Quianna Morton
Chicago,IL
Summary
Highly dedicated Customer Service Associate with 10 years of experience in health and home care. Adept at managing patient care, scheduling, and administrative tasks with a focus on empathy, professionalism, and efficiency. Skilled in adapting to challenging situations and working both independently and as part of a team. Seeking to expand skill set and explore new areas in leadership and support.
Insurance professional with robust experience in underwriting, claims management, and risk assessment. Known for strong analytical skills, clear communication, and adaptability to changing industry needs. Proven ability to collaborate effectively with teams to achieve results. Highly skilled in policy analysis, regulatory compliance, and customer service. Reliable and focused on delivering impactful solutions.
Overview
19
19
years of professional experience
Work History
Insurance Specialist 1
Insurance Specialist 1
Raleigh, NC
03.2024 - Current
- Deliver expert-level customer service for outbound calls, ensuring first-call resolution.
- Supply healthcare offices with updated plan forms, portals, and websites for authorizations and appeals.
- Execute benefit investigations, contacting HCPs, patients, pharmacies, or payors as necessary.
- Document and communicate insurance details accurately in the appropriate system of record.
- Identify and report Adverse Event situations to Pharmacovigilance per FDA regulations.
- Collaborate cross-functionally to improve processes and productivity.
- Coordinated insurance verification procedures, optimizing patient eligibility determinations for streamlined access to services.
- Trained new staff on patient access protocols, fostering a collaborative environment and improving team performance.
- Processed insurance claims efficiently, ensuring accuracy and compliance with industry regulations.
- Implemented best practices for claims processing, improving turnaround time and reducing errors.
- Developed training materials for new staff on policy guidelines and claims procedures.
- Analyzed data trends to identify areas for process improvement and cost reduction initiatives.
- Enhanced customer satisfaction by addressing insurance-related inquiries and resolving issues promptly.
- Processed eligibility and benefits verification and authorization requests.
- Tracked pending authorizations to resolve discrepancies and avoid revenue loss.
Patient Access Representative
RUSH
Chicago, IL
02.2023 - 03.2024
- Maintained up-to-date medical charts and accurate intake assessments of insurance.
- Communicated with clinical teams, scheduled appointments, and managed medication refill referrals.
- Built relationships and trust with patients and their families.
- Handled prior authorization requests and switchboard redirection.
- Managed appointment scheduling, enhancing patient flow and reducing wait times through efficient calendar management.
- Facilitated patient registration processes, ensuring accurate data entry and compliance with healthcare regulations.
- Implemented process improvements in front desk operations, increasing efficiency and enhancing overall patient experience.
- Led initiatives to enhance communication between departments, promoting seamless information exchange for better care coordination.
- Analyzed patient feedback to identify service gaps, driving strategic changes that improved satisfaction ratings significantly.
- Stayed calm under pressure to and successfully dealt with difficult situations.
- Adapted quickly to changing demands within the healthcare environment, demonstrating flexibility and a strong commitment to quality patient care.
- Provided excellent customer service through active listening skills, understanding patient needs, and offering tailored solutions where applicable.
- Contributed to a positive work environment by fostering strong relationships among colleagues, promoting teamwork, and sharing best practices.
- Enhanced overall patient experience with empathetic communication and thorough explanations of insurance benefits and coverage.
- Facilitated smooth billing processes by verifying insurance eligibility, obtaining authorizations, and accurately entering claim details into the system.
- Streamlined patient registration processes by implementing efficient data collection methods and reducing wait times.
- Assisted with administrative tasks such as filing, data entry, and report generation to support streamlined office operations.
- Supported medical staff by coordinating diagnostic testing appointments, lab results retrieval, and necessary referrals in a timely manner.
- Demonstrated excellent problem-solving skills by identifying potential bottlenecks within the registration process and implementing effective solutions to address them.
- Collaborated with healthcare providers to ensure timely appointment scheduling and coordinated follow-up care for patients'' needs.
Patient Care Coordinator
Cano Health
Chicago, IL
01.2021 - 02.2023
- Maintained medical charts and intake assessments.
- Conducted monthly follow-up calls and home visits for safety checks.
- Appointment scheduling, and medication refills.
- Built relationships and trust with patients and support teams.
- Handled communication and follow-up calls with families regarding their experience with the facilities.
- Coordinated patient appointments, ensuring efficient scheduling and minimal wait times.
- Managed patient records using electronic health systems to maintain accuracy and compliance.
- Facilitated communication between patients and healthcare providers, enhancing care coordination.
- Trained new staff on operational protocols, promoting adherence to best practices in patient care.
- Oversaw team workflows, optimizing resource allocation to meet evolving patient needs.
- Analyzed patient data trends to identify opportunities for service improvement and operational efficiency.
- Managed sensitive patient information with strict adherence to HIPAA guidelines, maintaining confidentiality and privacy at all times.
- Provided exceptional customer service by addressing concerns, answering questions, and ensuring patient satisfaction with their care experience at the clinic.
- Enhanced patient satisfaction by efficiently scheduling appointments and managing patient flow.
- Streamlined communication between patients and healthcare providers, ensuring timely responses to inquiries and concerns.
- Trained new staff members on office procedures and protocols, ensuring consistency in patient care delivery.
- Communicated with insurance companies to verify coverage and obtain authorizations for medical treatments and procedures.
- Delivered excellent patient experiences and direct care.
- Coordinated with insurance companies for accurate billing and claim processing, reducing errors and financial discrepancies.
- Collaborated with interdisciplinary teams to create seamless transitions between various stages of treatment plans, enhancing continuity of care.
- Fostered strong relationships with referral sources for increased network connections, benefiting both the clinic and its patients through expanded resources.
- Acted as a knowledgeable resource for patients seeking information about community resources and support services available to them in their healthcare journey.
- Monitored inventory levels of medical supplies and equipment, placing orders when necessary to prevent shortages or delays in patient care provision.
- Implemented a more efficient system for managing medical records, resulting in faster access to crucial information during patient visits.
Patient Services Coordinator II
Private Home Care Services, LLC
Chicago, IL
03.2020 - 01.2021
- Maintained medical charts and accurate intake assessments.
- Conduct follow-up calls and home visits for safety checks, appointment scheduling, and medication reminders.
- Coordinated patient scheduling to optimize care delivery and enhance service efficiency.
- Implemented electronic health record systems to streamline patient information management.
- Developed training materials for new staff to ensure consistent service standards.
- Facilitated communication between healthcare providers and patients to improve care coordination.
- Led initiatives to standardize operational processes, improving workflow efficiency across teams.
- Analyzed patient feedback to identify service improvement opportunities and enhance satisfaction.
- Managed complex cases, ensuring tailored solutions that addressed individual patient needs effectively.
- Managed sensitive patient data with strict adherence to HIPAA regulations, ensuring privacy and confidentiality at all times.
- Provided patient with after-visit summary and scheduled next appointment to maintain continuous care and facilitate treatment plan.
- Responded effectively to challenging situations involving distressed or dissatisfied patients while maintaining a calm demeanor and positive attitude.
- Collected patient co-pay and issued receipt to confirm payment.
- Enhanced patient satisfaction by efficiently scheduling appointments and handling registration tasks.
Direct Support Professional (DSP)
Benchmark Human Services
Hobart, IN
02.2020 - 01.2021
- Ensure the care and safety of individuals with disabilities.
- Provide support with Activities of Daily Living.
- Provided personalized support to individuals with disabilities, enhancing daily living skills and independence.
- Developed and implemented individualized care plans in collaboration with multidisciplinary teams.
- Monitored client progress, documenting observations and adjusting care strategies as needed.
- Trained new staff on best practices for client interaction and safety protocols, fostering a supportive team environment.
- Advocated for clients' needs within community resources, ensuring access to essential services and supports.
- Led workshops on life skills, empowering clients to achieve personal goals and improve self-sufficiency.
- Evaluated program effectiveness through client feedback, driving continuous improvement in service delivery methods.
- Documented progress notes thoroughly to track client achievements, concerns, or changes in behavior patterns that may need attention from the interdisciplinary team.
- Assisted with crisis intervention to de-escalate challenging behavior and maintain peaceful encounters.
- Enhanced quality of life for individuals with disabilities by providing compassionate and consistent direct support.
- Assisted clients in achieving personal goals through tailored care plans and daily skill-building activities.
- Supported clients with personal care tasks, ensuring their dignity and privacy were maintained at all times.
- Monitored medication administration, maintaining accurate records to ensure client safety and compliance with prescribed treatment plans.
- Participated in ongoing training opportunities to stay current on best practices in disability support services.
- Assisted disabled clients to support independence and well-being.
- Facilitated social outings and community integration activities, promoting inclusion and positive experiences for clients.
- Maintained a safe and inclusive environment by addressing behavioral challenges with patience and understanding.
- Monitored clients to assess and report physical and behavioral changes to supervisors.
- Encouraged and supported clients to participate in recreational and leisure activities to promote social interactions and reduce loneliness.
- Addressed emergency situations calmly and effectively, prioritizing the safety of both clients and staff members involved.
- Promoted physical well-being by supporting clients in engaging in regular exercise routines or therapeutic activities suited to their abilities.
- Transported clients to medical and dental appointments to provide support.
- Monitored progress and documented patient health status changes to keep care team updated.
- Improved client self-sufficiency through teaching essential skills such as meal preparation, housekeeping, and financial management.
- Implemented individualized behavior management plans, reducing incidents of challenging behaviors within the residence.
- Adapted support approaches based on individual client preferences, fostering increased trust and rapport over time.
- Advocated for clients'' rights within the broader community, raising awareness about issues affecting those with disabilities.
- Organized recreational events that encouraged relationship building among clients and increased their sense of belonging within the group home setting.
- Served as a reliable point of contact for family members, maintaining open lines of communication about client progress and addressing any concerns promptly.
- Collaborated with interdisciplinary teams to develop comprehensive support strategies for each client''s unique needs.
Customer Service Representative
PCG Consulting
Chicago, IL
01.2020 - 01.2021
- Handled inbound calls regarding healthcare coverage.
- Managed high-volume customer service, including benefits/eligibility and appointment scheduling.
- Delivered exceptional customer support through effective communication and problem-solving skills.
- Managed customer inquiries via phone, email, and chat while maintaining high satisfaction levels.
- Trained new staff on customer service protocols and company systems to enhance team performance.
- Developed strategies to improve response times and streamline issue resolution processes.
- Collaborated with cross-functional teams to address customer feedback and implement service enhancements.
- Analyzed customer data to identify trends, informing adjustments in service delivery practices.
- Led initiatives to enhance training materials, resulting in improved onboarding experiences for new hires.
- Implemented quality assurance measures to maintain compliance with operational standards and improve service consistency.
- Managed high-stress situations effectively, maintaining professionalism under pressure while resolving disputes or conflicts.
- Resolved customer complaints with empathy, resulting in increased loyalty and repeat business.
- Handled escalated calls efficiently, finding satisfactory resolutions for both customers and the company alike.
- Enhanced customer satisfaction by promptly addressing concerns and providing accurate information.
- Responded to customer requests for products, services, and company information.
- Developed rapport with customers through active listening skills, leading to higher retention rates and positive feedback from clients.
- Developed strong product knowledge to provide informed recommendations based on individual customer needs.
- Collaborated with team members to develop best practices for consistent customer service delivery.
CNA/Med Tech Lead/Weekend On-Call Scheduler
Wellmore
Charleston, SC
12.2017 - 02.2020
- Assisted with scheduling, staffing management, and resolving staffing issues.
- Developed and implemented safety plans for staffing during emergencies.
- Provided compassionate care to patients, ensuring comfort and dignity in daily activities.
- Assisted with mobility and transfers, promoting safety and independence for residents.
- Monitored vital signs, documenting changes accurately to inform healthcare teams.
- Trained new staff on protocols and best practices, enhancing team performance and efficiency.
- Collaborated with nursing staff to develop individualized care plans based on patient needs.
- Implemented infection control measures, contributing to a safe environment for patients and staff.
- Advocated for patient needs during interdisciplinary meetings, improving overall care quality.
- Developed strong relationships with families, ensuring effective communication regarding patient progress and concerns.
- Assisted patients with daily living activities, promoting independence and dignity.
- Checked patient vitals such as temperature, blood pressure, and blood sugar levels.
- Promoted good oral and personal hygiene by aiding patients with shaving, bathing, and teeth brushing.
- Enhanced patient satisfaction by providing compassionate and attentive care.
- Maintained confidentiality of patient information according to HIPAA guidelines while communicating effectively with team members about critical updates.
- Answered call lights and supported patient comfort and safety by adjusting bed rails and equipment.
- Utilized proper body mechanics and assistance devices when transferring patients, minimizing the risk of injury for both parties.
- Ensured prompt response to call lights, addressing patient needs in a timely manner.
- Assisted with feeding and monitored intake to help patients achieve nutritional objectives.
- Delivered individualized patient care by recording vital signs, documenting observations, administering treatments, and evaluating patient needs.
- Prevented bedsores by regularly repositioning patients and implementing proper wound care techniques.
- Implemented fall prevention measures by identifying high-risk patients and maintaining clutter-free environments around bedsides.
- Provided emotional support for patients during challenging times, fostering a positive healing environment.
- Cared for residents in assisted living facility and delivered high-quality support to meet needs.
- Reduced patient stress levels through effective communication and active listening skills.
- Promoted infection control practices within the facility by adhering to strict hand hygiene procedures and utilizing personal protective equipment when necessary.
- Cared for clients with diagnoses such as respiratory failure, diabetes, Parkinson's disease and muscular dystrophy.
- Offered immediate assistance in emergency and routine paging situations to evaluate needs and deliver care.
- Oversaw and maintained patients' rooms, group living areas, and nurse stations.
- Evaluated patients to identify and address wounds, behavioral concerns, and medically relevant symptoms.
- Assisted in emergency situations under the direction of nursing supervisors or physicians, providing crucial support during life-saving interventions.
- Supported ambulation and physical therapy needs by conducting planned exercise routines.
- Participated in ongoing educational opportunities in order to stay up-to-date on best practices in nursing care.
- Conducted basic physical assessments on new admissions to gather baseline data for nursing staff evaluation.
- Collaborated with interdisciplinary healthcare teams to develop and implement individualized care plans for patients.
- Served as a liaison between patients, families, and medical staff to ensure clear communication and understanding of treatment plans.
- Facilitated smooth patient transitions from hospital settings to home or long-term care facilities, ensuring continuity of care throughout the process.
Remote Customer Service Representative
Teleperformance
Columbia, SC
10.2007 - 12.2016
- Troubleshoot issues for residential and business customers in a call center environment.
- Handled high-volume calls and resolved billing and connection issues.
- Resolved customer inquiries through effective communication and problem-solving techniques.
- Managed high-volume calls while maintaining professionalism and empathy in interactions.
- Trained new team members on customer service protocols and system navigation.
- Implemented process improvements to enhance response times and customer satisfaction rates.
- Collaborated with cross-functional teams to address complex customer issues efficiently.
- Created detailed documentation for recurring issues, streamlining future troubleshooting efforts.
- Analyzed customer feedback to identify trends and recommend improvements to services offered.
- Led initiatives for quality assurance, ensuring compliance with company standards and policies.
- Maintained detailed records of customer interactions, ensuring proper follow-up and resolution of issues.
- Assisted customers in navigating company website and placing online orders, improving overall user experience.
- Contributed to sales growth by upselling products and services based on individual customer requirements.
- Provided coaching and mentoring to new hires, contributing to their successful integration into the team.
- Exceeded performance metrics consistently, earning recognition as a top performer within the team.
- Maintained detailed records of customer interactions, contributing to comprehensive database for future reference.
- Implemented rewards program that encouraged repeat business and strengthened customer relationships.
- Collaborated with product team to communicate customer feedback, resulting in product enhancements.
- Boosted team morale by consistently recognizing colleagues' contributions and achievements.
- Participated in training programs to enhance product knowledge and customer service skills.
Education
High School Diploma -
High School Diploma - undefined
PATCH Career Institute
10.2018
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James Island High School
James Island, SC01.2003
Skills
- Customer Service
- Member Engagement
- Empathy and Compassion
- Aetna Plans Knowledge
- Problem Resolution
- Call Center Experience
- Transaction-Based Environment
- Healthcare Customer Support
- Dental Service Knowledge
- Customer Education
- Written Correspondence
- Production Environment
- Issue Resolution
- Customer Inquiries
- Plan Sponsor Communication
- Tools and Resources Guidance
- Policy analysis
- Documentation skills
- Reporting skills
- Regulatory compliance
- Insurance law
- Claims management
- Documentation
- Customer service
- Client relations
- Account management expertise
- Underwriting expertise
- Health insurance
- CRM software
- New client acquisition
- Revenue generation
- Email marketing
- Legal codes
- Marketing strategies
- Customer follow-up
- Policy adjustment
- Critical thinking
- Insurance coverage verification
- Customer complaint resolution
- Customer billing
- Records maintenance
- Data entry
Timeline
Insurance Specialist 1
Insurance Specialist 1
03.2024 - Current
Patient Access Representative
RUSH
02.2023 - 03.2024
Patient Care Coordinator
Cano Health
01.2021 - 02.2023
Patient Services Coordinator II
Private Home Care Services, LLC
03.2020 - 01.2021
Direct Support Professional (DSP)
Benchmark Human Services
02.2020 - 01.2021
Customer Service Representative
PCG Consulting
01.2020 - 01.2021
CNA/Med Tech Lead/Weekend On-Call Scheduler
Wellmore
12.2017 - 02.2020
Remote Customer Service Representative
Teleperformance
10.2007 - 12.2016
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James Island High School
High School Diploma - undefined
PATCH Career Institute
High School Diploma -
Section name
- Dear [Hiring Manager's Name]
- I am excited to apply for the Dental Customer Service Representative position at CVS. My background in customer service, combined with my passion for delivering empathetic and compassionate support, makes me a strong candidate for this role. I am confident in my ability to contribute positively to your team and provide an exceptional member experience.
- In my previous roles, I have developed expertise in key areas directly aligned with Aetna’s priorities, including:
- Customer Service: Demonstrated excellence in addressing customer needs in high-volume, fast-paced environments, maintaining professionalism and building trust with members.
- Call Center Experience: Managed large volumes of incoming inquiries, efficiently resolving issues while adhering to quality and productivity standards.
- Empathy and Compassion: Delivered member-focused support by actively listening to concerns and offering personalized solutions to meet unique needs.
- Issue Resolution: Successfully resolved complex member inquiries, balancing attention to detail with timely follow-through to achieve high satisfaction rates.
- Transaction-Based Environment: Thrived in performance-driven roles that required consistent delivery of measurable results, including meeting targets for speed and accuracy.
- I am particularly drawn to CVS’s commitment to guiding members through their healthcare journey with accessible resources and exceptional support. My ability to engage with members, educate them on services, and provide clear communication positions me to excel in this role.
- Thank you for considering my application. I would be delighted to discuss how my skills and experiences align with Aetna’s needs.
- Sincerely
- [Your Full Name]
- [Your Contact Information]