Patient scheduling
- Utilization review experience
- Quality assurance practices
- HIPAA compliance
- Healthcare regulations
Timeline
CSR II
Evolent Health
03.2025 - Current
Care Review Processor
Insight Global
02.2025 - 07.2025
Technical Support Specialist
Conduent
02.2024 - 02.2025
Certified Nursing Assistant
The Village Caregiving
07.2022 - 03.2024
Certified Nursing Assistant
Stonerise Rehabilitation and Nursing Facility
06.2017 - 07.2022
Customer Service Representative
Teletech
06.2012 - 10.2015
High School Diploma -
Certified Nursing Assistant -
Associate Degree in Nursing - Nursing
WVJC