Summary
Overview
Work History
Education
Skills
Certification
Activities
Timeline
Generic

Rachel Davidson

Jeffersonville,Indiana

Summary

Highly experienced Healthcare and Contact Center Professional with over 12 years of progressive experience in Call Center and Call Center Leadership, Medical Assisting, Billing and Coding, and Patient Account Management. Proven track record in customer service, team leadership, training facilitation, and subject matter expertise. Strong background in insurance processes, compliances, and healthcare operations. Recognized for process improvement, employee engagement, and delivering exceptional member and team experience.

Overview

12
12
years of professional experience
3
3
Certification

Work History

Inbound Contact Representative 2/SME/Facilitator/Interim Team Lead

Humana
01.2021 - Current
  • Subject Matter Expert (SME)
  • Certified SME; 03/2023
  • Rep Advocate
  • Assist in chat, answering rep questions as needed.
  • Work multiple reports; Hospices, Multiple INOs, BAE Mailbox, Voicemail (pulling and making callbacks).
  • Assist Supervisor and Team lead as necessary for additional projects, including PPT, SME side by side (Feedback), and to follow up on cases for review.
  • Created Huddle Notes
  • Ran team huddle
  • Authored and co-authored multiple process related PPTs.
  • Team Engagement; Created multiple games within Teams for Team Engagement within the department.
  • Interim Team Lead
  • Assisted as Interim Team Lead; 03/26/2025-04/21/2025
  • Completed monthly side by side with representatives
  • Followed up on and forwarded Exception Requests to RSO
  • Assisted supervisor
  • Troubleshoot team issues.
  • Posted reminders for team in Teams chat.
  • Forwarded process reminders to team as needed through email.
  • Created Huddle Notes
  • Ran team huddle
  • Observed meetings
  • Facilitator
  • Certified Facilitator; 04/2024
  • Review training materials and class preparation.
  • Monitoring attendance
  • Co-Created department Refresher Training
  • Facilitated curriculum
  • Lead facilitator for multiple Upskill/Bailout training classes
  • Inbound Contact Representative
  • Inbound calls from members, providers and pharmacies, verifying eligibility for LINET coverage (temporary Part D), as well as resolving issues and assisting with claims processing. Also assisting callers with general questions and questions regarding Direct Member Reimbursement and letters received.
  • Making Outbound calls as needed to return voicemail messages from members/callers. As well as making Outbound Calls to assist with Immediate Need Overrides and resolve patient issues as needed.
  • Updating systems (CRM) to notate calls; as well as notating additional system as needed; CI when reviewing case.
  • Reviewing system; RX Connect to check the status of denied claims as well as to check for additional information as needed.
  • Call de-escalation
  • STAR Award
  • Star Award-Bronze- 04/2024
  • Star Award- Bronze- 08/2024
  • Star Award- Silver- 05/2024
  • Star Award- Bronze- 03/2025
  • Adapted communication style based on individual preferences or cultural backgrounds of clients, ensuring clear understanding from both parties.

Supervisor/Team Lead/Patient Account Representative

Med Assist
01.2017 - 08.2021
  • Started as Patient Account Representative at Med Assist then moved into a Team Lead and then Supervisor role within that same department.
  • Patient Account Representative
  • Assisted un-insured hospital patients with enrolling into either Medicaid within the state or hospital financial assistance.
  • Answered both Inbound Calls as well as making Outbound Calls to assist members with enrollment and then following up on that enrollment up through approval.
  • Team Lead
  • Team Lead for both Mercy Health Hospital as well as Columbus
  • Run and filter reports to distribute workflow for team to work.
  • Monthly meetings with leadership to speak on Inventory.
  • Side by side with representatives
  • Monitored employee terminations with Supervisor and HR.
  • Supervisor
  • Ran and filtered reports to review Inventory and distribute work as needed to team.
  • Supervisor for; Mercy Health, Columbus, Dialer Team and Data Entry
  • Supervisor over 25 representatives.
  • Quality Audits for all teams
  • Monitored and approved vacation requests.
  • Monitored attendance and point system.
  • Monthly side by side
  • Weekly/Monthly meetings with leadership and upper leadership to review and speak on Inventory.
  • Employee Termination along with HR

Certified Medical Assistant/Front Desk/Billing

The Pain Management and Rehabilitation Center
04.2013 - 01.2017
  • Front Desk
  • Worked multiple offices, Jeffersonville Indiana and Seymour Indiana
  • Front desk intake; check in and check out.
  • Taking copays as needed.
  • Updated patient information as needed.
  • Updated patient plan information as needed.
  • Contacted insurance to obtain PAs for members procedures.
  • Scheduled referrals to other offices for visits/procedures.
  • Reminder calls for patient visits
  • Billing
  • Coded/Billed office visits and procedures.
  • Updated electronic paid claims in patient accounts
  • Updated paper paid claims in patient accounts
  • Followed up insurance on pending and denied claims.
  • Sent accounts to collections as needed.

Education

Associate of Applied Science - Medical Assisting, Technical Certificate Medical Billing and Coding

Ivy Tech Community College
Sellersburg, IN
04.2013

Skills

  • Team Management
  • Results-oriented
  • Team player
  • Strong Communication Skills
  • Leadership skills
  • Word
  • Excel
  • PowerPoint
  • CRM
  • Analytical Skills
  • RX Nova
  • PA Hub
  • CI
  • Epic
  • Greenway PrimeSUITE
  • Conflict Resolution
  • Deadline Management
  • Detail-Oriented
  • Education
  • Insurance
  • Quality Standards Inbound Calls
  • Outbound Calls
  • Data Entry
  • Scheduling
  • Workflow Management
  • Billing
  • Confidentiality
  • Customer Care
  • Documentation
  • Financial Assistance
  • Medicaid
  • Problem Solving
  • Claims Processing

Certification

  • Facilitator Certification; 04/2024
  • Subject Matter Expert (SME); 03/2023
  • Technical Certification/Billing and Coding; Ivy Tech-04/2013

Activities

Antique stores crafts family time

Timeline

Inbound Contact Representative 2/SME/Facilitator/Interim Team Lead

Humana
01.2021 - Current

Supervisor/Team Lead/Patient Account Representative

Med Assist
01.2017 - 08.2021

Certified Medical Assistant/Front Desk/Billing

The Pain Management and Rehabilitation Center
04.2013 - 01.2017

Associate of Applied Science - Medical Assisting, Technical Certificate Medical Billing and Coding

Ivy Tech Community College

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