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
Remote
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
Remote
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
Morgantown, WV
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
Morgantown, WV
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