Ravyn Carson
Kankakee,IL
Summary
Knowledgeable and dedicated customer service professional with extensive experience in the Insurance healthcare industry. Solid team player with outgoing, positive demeanor and proven skills in establishing rapport with clients. Motivated to maintain customer satisfaction and contribute to company success. Specialize in quality, speed and process optimization. Articulate, energetic and results-oriented with exemplary passion for developing relationships, cultivating partnerships and growing businesses.
Overview
13
13
years of professional experience
Work History
Health Coordinator
HCSC - Blue Cross Blue Shield Of Illinois
09.2023 - Current
- Responsible for contacting members to inform and educate them on our medical management programs, conducting research, performing data entry, responding to inquires from members, and supporting the clinicians in the Management department with their provider and member activities.
- Work with care coordinator and assist with the management of the EMOD process for home modifications.
- Provided ongoing support to both patients and families throughout their healthcare journey, addressing concerns or challenges as they arose.
- Improved patient outcomes by coordinating care plans and collaborating with multidisciplinary healthcare teams.
- Enhanced patient satisfaction by implementing personalized health education programs and resources.
- Developed a comprehensive resource directory for patients and families, enabling easier access to essential support services.
- Expedited insurance authorizations for treatments or procedures, streamlining financial aspects of patient care delivery.
Senior Customer Service Representative
Cigna-HealthSpring
05.2022 - 06.2023
- Interview clients/potential buyers to determine desired property(ies) and qualifications for housing program ·
- Act as an intermediary between buyers and closers, generally representing the buyer
- Present purchase offers to sellers and office director for consideration · Prepare documents such as representation contracts, purchase agreements, closing statements, deeds and leases ·
- Confer with escrow companies, lenders, home inspectors, and pest control operators to ensure that terms and conditions of purchase agreements are met before closing dates.
- Coordinate property closings, overseeing signing of documents and disbursement of funds
Intake Coordinator
Express Scripts
10.2020 - 07.2021
- Maintained strict confidentiality of sensitive patient information while handling medical records and personal documents in accordance with HIPAA guidelines.
- Cancel Cases
- Process pharmacy claims for direct member reimbursement request
- Verify Benefits & Eligibility
- Use the following systems: EPA, EPIC, HDQ, Overview, ESD
- Verify eligibility and compliance with authorization requirements for service providers.
- Obtain and log accurate patient insurance and demographic information for the use of many insurance providers and medical personnel.
- Maintained accurate medical records, contributing to better-informed treatment decisions by healthcare providers.
- Resolved billing discrepancies through effective communication with insurance companies and patients alike, ensuring accurate accounts receivable management.
Customer Service Pharmacy Help Desk Agent
Cigna
03.2011 - 10.2020
- Selected and awarded by Upper-level Management as Team MVP November 2010 for Outstanding work performance and Client satisfaction; Award based on overall job performance, attendance, customer satisfaction and 98% or above on all QA monitored phone calls
- Also awarded several gift cards for continuous top performance on team and received quarterly performance-based bonus
- Responsible for assisting Pharmacists/MD Offices with Medicare PT D insurance claims processing for prescription drug services; Perform any other clerical/administrative duties as necessary
- Verify Medicare A, B, C & D Benefits & Coverage
- Claims Processing
- Process Prior Authorizations for Prescription medications
- Managed high-volume call center, prioritizing tasks and ensuring prompt assistance for users.
Education
Certificate - Medical Office Assistance
First Institute
Crystal Lake, IL02.2008
GED -
Kankakee Community College
Kankakee, IL07.2007
Skills
- Exceptional organizational and communication skills
- MS Windows proficient
- Quick learner
- Creative problem solver
- Multi-line phone operation proficiency
- Exceptional workflow management
- Skilled in call center operations
- Adheres to customer service procedures
- Call center experience
- Data Entry
- Data Collection
- HIPAA Compliance
- Insurance Verification
- Prescription Coordination
- Follow-up skills
- Benefit Coverage
- Basic medical terminology
- Authorizations
- Healthcare Industry Knowledge
- Understanding of medical terms
- Medicare and Medicaid knowledge
- Insurance procedures
- Claim research
Timeline
Health Coordinator
HCSC - Blue Cross Blue Shield Of Illinois
09.2023 - Current
Senior Customer Service Representative
Cigna-HealthSpring
05.2022 - 06.2023
Intake Coordinator
Express Scripts
10.2020 - 07.2021
Customer Service Pharmacy Help Desk Agent
Cigna
03.2011 - 10.2020
Certificate - Medical Office Assistance
First Institute
GED -
Kankakee Community College
Similar Profiles
Sana AmjadSana Amjad
Senior HRBP at HCSC - Blue Cross Blue Shield of IllinoisSenior HRBP at HCSC - Blue Cross Blue Shield of Illinois
Amber BernachiAmber Bernachi
Customer Advocate II at HCSC - Blue Cross Blue Shield of IllinoisCustomer Advocate II at HCSC - Blue Cross Blue Shield of Illinois
Nikki SiegmundNikki Siegmund
UM at HCSC - Blue Cross Blue Shield of IllinoisUM at HCSC - Blue Cross Blue Shield of Illinois
Sary PerezSary Perez
Quality Control and Coaching Associate at HCSC - Blue Cross Blue Shield of IllinoisQuality Control and Coaching Associate at HCSC - Blue Cross Blue Shield of Illinois
Samantha RosemondSamantha Rosemond
Patient Services Manager at Riverside Medical Center, Inc.Patient Services Manager at Riverside Medical Center, Inc.