Rachelle Johnson
Frisco,TX
Summary
Dedicated and experienced professional with a strong educational background and over 5 years of expertise in IT data analytics. Actively seeking a challenging position in the healthcare industry. Proficient in R and Python programming, data visualization, and skilled in conducting extensive research and delivering impactful presentations. Possesses the necessary competencies to effectively communicate complex information. Eager to utilize skills and knowledge to contribute to the success of an organization in the field of healthcare.
Overview
10
10
years of professional experience
1
1
Certification
Work History
Root Cause Analyst
Teladoc Health
Lewisville, TX
05.2016 - Current
- Collaborated with diverse clients daily to guarantee prompt responses to all member requests and resolve escalated issues, driving high member satisfaction
- Researched and resolved 100+ account issues monthly including eligibility, technical support, and portal navigation to maintain seamless member experiences
- Performed operational tasks like processing 150+ refund petitions, compiling legal documents, addressing physician complaints, and sending compliance notifications weekly to uphold policies and regulations
- Managed member accounts end-to-end including enforcing HIPAA standards, reporting incidents, and fielding billing inquiries to safeguard privacy/security
- Disclosed necessary information properly to perform job duties while maintaining confidentiality of protected health information for 100% compliance
- Monitored queues to meet 24-hour SLA daily, resolving 90% of tickets within 4 hours
- Served as the main point of contact for other departments and point person for billing questions, providing excellent cross-department collaboration
- Maintained up-to-date knowledge of policies, compliance standards, and regulations to provide accurate information to members and providers.
Member Service Specialist
Teladoc Health
Lewisville, TX
08.2014 - 05.2016
- Represented Teladoc professionally to over 50 million members and 150+ major clients like Aetna and UnitedHealthcare, delivering excellent customer service
- Responded to member requests for registration, medical records, appointment scheduling, and other services
- Interacted cross-functionally with various internal and external departments to resolve member problems and escalations
- Handled irate call volume with empathy and redirected members appropriately, resolving concerns
- Ensured 100% HIPAA compliance across all procedures and processes through real-time monitoring and training
- Developed strong relationships with members by providing personalized and timely responses to inquiries
- Streamlined registration and scheduling processes by 33% through cross-functional collaboration
- Reduced irate call volume by 35% by implementing new de-escalation protocols
- Created knowledge base documents and FAQs to enable self-service options for members
- Identified process gaps and recommended improvements to enhance compliance monitoring
- Pinpointed major drivers of irate calls as registration difficulties and proposed registration flow optimizations
- Analyzed trends in HIPAA violations to highlight areas needing improved protocols and delivered targeted training
- Conducted testing to reveal system limitations for medical records requests and sug
Skills
- Cause and effect analysis
- Account
- Documentation and reporting
- Microsoft Office
- Tier II Tech support
- Customer support management
- Root cause analysis
- Verbal and written communication
- Data entry
- Complaint resolution
- Salesforce
- Zendesk
Certification
Professional Scrum Master I (PSM I)
Timeline
Root Cause Analyst
Teladoc Health
05.2016 - Current
Member Service Specialist
Teladoc Health
08.2014 - 05.2016
Professional Scrum Master I (PSM I)