NANCY NAUMOVSKI
Gahanna
Summary
Patient Service Representative with extensive experience at Quantum Health. Skilled in improving member experiences and advocating for essential healthcare services while maintaining HIPAA compliance. Notable for attention to detail and strong communication skills, resulting in enhanced patient outcomes. Committed to delivering exceptional customer service and fostering a positive environment.
Overview
25
25
years of professional experience
Work History
Patient Service Representative
Quantum Health
Dublin
01.2021 - Current
- Assisted with inquiries regarding benefits, claims, and provider options to facilitate timely care.
Provided clear guidance to empower members in making informed healthcare decisions.
Resolved member concerns effectively while enhancing overall healthcare experience.
Identified cost-saving opportunities and advocated for necessary healthcare services.
Collaborated with internal teams to streamline access to healthcare resources.
Coordinated pharmacy needs to ensure seamless medication management.
Removed barriers to care, making significant impacts on member health outcomes. - Adhered to HIPAA regulations when handling confidential patient information.
- Assisting as a rapid Provider Information Coordinator and Clinical Support Coordination since March 2023
Pharmacy Customer Service Associate
Optum
Westerville
07.2017 - 07.2020
- Managed pharmacy program for Workers' Compensation claims by coordinating with adjusters and pharmacies.
- Collaborated with clients, insurance adjusters, employers, and nurse case managers to support injured workers.
- Documented patient files according to instructions from the assigned adjuster handling each claim.
- Communicated with injured parties to clarify claim processes and authorized benefits or medications.
Customer Service Representative
VSP Inc.
Columbus
05.2014 - 12.2016
- Provided member service support, over the phone, in a timely, consistent and courteous manner to VSP members and providers.
- Assists VSP members by answering benefit questions, eligibility, web registration, authorizations, provider location inquiries and claims details.
- Interfaced with providers to verify member eligibility and authorize services.
Pharmacy Technician
CVS
Columbus
04.2013 - 05.2014
- Dispensed an average of 100 prescriptions daily with meticulous accuracy.
- Resolved insurance rejections and billing issues efficiently to enhance service delivery.
- Assisted pharmacy staff in managing drug inventory, purchasing, and receiving processes.
- Updated patient profiles by documenting comprehensive medication lists accurately.
- Conducted accurate cycle counts and managed inventory for optimal stock levels.
- Processed will-calls for customers to ensure timely access to medications.
Customer Relationship Manager
Discover Financial Services
New Albany
02.2000 - 04.2011
- Facilitated communication between customers and internal departments to enhance collaboration.
- Resolved customer inquiries and complaints with empathy and efficiency.
- Managed critical inter-departmental escalations to ensure timely follow-up.
- Delivered exceptional service to strengthen customer relationships for future business opportunities.
Education
Certificate of Completion - Tourism, Travel And Hospitality Services
Associated Travel Inc.
North Miami Beach, FL08.1990
Skills
- High-energy attitude
- Call center expertise
- Problem-solving
- Inbound and outbound communication
- Customer relationship management
- Microsoft Office proficiency
- Verbal and written communication
- Phone etiquette
- Patient confidentiality adherence
- Attention to detail
- Customer service excellence
- HIPAA compliance
Timeline
Patient Service Representative
Quantum Health
01.2021 - Current
Pharmacy Customer Service Associate
Optum
07.2017 - 07.2020
Customer Service Representative
VSP Inc.
05.2014 - 12.2016
Pharmacy Technician
CVS
04.2013 - 05.2014
Customer Relationship Manager
Discover Financial Services
02.2000 - 04.2011
Certificate of Completion - Tourism, Travel And Hospitality Services
Associated Travel Inc.
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