Nija Harrison
Stow,OH
Summary
Knowledgeable in medical terminology and scheduling. Ready to bring 10 years of relevant work experience to your team. Knowledgeable and dedicated customer service professional with extensive experience in the customer service industry. Solid team player with outgoing, positive demeanor and proven skills in establishing rapport with clients. Motivated to maintain customer satisfaction and contribute to company success. Specialize in quality, speed and process optimization. Articulate, energetic and results-oriented with exemplary passion for developing relationships, cultivating partnerships and growing businesses.
Overview
9
9
years of professional experience
Work History
Appointment Center Patient Service Specialist IV
Cleveland Clinic
02.2023 - Current
- Assisted patients with completing paperwork and understanding medical terminology
- Maintained strict confidentiality of protected health Information to comply with HIPAA regulations
- Review medical record documentation
- Conducted intake interviews and collected necessary documentation
- Scrutinized prescriptions and referrals for accuracy to verify patient service and treatment
- Verified and updated changes in patient, physician, or insurance to maintain proper billing
- Explained policies, procedures, and services to patients using medical and administrative knowledge
- Interviewed patients or representatives to identify problems relating to care
- Referred patients to appropriate health care services or resources
- Verified patient insurance coverage before scheduling appointments or providing treatment
- Resolved billing inquiries and disputes in timely fashion.
- Managed patient registration process, confirming data accuracy and completeness.
Internet Sales and Support Representative II
The Pink Label Co
12.2019 - 01.2023
- Created and processed orders and reviewed pending orders to verify adherence to fulfillment schedule.
- Tackled customer concerns and responded to inquiries within 24-48 hours to provide immediate issue resolution.
- Developed working knowledge of CRM to effectively track sales leads and activities.
- Actively listened to customers, handled concerns quickly and escalated major issues to supervisor.
- Trained and mentored new sales representatives.
- Answer customers’ questions about specific products/services
- Build positive relationships by going above and beyond with customer service, ensuring that all questions, cancellations, and confirmations are handled appropriately
- Identify opportunities for driving sales and revenue of the company’s existing product suite, and seize opportunities to upsell when appropriate
- Create and maintain record of daily problems and remedial actions taken, using call-center database
- Handle a large volume of inbound and outbound calls in a timely manner
- Identify customer needs, research issues, resolve complaints, and provide solutions
Full-Time Caregiver
Leave Of Absence
09.2019 - 12.2019
- Provided round-the-clock care for terminally ill family member, including medication management, assistance with activities of daily living, coordinating in-home therapies and services, and therapeutic recreation.
Intake Specialist
University Hospitals
03.2018 - 09.2019
- Completed intake assessment forms and filed clients' charts.
- Relayed triage information and facilitated communication between provider and patient concerning patient disposition.
- Knowledge of health insurance products such as Medicare, Medicaid and commercial health plans
- Updated patient information on computer system to maintain billing accuracy
- Answered telephones to direct calls and take messages for medical advice center
- Added to case information with dates of service, diagnosis or procedure codes and facility and doctor information.
- Obtained case history and gathered triage information to determine appropriate avenue for care.
- Counseled patients via telephone according to established guidelines and protocols, advising on provider-established plans of care.
- Scheduled appointments for patients not requiring emergency services but needing examination from provider and consulting directly with provider.
Full-Time Student
Kent State University
01.2015 - 03.2018
- Adhered to strict time-management schedule to meet deadline requirements for assignments, quizzes, tests and other measures of comprehension.
- Worked in team environment to maintain high levels of productivity.
- Participated in class discussions, contributing research and learned elements to demonstrate personal enrichment.
- Collaborated on group projects to complete professional deliverables.
- Demonstrated comprehension of textbooks and other assigned reading materials via written and oral presentations.
- Kept detailed records regarding returned assignments, papers, quizzes and tests in event of discrepancy.
- Completed projects and submitted research proposals to propel personal learning ambitions.
- Formed study groups to support exam preparation.
Coverage Determination Specialist
CVS Health
12.2014 - 12.2015
- Handled incoming cases via phone or fax to process coverage requests from members and providers
- Input all patient data regarding claims and prior authorizations into the system accurately
- Conducted outreach to healthcare providers to obtain additional information needed to process Prior
- Authorizations and drug benefit exception requests
- Assign Urgent / Escalated Cases to Appeals team for further review
- Identify CPT and diagnostics codes
- Interpret and analyze medical records
- Knowledge of health insurance products such as Medicare and Medicaid
- Analyzed and interpreted written, numerical, and verbal data from various sources
- Utilized electronic files to conduct authorization reviews and updates
- Detected and evaluated potential fraudulent situations, reporting to leadership for investigation.
- Utilized specialized software to process incoming claims, enter data and generate reports.
Education
BACHELOR'S DEGREE - PUBLIC HEALTH
Kent State University
Kent, OHASSOCIATE DEGREE - LIBERAL ARTS
Kent State University
Kent, OHSkills
- Microsoft Excel, Outlook, Word, Powerpoint
- Account Management
- Customer Relationship Management
- Epic Software, Keona Health
- Salesforce, Sharepoint
- Problem-Solving and Creative Thinking Skills
Timeline
Appointment Center Patient Service Specialist IV
Cleveland Clinic
02.2023 - Current
Internet Sales and Support Representative II
The Pink Label Co
12.2019 - 01.2023
Full-Time Caregiver
Leave Of Absence
09.2019 - 12.2019
Intake Specialist
University Hospitals
03.2018 - 09.2019
Full-Time Student
Kent State University
01.2015 - 03.2018
Coverage Determination Specialist
CVS Health
12.2014 - 12.2015
BACHELOR'S DEGREE - PUBLIC HEALTH
Kent State University
ASSOCIATE DEGREE - LIBERAL ARTS
Kent State University