Raquel Washington
Pooler ,GA
Summary
Talented Manager, Customer Service, Care Manager, Insurance Billing, Claims, Collections, Computer expert, Front Desk Manager , Work From Home with expert team leadership. 25 sum years of experiences on planning and organizational skills built during successful career. Smoothly equip employees to independently handle daily functions and meet customer needs. Diligent trainer and mentor with exceptional management abilities and results-driven approach.
Overview
10
10
years of professional experience
Work History
Service Contractor
HGS HUMANA
Atlanta , GA
08.2021 - Current
- Maintained customer satisfaction with forward-thinking strategies focused on addressing customer needs and resolving concerns.
- Provided primary customer support to internal and external customers.
- Developed community reputation through commitment to customer satisfaction and strong client relationships.
- Provided information regarding charge accounts and loyalty programs.
- Used CRM to post medical charges, payments and adjustments.
- Initiated outbound customer calls to review policy reviews and late payments to avoid lapse in coverage.
- Directed incoming calls to internal personnel and departments, routing to best-qualified department.
- Examined claims forms and other records to determine insurance coverage.
- Evaluated evidence with ultimate goal of creating positive outcomes for client's claims.
- Reviewed field inspections and coordinated all insurance claim audits.
- Maintained positive customer relations by addressing problems head-on and implementing successful corrective actions.
- Verified insurance coverage by telephone and online to guarantee proper reimbursement of benefits and estimate patients' financial responsibilities.
- Scanned, received and sent faxes to insurance claims, co-pay assistance information and patient documentation.
- Kept digital records of patient details, medications, billing and other activities.
Front Desk Manager
Just Believe Counseling Service LLC
Brunswick, GA
03.2016 - 08.2021
- Held quarterly office meetings with staff to answer questions, resolve issues and keep employees informed of changes.
- Built and maintained positive staff relationships to promote teamwork and better serve clients.
- Facilitated on-site activities, support groups and outings for clients.
- Completed documentation for every incident and forwarded to correct personnel for review.
- Performed client intake procedures according to internal standards for new admissions.
- Recognized individuals under influence of drugs or alcohol and typical behaviors associated with each.
- Coordinated with medical and paramedical professionals to provide appropriate input and effectively formulate and implement treatment plans for patients.
- Prepared and submitted daily [Type] reports to management.
- Monitored, tracked and conveyed important patient information to healthcare staff to help optimize treatment planning and care delivery.
- Visited individuals in homes and attended group meetings to provide information on agency services, requirements and procedures.
- Implemented performance review and motivational strategies to elevate HR team results.
- Evaluated training program success and presented strategic improvement recommendations to upper management.
- Maintained payroll and benefits for employees in various locations and diminished financial discrepancies through expert program management.
- Coordinated with senior leadership and handled managerial needs by implementing fresh solutions into business strategies.
- Facilitated onboarding sessions and on-the-job training for new hires, bolstering employee job position knowledge and skillset.
- Managed Access databases converting complex data into easy-to-interpret data.
- Generated reports and typed letters in Word and prepared PowerPoint presentations.
- Processed invoices and expenses using QuickBooks to facilitate on-time payment.
- Created PowerPoint presentations for business development purposes.
- Coached new employees on administrative procedures, company policies and performance standards.
- Answered multi-line phone system, routing calls, delivering messages to staff and greeting visitors.
- Organized weekly staff meetings and logged minutes for corporate records.
- Scheduled office meetings and client appointments for staff teams.
Case Manager
Gateway Behavioral Health
Brunswick , GA
11.2011 - 03.2016
- Increased referral rates by providing excellent service and building meaningful relationships with patients and caregivers.
- Identified care needs of individual patients and coordinated responses based on physician advice, insurance limitations and procedural costs.
- Participated in professional growth programs to support special education improvement efforts.
- Developed positive relationships with parents to foster communication and encourage involvement for student growth.
- Managed support services and fostered communication among social workers, therapists, hospital staff and patients.
- Addressed delays in discharge, postponed procedures and discharge equipment unavailability.
- Consulted with clinicians to devise and manage ongoing care plans for at-risk patients.
- Educated patients and loved ones about different treatment options and outside care approaches to reduce burden on hospital resources.
- Helped patients receive appropriate, high-quality care with reasonable results.
- Applied evidence-based techniques such as behavioral activation, problem-solving treatment and motivational interviewing to support behavioral interventions.
- Verified successful coordination of counseling efforts with mental health professionals, doctors, social workers and other stakeholders.
- Conducted assessments to determine individual needs and developed personalized care plan to address stated objectives.
- Managed over 25 patients while monitoring and evaluating care plans.
- Recorded patient progress and treatment recommendations to be shared with medical providers, psychiatric consultants and other treating providers.
- Involved clients' family members in planning social service programs.
- Developed goal-oriented psychoeducational and activity therapy groups to improve clients' level of functioning.
- Worked collaboratively with other mental health professionals to provide consistent care and minimize diversion.
- Managed caseload of 50 patients with substance dependence and co-occurring Axis I and Axis II disorders.
- Encouraged patients to discuss experiences in group and individual settings.
- Provided comprehensive case management services, created treatment plans and connected clients and families to appropriate resources.
- Worked with medical teams, patients and families to implement effective treatment plans.
- Coordinated program referrals for community-based resources.
- Organized clinical documentation, treatment plans, and referrals.
- Coordinated individualized discharge plans to manage safe transition back into community and home environments.
- Referred families to shelters, legal resources and educational programs.
- Referred clients to appropriate team members, community agencies and organizations to meet treatment needs.
- Used coordination and planning skills to achieve results according to schedule.
- Became strong advocate for behavioral health reform.
- Taught clients how to complete basic household chores and prepare food.
- Conducted client rounds to check on residents.
- Completed documentation for every incident and forwarded to correct personnel for review.
- Built and maintained positive staff relationships to promote teamwork and better serve clients.
- Recognized individuals under influence of drugs or alcohol and typical behaviors associated with each.
- Treated clients and families with respect and dignity.
- Recommended continuing care and medications to clients and communicated with family members on treatment and discharge plans.
Education
Associate of Science - Psychology
New Life Christian Academy
Guam04.2000
High School Diploma -
John F Kennedy High School
Guam11.1997
Skills
- Calm and Professional Under Pressure
- Creative Problem Solving
- CRM Software
- Understanding Customer Needs
- Verbal and Written Communication
- Multitasking and Prioritization
- Customer Retention Strategies
- Responding to Difficult Customers
- Efficient and Detail-Oriented
- Upbeat and Positive Personality
- Building Customer Trust and Loyalty
- Multi-Line Phone Systems
- Team-Oriented and Cooperative
- Strong Analytical and Problem Solving Skills
- Computer Proficiency
- Excellent Attention to Detail
- Proficiency in Microsoft Office and G Suite
- Administrative and Office Support
- Salesforce CRM
- Database Management
Accomplishments
- Attended leadership meetings on three different departments under the same company
- All behavioral health courses completed
- Opened a new department which I managed and was successfully awarded by the DBHDD
- Used Microsoft Excel to develop inventory tracking spreadsheets.
- Supervised team of 10 staff members.
- Team work is a big deal with me and communication
- Being organized is what makes my job easier
- Independent working
- Hard worker and completes all task by management in a timely matter
- Customer service is what makes it great
Timeline
Service Contractor
HGS HUMANA
08.2021 - Current
Front Desk Manager
Just Believe Counseling Service LLC
03.2016 - 08.2021
Case Manager
Gateway Behavioral Health
11.2011 - 03.2016
Associate of Science - Psychology
New Life Christian Academy
High School Diploma -
John F Kennedy High School