NANCY NAUMOVSKI
Gahanna,OH
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.
Detail-oriented individual with exceptional communication and project management skills. Proven ability to handle multiple tasks effectively and efficiently in fast-paced environments. Recognized for taking proactive approach to identifying and addressing issues, with focus on optimizing processes and supporting team objectives.
Overview
26
26
years of professional experience
Work History
Patient Service Representative
Quantum Health
01.2021 - Current
- Streamlined inquiry resolution regarding benefits, claims, and provider options for optimal care delivery.
- Enhanced member satisfaction by addressing concerns and advocating for vital services.
- Implemented cost-saving initiatives within healthcare access strategies to improve efficiency.
- Fostered collaboration with internal teams to optimize resource accessibility.
- Proactively resolved barriers to care, including issues with medical bills and pharmacy coordination.
- Ensured strict adherence to HIPAA regulations in managing sensitive patient information.
- Providing support as a Rapid Provider Information Coordinator and Clinical Support Coordinator since March 2023.
- Provided clear guidance on healthcare processes, resulting in improved member engagement.
Pharmacy Customer Service Associate
Optum
07.2017 - 07.2020
- Managed pharmacy program for Workers' Compensation claims by coordinating with adjusters and pharmacies.
- Coordinated pharmacy needs to ensure seamless medication management.
- 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.
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.
Customer Relationship Manager
Discover Financial Services
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
- Call center operations
- Problem-solving abilities
- Communication (inbound/outbound)
- Written and verbal skills
- Professional phone etiquette
- Detail orientation
- Customer service excellence
- HIPAA adherence
- Pharmacy benefit knowledge
- Administrative skills proficiency
- Microsoft Office applications expertise (Outlook, Word, Excel, PowerPoint)
- Trustworthy professional demeanor
- Self-sufficient work style
- Claims processing
- Benefits determination
- Patient advocacy
- Healthcare 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
Customer Relationship Manager
Discover Financial Services
02.2000 - 04.2011
Certificate of Completion - Tourism, Travel And Hospitality Services
Associated Travel Inc.