Melonese Schumieglow
Riverview,FL
Summary
Seeking a challenging position, in which I can obtain on the job professional skills to incorporate with my college education. In return, be an asset to the company.
Overview
14
14
years of professional experience
Work History
Central Support Operation Coordinator
United Healthcare Group/Navihealth
12.2023 - Current
- Manage inbound and outbound telephone communication in a professional manner and according to productivity and quality standards
- Process inbound and outbound data and communication (i.e., faxes, emails and electronic communication) according to productivity and quality standards
- Enter the required data into the naviHealth database accurately and in a timely manner
- Complete administrative documentation for member records including but not limited to disenrollment, transitioning, creating authorization shells, attaching documents (i.e., medical records), and logging therapy information.
- Enter, review and or verify member information in the nH Coordinate care management platform and communicate approved pertinent information with healthcare providers and / or naviHealth team as needed
- Assist in a smooth coordination of members care between health providers and the health plan
Engagement Center Rep - Remote
Advocate Aurora Health Care
Chicago, IL
05.2023 - Current
- Scheduling patient appointments and coordinating cancellations, reschedules, and additions to schedules.
- Obtains demographic and insurance information, verifies insurance coverage, and may collect co-pays, deductibles, and previous balances.
- Ensures insurance and patient information obtained is complete and accurate, updating information if necessary
- Verifies and updates the medical record with customer information.
- Provides referrals to physicians/providers.
- Determines the level of care needed by patients calling which results in routing patients for triage, scheduling, rescheduling, and canceling appointments, submitting medication refill requests for evaluation, and paging providers and facilities as appropriate.
- Performs additional duties based on department needs such as faxing, updating medical records, logs, and reports, managing files/databases, assisting with entering, gathering, organizing, and compiling data for reports.
Customer Care Advocate
Verizon Wireless
Tampa, FL
01.2019 - 04.2023
- Inbound calls
- Outbound calls for follow up reasons
- Assisting customers with their account
- Tier 1 Technical
- Billing overview
- Interacted with customers to provide and process information in response to inquiries, concerns and requests about services and products.
- Promptly responded to customer inquiries and resolved complaints to promote loyalty.
- De-escalated customer issues with proven conflict mediation and problem-solving abilities.
- Educated customers where applicable to alleviate need for future contact.
- Delivered customer support to high call load each shift.
- Researched resolutions, contacted necessary departments and responded to customer by phone, mail or fax as follow-up.
- Recommended potential products or services after analyzing customer needs.
- Documented customer correspondence in CRM to track requests, problems and solutions.
Customer Care Rep
Quest Diagnostics
Tampa, FL
08.2017 - 11.2018
- Outbound Calls too Hospitals, Doctor offices, nursing homes, etc to give patients results
- Relaying priority results in a timely
- Applied knowledge of Medical Terminology
- Giving accurate results
- Schedule patient visits for labs
- Problem tracking and Claims
- Audits
- Organized information by using spreadsheets, databases or word processing applications.
- Accessed patient information through various software applications, maintaining strict confidentiality to remain compliant with HIPAA regulations.
Customer Service Rep
EGS/Alorica
Tampa, FL
01.2015 - 04.2017
- Assisting customers with their UPS packages
- Inbound Calls/Outbound
- Scheduling pickups
- Investigating lost packages
- Take payments when necessary
- Remained calm and professional in stressful circumstances and effectively diffused tense situations.
Dispatcher/Customer Service
Delta Mechanical
Brandon, FL
02.2015 - 08.2015
- Setting up customers with AC service
- Customer Service
- Schedule appointments
- Dispatch Techs
- Contacted technicians in afternoon to find out status for following morning and prepared start sheet.
- Prepared daily work and run schedules.
CSR/Sales Rep
One Touch Direct
Tampa, FL
05.2014 - 10.2014
- Customer Service for Verizon Fios
- Upselling Products
- Taking inbound calls
- High Volume Calls
- Satisfying customer needs and solving their issue correctly
- Built and maintained knowledge of evolving product and service offerings to promote additional sales to existing customers.
Medical Receptionist
Taylor Made Rehab Services
Tampa, FL
05.2012 - 01.2014
- Scheduled and followed up on patient appointments, collected and processed patient payments and maintained patient files.
- Gathered, transcribed and typed medical information into charts.
- Applied knowledge of medical terminology and insurance processes to support office administration productivity.
- Greeted each patient pleasantly and offered desk sheet for easy sign-in.
- Took messages from patients and promptly relayed to appropriate staff.
- Retrieved faxes and uploaded documents to patient charts to assist clinical staff.
- Checked patients in and out for appointments and collected co-payments.
Education
Certificate - Medical Billing And Coding
Rasmussen College
Tampa, FL02.2024
High School Diploma -
Newsome High School
05.2013
Skills
- Customer Service
- Inbound and outbound calls
- Data Entry and Maintenance
- Order and Refund Processing
- Insurance Verification
- 40 wpm Typing Speed
- Microsoft Programs
- Call Documentation
- Medical Claims
- Medical Terminology
- EMR
- EPIC
- Patient Registration
- ICD and CPT
- Insurance Authorizations
- Prior authorizations
- De-escalation Techniques
- HIPAA Compliance
- Appointment Scheduling
- Medical records
- Payment Collection
- Data Entry
- Patient Scheduling
- Patient Referrals
- SNF,LTAC,IRF
- FAX
Timeline
Central Support Operation Coordinator
United Healthcare Group/Navihealth
12.2023 - Current
Engagement Center Rep - Remote
Advocate Aurora Health Care
05.2023 - Current
Customer Care Advocate
Verizon Wireless
01.2019 - 04.2023
Customer Care Rep
Quest Diagnostics
08.2017 - 11.2018
Dispatcher/Customer Service
Delta Mechanical
02.2015 - 08.2015
Customer Service Rep
EGS/Alorica
01.2015 - 04.2017
CSR/Sales Rep
One Touch Direct
05.2014 - 10.2014
Medical Receptionist
Taylor Made Rehab Services
05.2012 - 01.2014
Certificate - Medical Billing And Coding
Rasmussen College
High School Diploma -
Newsome High School