Raondra Love
Mount Prospect,IL
Summary
Self-motivated Benefits Specialist demonstrating superior understanding of employee benefits laws and human resource software systems. Astute professional providing benefits support in fast-paced corporate settings.
Overview
10
10
years of professional experience
Work History
Benefits Verification Specialist
Endeavor Health
01.2024 - Current
- Reviews and analyzes all required demographic, insurance/financial, and clinical data procured by patient intake and registration areas necessary to expedite payment on patient's accounts
- Resolves all issues including obtaining information and signatures on documents required by the patient's insurance carrier
- Corrects information in both the Patient Management System and Patient Account Systems
- Interacts, via telephone and in person, with patients, their representatives, physicians, physician's office staff, employers, and others, and reviews new and previously recorded patient, insurance and procedural information
- Electronically records all phone interactions and records resolution to follow-up items in a timely manner
- Communicates hospital policies to patients or their representatives
- Follows HIPAA, payer and applicable regulations and standards for registration and billing
- Performs pre-certification notification via telephone or electronically and gathers and completes all required documentation for submission to insurance carriers per payer requirements
- Enters patient procedure insurance and benefits eligibility information into the hospital Patient Management and Patient Accounting computer systems
- Ensures patient has coverage for procedure to be performed with a minimum standard set by Access Services Policy in advance of scheduled procedure
- Acts as a liaison between patients and physicians with insurance companies to pre-certify all inpatient, outpatient and observation procedures/cases per insurance contract requirements
- Notifies patients, physicians and ancillary departments regarding procedures that are potentially not covered and coordinates with Financial Counselors to initiate payment plan arrangements prior to patient services being rendered.
Patient Support Associate
Endeavor Health
03.2023 - 01.2024
- Complete patient registration, check in and check out patients
- Review schedules to ensure accuracy and fill appointment opportunities
- Schedule and reschedule appointments
- Collect, verify, update and document patient demographics, insurance information and forms
- Verify active insurance coverage and status and keep information updated
- Collect patients payments, balances and co-pays
- EPIC Systems, Health Information Systems, Revenue Cycle.
Customer Experience Associate
Rent the Runway
03.2021 - 01.2022
- Documented customer correspondence in CRM to track requests, problems and solutions
- Upheld quality control policies and procedures to increase customer satisfaction
- Resolved customer inquiries, questions and concerns to consistently offer quality service and meet performance benchmarks
- Monitored QA procedures for adherence by employees, notifying personnel of non-compliance issues
- Executed and developed methods to obtain post-production product feedback from customers
- Reorganized and revised standard operating procedures to streamline processes and improve communication and collaboration.
Store Manager
Lane Bryant
02.2016 - 01.2022
- Hire, train, developed to staffing needs
- Ensure strategic goals and sales targets of the store are met by maximizing sales and profit, reviewing sales performance, controlling expenses and managing inventory
- Drive customer service excellence to every aspect of the store, including store appearance, display of merchandise, product placement, story layout and selling procedures
- Coordinate daily staffing and staffing schedules, provide staff with feedback, coaching, and performance evaluations
- Perform administrative tasks to support store operations
- Including timely submissions of all personnel paperwork, preparing and submitting reports, and monitoring sales receipts and cash
- Monitor stock and inventory, and perform quality assurance of merchandise on a regular basis.
Customer Service Team Leader
Eileen Fisher
04.2016 - 02.2019
- Interviewed, hired, and coordinated training of new team members
- Assisted in escalated customer problems via phone, email, and live chat
- Conducted regular call monitoring to ensure a superior client experience
- Coached, motivated & counseled staff on performance including administering disciplinary action when necessary
- Communicated performance expectations and monitored performance plans
- Participated in project meetings, created new processes and procedures, and trained agents accordingly
- Coached sales associates in product specifications, sales incentives and selling techniques, significantly increasing customer satisfaction ratings
- Reviewed and monitored scheduling, purchases and other expenses to maintain quarterly budget
- Maintained proper product levels and inventory controls for merchandise and organized backroom to facilitate effective ordering and stock rotation.
Merchandise Coordinator
TJ Maxx
06.2014 - 12.2016
- Ensure an excellent customer experience by engaging and interacting with all customers, and maintaining a clean and organized store
- Truck delivery, prioritizing the processing of merchandise onto the sales floor
- Takes an active role in training and mentoring associates, assisted the store manager and merchandising manager in the areas of merchandising, operations, and customer service within a high volume store
- Organized on-site trainings to educate management and sales staff on benefits and care of product lines
- Supervised departmental employees, promotes safety awareness and supports the store shrink reduction goals
- Promotes credit and loyalty programs during customer interactions.
Customer Service Specialist
Macys
07.2015 - 09.2016
- Answered inbound calls, chats and emails to facilitate customer service
- Fielded customer complaints and queries, fast-tracking for problem resolution
- Upheld quality control policies and procedures to increase customer satisfaction
- Escalated customer concerns, issues and requirements to supervisors for immediate rectification
- Mentored new employees on procedures and policies to maximize team performance.
Education
Certificate in Human Resources -
Harper College
Palatine, IL12.2018
Bachelors in Textile, Apparel & Merchandising -
Northern Illinois University
Dekalb, IL05.2015
Associate of Applied Science in Business Administration -
Ivy Tech Community College
Anderson, IN05.2013
Skills
- Accuracy and Precision
- Healthcare regulations
- Policy Interpretation
- Verbal and written communication
- Written and oral communication
- Benefits Explanation
Timeline
Benefits Verification Specialist
Endeavor Health
01.2024 - Current
Patient Support Associate
Endeavor Health
03.2023 - 01.2024
Customer Experience Associate
Rent the Runway
03.2021 - 01.2022
Customer Service Team Leader
Eileen Fisher
04.2016 - 02.2019
Store Manager
Lane Bryant
02.2016 - 01.2022
Customer Service Specialist
Macys
07.2015 - 09.2016
Merchandise Coordinator
TJ Maxx
06.2014 - 12.2016
Certificate in Human Resources -
Harper College
Bachelors in Textile, Apparel & Merchandising -
Northern Illinois University
Associate of Applied Science in Business Administration -
Ivy Tech Community College
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