MICHELE L ELLISON
Lake Milton,OH
Summary
Proactive and versatile professional with dedication to quickly adapting to new challenges. Strong analytical and creativity in solving account issues, building and maintaining relationships with clients, healthcare providers and patients.
Overview
15
15
years of professional experience
Work History
Account Coordinator
Home Care Delivered
Remote, VA
09.2021 - 09.2026
- Managed client accounts to ensure timely delivery of home care products.
- Acted as the main point of contact in matters relating to client concerns and needs.
- Cultivated partnerships with Care Coordinators, patients and healthcare providers' offices.
- Facilitated communication between partnerships and internal departments, streamlining information flow and support.
- Investigated escalated issues and implemented appropriate tactics for swift resolution.
- Analyzed client feedback to enhance service offerings and address concerns.
Supervisor Customer Care Call Center
CVS/CAREMARK MED D
Solon, Ohio
09.2019 - 09.2021
- Managed customer service operations for callers regarding pharmacy benefits and prescription inquiries. Resolved escalated customer issues swiftly, ensuring high customer satisfaction.
- Supervised the team in productivity, metrics, quality, training, coaching, and development to enhance overall performance.
- Researched complex issues, assisted in call escalation, obtained prior authorization for swift resolution on accounts.
- Conducted talent acquisition processes to identify and recruit qualified candidates., interviewed, hired, trained and mentored staff to enhance team performance and productivity.
Supervisor Member Services
BroadPath Healthcare
Remote, AZ
01.2015 - 09.2019
- Guided and coached representatives on inbound calls for coverage determination and appeals process, enhancing workflow and administrative support.
- Answered member questions regarding healthcare benefits, enrollment, claims, referrals and pre-authorizations.
- Reviewed prior authorization request documentation and liaised with payers to resolve issues efficiently.
- Enhanced team members' skills through targeted coaching and leadership initiatives, fostering a culture of continuous improvement.
- Created training programs for staff on customer service best practices, improving overall service quality.
- Conducted quality assurance reviews on recorded calls to ensure compliance with service standards.
- Responded to customer inquiry emails regarding insurance coverage and policies to assist with informed decision-making.
Patient Financial Advocate
VALLEY HEALTH CARE SYSTEMS
01.2012 - 01.2015
- Educated patients and families on healthcare options and financial support resources, providing timely updates on verification and authorization status to aid decision-making for admissions and insurance coverage.
- Educated patients and families on healthcare options and financial support resources, providing timely updates on verification and authorization status to aid decision-making for admissions and insurance coverage.
- Managed entry, authorization, appeal, and resolution of simple to moderately complex claims, ensuring adherence to company and federal guidelines.
Education
Associate of Applied Science -
Eastern Gateway Community College
Steubenville, OHCertification
Medical Assistant
Certification
Medical Coding And Billing
Skills
- Account Management
- Client Partnerships
- Prior Authorization
- Health & Wellness Benefits
- Quality Assurance
- Process Improvement
- Data Analysis
- Documentation
- Staff Development and Training
- Leadership
- Talent Acquisition
- Patient Advocate
Timeline
Account Coordinator
Home Care Delivered
09.2021 - 09.2026
Supervisor Customer Care Call Center
CVS/CAREMARK MED D
09.2019 - 09.2021
Supervisor Member Services
BroadPath Healthcare
01.2015 - 09.2019
Patient Financial Advocate
VALLEY HEALTH CARE SYSTEMS
01.2012 - 01.2015
Associate of Applied Science -
Eastern Gateway Community College
Certification
Medical Assistant
Certification
Medical Coding And Billing