Quinton Cleveland
Orlando,FL
Summary
Talented Team Leader experienced and dedicated to enhancing employee satisfaction and business success. Diplomatic and friendly with proven commitment to employee training. Hardworking team player bringing necessary experience and knowledge to tackle any operational demand.
Overview
11
11
years of professional experience
Work History
Reimbursement Specialist
Johnson & Johnson
Orlando, FL
04.2024 - Current
- Provided exceptional customer service when responding to patient inquiries about reimbursement status and procedures.
- Supported company objectives by maintaining compliance with all relevant state and federal regulations governing medical billing practices.
- Identified trends in reimbursement denials, recommending process improvements to minimize future occurrences.
- Advanced internal communication channels by sharing best practices among colleagues, fostering an environment of continuous learning and improvement.
Supervisor
Caremetx "Coherus"Blizzard
Lake Mary, FL
08.2023 - 04.2024
- Collaborated with other department leads to streamline workflows, improve interdepartmental coordination, and achieve business goals collectively.
- Conducted regular performance evaluations, setting clear expectations and providing constructive feedback to support professional growth.
- Led weekly team meetings to discuss performance goals, share best practices, and maintain open communication among team members.
- Monitored team metrics, identifying opportunities for improvement and implementing targeted coaching plans.
- Improved team productivity by implementing efficient project management strategies and streamlining communication channels.
- Managed and motivated 30 plus employees to be productive and engaged in work.
Team Lead/Senior Case Manager
United BioSource "Acthar"
Lake Mary, FL
08.2022 - 08.2023
- Maintained patient records by reviewing case notes; logging events and progress.
- Monitored cases by verifying patient attendance; observing and evaluating treatments and responses; advocating for needed services and entitlements; obtaining additional resources; providing personal support.
- Utilized grant writing skills to secure additional program funding.
- Enhanced communication between clients and providers through consistent follow-ups and progress updates.
- Assisted in tracking and following up on the status of specialty case referrals.
- Managed an diverse team of professionals, fostering an positive work environment and high employee satisfaction.
- Directed and supervised a team of 20 individuals who were engaged in both business as usual (BAU) operations and pharmacy development.
Patient Access Specialist
AssistRx "Insulet Corporation"
Orlando, FL
01.2020 - 08.2022
- Conducted outside calls to vendors, insurance companies for verification and eligibility request.
- Conducted followed up calls related to co-pay programs.
- Obtained patient's insurance information and determined eligibility for benefits for specific services rendered.
- Contributed to a positive work environment through effective teamwork and communication with colleagues.
- Protected the safety of patient information by verifying patient identity to preserve the integrity of the patient record and ensures all records are complete, accurate, and unique to one patient.
- Demonstrated flexibility adapting quickly during peak hours or emergencies prioritizing tasks effectively meeting deadlines.
Senior Patient Care Coordinator
Kroger Specialty Pharmacy
Orlando, FL
01.2019 - 01.2020
- Documented case activity, communications and correspondence in computer system to ensure completeness and accuracy of patient contact records.
- Ensured work activities are conducted in compliance with regulatory requirements and the organization’s defined standards and procedures, and in a manner that provides the best available level of service and quality.
- Contacted patients to schedule delivery of medications in keeping with their requirements or to communicate refill denials and encourage follow up contact with their prescription provider.
- Facilitated communication between internal team, patients and prescribers offices to support patient’s therapy compliance through transmittal of status updates, template letters, notifications of triage or transfer, and other similar actions designed to maintain effective and efficient response and superior service quality.
Customer Service Advocate
OptumRx
Orlando, FL
07.2016 - 12.2018
- Partnered with other departments to research and resolve pharmacy related issues and claim rejections.
- Adhered to quality and production standards while complying with all applicable company, state and federal safety standards.
- Managed high call volume during peak hours, prioritizing urgent cases while maintaining attention to detail.
- Participated in regular performance evaluations, consistently exceeding expectations in key metrics such as first-call resolution rate.
- Promoted superior experience by addressing customer concerns, demonstrating empathy, and resolving problems swiftly.
Patient Care Advocate
Express Scripts/Accredo Pharmacy
Orlando, FL
11.2014 - 07.2016
- Handled customer service inquiries from members, providers, physicians and internal and external clients related to pharmacy benefits.
- Answered questions related to pharmacy benefits, while maintaining productivity standards and performance guarantees where applicable.
- Worked with other operational departments to research and resolve mail order and claims issues and respond to members within performance agreement guidelines.
- Enhanced patient satisfaction by addressing concerns and providing clear communication on treatment plans.
Education
High School Diploma -
Maynard Evans High School
Orlando, FL06.2011
Skills
- Pharmaceutical processing expertise
- Calculations in pharmacy settings
- Terminology in medical fields
- Drug safety and classification knowledge
- Inventory management for medications
- Compliance with FDA regulations
- Building customer relationships and service excellence
- Advocacy for clients and team oversight
- Management of workforce development initiatives
- Effective verbal and written communication skills
- Certified in CPR techniques
- Proficient in Five9 and Connect platforms
- Salesforce application skills
- Expertise in Microsoft Office suite tools
- Familiarity with policy management systems like PolicyTech, Kronos, Paycom, and Paylocity
Education
true
Timeline
Reimbursement Specialist
Johnson & Johnson
04.2024 - Current
Supervisor
Caremetx "Coherus"Blizzard
08.2023 - 04.2024
Team Lead/Senior Case Manager
United BioSource "Acthar"
08.2022 - 08.2023
Patient Access Specialist
AssistRx "Insulet Corporation"
01.2020 - 08.2022
Senior Patient Care Coordinator
Kroger Specialty Pharmacy
01.2019 - 01.2020
Customer Service Advocate
OptumRx
07.2016 - 12.2018
Patient Care Advocate
Express Scripts/Accredo Pharmacy
11.2014 - 07.2016
High School Diploma -
Maynard Evans High School