Phylicia Stubblefield
Houston
Summary
Dedicated healthcare customer service professional with more than 1 year of experience supporting Medicare beneficiaries across high-volume, fast-paced contact center environments. Skilled at managing inbound and outbound inquiries, resolving benefit and eligibility questions, and coordinating care across multiple systems and departments. Adept at documenting interactions accurately, navigating proprietary software, and delivering empathetic, consultative support. Recognized for problem-solving, process improvement, and maintaining compliance in telecommute and onsite healthcare settings.
Overview
5
5
years of professional experience
Work History
Patient Care Advocate
Express Scripts Pharmacy
Houston, Texas
08.2024 - Current
- Serve as primary contact for patients, responding to high-volume inbound/outbound calls regarding medications, benefits, and care navigation.
- Resolve escalated issues and guide patients using consultative communication, ensuring timely follow-up and resolution.
- Document patient interactions accurately in CRM and internal systems, maintaining HIPAA compliance.
- Collaborate cross-functionally with claims, pharmacy, eligibility, and billing teams to resolve issues efficiently.
- Meet and exceed productivity and service-level goals through disciplined time management and data-informed prioritization.
- Supported patient adherence initiatives, medication management, and follow-through on care plans.
- Collaborated with claims, billing, pharmacy, and provider teams to remove barriers and expedite resolution of patient requests.
- Contacted third-party payors to obtain and confirm authorization for services and communicated necessary related clinical information.
- Educated patients about available resources, enabling informed decision-making regarding their care options.
- Advocated for patients'' rights, ensuring access to appropriate services and fair treatment within the healthcare system.
Patient Support Specialist
Everise Group (Remote Pharmacy/Healthcare)
Houston, TX
11.2022 - 08.2024
- Managed a high-volume patient caseload, providing benefits clarification, care coordination, and appointment scheduling.
- De-escalated sensitive situations, resolving patient concerns while maintaining documentation accuracy.
- Partnered with cross-functional teams to remove eligibility, billing, and care barriers, enhancing patient satisfaction.
- Managed a high-volume patient caseload, responding to inbound calls and initiating outbound outreach to support healthcare navigation.
- Provided guidance on benefits, eligibility, claims, and care options while documenting all interactions accurately in CRM/ticketing systems.
- Enhanced patient communication by implementing feedback mechanisms and support systems.
Patient Care Advocate
Conduent (Healthcare/Pharmacy)
Florham Park, New Jersey
11.2021 - 11.2022
- Assisted patients with benefits verification, claim status, prescription refills, prior authorizations, and coverage questions.
- Navigated multiple internal systems and external resources to provide accurate, timely solutions while on the phone.
- Documented every patient interaction thoroughly in EHR and case-management systems, ensuring data integrity and follow-up visibility.
- Escalated complex cases to appropriate departments and collaborated with internal teams to ensure resolution.
- Supported patient adherence initiatives, medication management, and follow-through on care plans.
- Developed strong relationships with local pharmacies to expedite prescription refills and prevent gaps in medication therapy.
- Streamlined intake processes, reducing wait times for patient assessments and care coordination.
Licensed Medicare Sales Agent
Spring Venture Group
Kansas City, Missouri
01.2021 - 11.2021
- Consistently exceeded sales targets, achieving 120% of assigned quota, demonstrating strong persuasion, relationship-building, and goal-oriented performance.
- Provided clear, accurate explanations of Medicare benefits, eligibility criteria, and plan options, helping beneficiaries make informed healthcare decisions.
- Maintained meticulous documentation of patient interactions, plan selections, and next steps across multiple CRM and insurance systems to ensure compliance and data accuracy.
- Identified recurring patient questions and service gaps, providing insights to leadership to improve processes and reduce repeated inquiries.
- Led and coached a team of 10+ agents on workflow adherence, communication accuracy, and compliance with regulatory standards.
- Built trust-driven relationships that enhanced patient engagement, retention, and satisfaction while achieving individual and team performance goals.
- Applied problem-solving skills to navigate complex, sensitive, or escalated patient concerns, maintaining empathy and professionalism in a metrics-driven environment.
Education
Masters of Public Health - Public Health Research, Health Care Systems, Epidemiology
Grand Canyon University
Phoenix, Arizona03-2024
Bachelor of Science - Community Health Education
California State University
Sacramento, California12-2021
Skills
- MS Office Core Products: Word, Excel, SharePoint, Visio, Power Point, Access, Outlook, Adobe Suite
- Administrative Skills: Filing, Data Entry, 10 key-Touch/Sight, Faxing, and Copying
- Documentation Design & Editing: Adobe and Canva
- Database /Web Apps Management: Mail Chimp, Kartra, Keap, Zapier, Geru and Customer Relationship Management software
- Project/Work Management: Star Infinity, Slack and Trello
- Collaboration / Virtual Meeting Tools: Google Workspace, Dropbox, Zoom, Airmeet, Go to Webinar, WebEx Meet, Go to Meeting, GroupMe, 8x8, band, WhatsApp, Free Conference Call, UberConference, Meetup and Community
- Sales Skills: Point of Sales POS machine
- Research: Qualitative Analysis and Literature Reviews
- Analytical Software: Excel Pivot Tables, Access Database, Google Analytics, SPSS, HTML 5, CSS
- Social Media Management: Twitter, Instagram, Facebook, LinkedIn, Facebook, Skype, Snapchat and Pinterest
- Internet Browsers: Internet Explorer, Mozilla Firefox, and Chrome
- Operating Systems: Windows, Apple, and Mac OS
Timeline
Patient Care Advocate
Express Scripts Pharmacy
08.2024 - Current
Patient Support Specialist
Everise Group (Remote Pharmacy/Healthcare)
11.2022 - 08.2024
Patient Care Advocate
Conduent (Healthcare/Pharmacy)
11.2021 - 11.2022
Licensed Medicare Sales Agent
Spring Venture Group
01.2021 - 11.2021
Bachelor of Science - Community Health Education
California State University
Masters of Public Health - Public Health Research, Health Care Systems, Epidemiology
Grand Canyon University
CORE COMPETENCIES
- High-Volume Customer Service & Support
- Benefits, Eligibility & Claims Resolution
- Introspection to Understand Customer Needs
- Escalation Management & Problem-Solving
- Inbound & Outbound Patient Outreach
- HIPAA & Compliance Adherence
- Remote Work & Telecommute Readiness
- Cross-Functional Team Collaboration