Reshma Annam
Decatur,AL
Summary
• Healthcare customer service and enrollment professional with 10+ years of experience supporting patients, families, caregivers, healthcare providers, members, and customers in high-volume healthcare, pharmacy benefits, medical office, call center, insurance, and case-processing environments. Experienced with patient intake, enrollment support, outreach, education, eligibility and benefits verification, documentation, case follow-up, healthcare inquiries, and complex problem resolution. Experienced supporting patients and families with dementia and complex care needs, communicating sensitive information with empathy and professionalism. Strong ability to manage high-volume telephonic interactions, research information across multiple healthcare and computer systems, maintain accurate records, identify issues, escalate when appropriate, and coordinate with multidisciplinary teams. Proven ability to work independently, manage competing priorities, meet quality and productivity expectations, protect confidential information, and provide compassionate support in fast-paced healthcare environments.
Overview
16
16
years of professional experience
Work History
Disaster Recovery Specialist
ITCON Services ( Contractor For FEMA)
05.2024 - 12.2025
- Managed assigned cases from intake through processing and follow-up, ensuring timely resolution of customer requests.
- Identified complex issues and guided resolution or escalation in accordance with established procedures to maintain service quality.
- Managed multiple cases and competing priorities while maintaining quality, productivity, accuracy, and timely processing.
- Processed high-volume customer intake applications while responding to questions regarding application status, documentation requirements, case information, eligibility-related information, and next steps.
- Researched customer records using multiple web-based applications and computer systems to identify information required to process cases and resolve customer concerns.
- Managed 60+ customer calls per day in a high-volume environment, providing professional assistance, education, and guidance throughout the application and enrollment process.
- Coached 20+ representatives as Subject Matter Expert on customer service, documentation standards, case handling, and problem resolution to enhance team performance.
- Worked independently while protecting confidential customer information and maintaining professional communication.
Prescription Benefit Specialist
Alorica for CVS
Decatur, AL
12.2022 - 05.2023
- Managed 65+ calls per day in a high-volume healthcare contact center, assisting members, pharmacies, and healthcare providers with prescription benefits, eligibility, coverage, claims, prior authorizations, and account information.
- Provided education regarding prescription coverage, claim issues, authorization requirements, refill limitations, plan restrictions, and next steps.
- Resolved pharmacy benefit issues by researching multiple healthcare systems and web-based provider portals, ensuring accurate and timely solutions for members.
- Researched member records, claim information, benefit coverage, and eligibility to identify discrepancies and determine appropriate resolutions.
- Interpreted pharmacy benefit rejection codes, including refill-too-soon, prior authorization required, and plan limitation rejections.
- Processed prior authorization requests while following established healthcare procedures and documentation requirements.
- Coordinated resolution of complex member issues by collaborating with pharmacies, healthcare providers, insurance carriers, and internal departments, enhancing member satisfaction.
- Identified customer needs through active listening and probing questions, delivering appropriate solutions and clear communication of next steps to enhance member experience.
- Accurately documented customer interactions, research findings, benefit information, authorization activity, and resolutions in CRM and healthcare systems.
- Navigated multiple complex computer systems simultaneously while maintaining accuracy, quality, productivity, and customer service standards.
- Protected confidential member and healthcare information during member, pharmacy, and provider interactions.
- Managed high-volume healthcare inquiries while demonstrating empathy, professionalism, patience, and a customer-focused approach
Customer Service Representative
DIRECTV
Huntsville, AL
01.2022 - 12.2022
- Investigated customer concerns and identified appropriate solutions to improve satisfaction and retention.
- Built customer relationships through effective communication and problem-solving.
- Resolved technical account and service issues through inbound customer interactions.
- Navigated multiple systems simultaneously while documenting customer interactions.
- Consistently met quality, productivity, and customer satisfaction goals in a high-volume contact center environment.
Medical Receptionist
Family Health Care Clinic
Decatur, AL
05.2018 - 11.2021
- Supported patient intake, registration, appointment scheduling, insurance verification, medical records, and electronic patient record maintenance in a high-volume healthcare environment.
- Processed Patient Assistance Program (PAP) applications for patients seeking assistance with prescription medications, including gathering required documentation, reviewing applications for completeness and accuracy, and following up on application requirements.
- Assisted eligible and underinsured patients with pharmaceutical assistance programs to help them obtain needed medications.
- Informed patients about PAP application requirements, documentation needed, application status, and next steps to facilitate access to medications.
- Ensured accuracy of patient demographic, insurance, and medical information while identifying and resolving discrepancies to maintain data integrity.
- Verified insurance benefits and eligibility and assisted patients with medication-access and coverage-related questions.
- Coordinated medical record requests for healthcare providers, adhering to authorization, privacy, and confidentiality procedures to ensure compliance.
- Reviewed, scanned, and indexed completed ROI forms and medical documentation into electronic patient records for accurate recordkeeping and retrieval.
- Communicated with patients by telephone and in person regarding medical records, authorizations, documentation, and administrative requirements.
- Collaborated with patients, physicians, clinical staff, and healthcare providers to support timely completion of requests and administrative follow-up.
- Accurately entered and updated patient information in electronic healthcare systems.
Administrative Assistant
River City Center
Decatur, AL
04.2017 - 06.2018
- Gathered and documented patient demographic, insurance, financial, and administrative information during the admission process to facilitate smooth transitions into care.
- Communicated with patients, family members, and caregivers regarding admission-related information, documentation, insurance requirements, and financial responsibilities.
- Provided compassionate and professional support to patients and families during the transition into long-term care and rehabilitation.
- Maintained accurate patient records and documentation while protecting confidential healthcare and financial information.
- Verified insurance eligibility, benefits, and copay responsibility and communicated applicable financial information clearly.
- Assisted with Medicaid enrollment by gathering required documentation, communicating application status, and following up on eligibility reviews.
- Supported accounts receivable through payment collection, copay collection, payment posting, invoice processing, and financial documentation.
- Collaborated with facility staff to address patient and family inquiries, ensuring effective follow-up on admissions and financial matters.
Commercial Customer Service Representative Call Center
BBVA Compass
Decatur, AL
10.2015 - 01.2017
- Resolved customer inquiries and complaints related to merchant accounts and credit card transactions, enhancing customer satisfaction.
- Engaged business customers to understand account concerns, investigate issues, and identify appropriate solutions.
- Collaborated with internal partners and departments to address and resolve complex business account issues, ensuring timely solutions.
- Maintained ownership of customer concerns through final resolution.
- Utilized professional communication and problem-solving skills to manage multiple customer needs effectively.
- Provided customer service support for commercial and merchant accounts in a high-volume call center environment.
- Researched account information and discrepancies to determine resolution options.
- Accurately documented customer interactions, account information, research, and resolution activities.
- Followed banking regulations, established procedures, confidentiality requirements, and quality standards.
Teller II
PNC Bank
Decatur, AL
01.2012 - 04.2013
- Cashed checks and paid out money by verifying signatures, ensuring written and numerical amounts matched, and confirming sufficient account funds.
- Received checks and cash for deposit, verify amounts, and check accuracy of deposit slips.
- Balanced currency, coin, and checks in cash drawers at shift's end and calculated daily transactions accurately.
- Recorded customer transactions in computer system and issued accurate receipts.
- Inspected bank vaults regularly to ensure all cash balances were accurate to ensure cash balances are correct, Successfully met and exceeded teller referral goals monthly.
Cash Vault and Commercial Teller
Regions Bank
Decatur, AL
02.2010 - 01.2012
- Prepared cash and coin orders ensuring timely availability for branch tellers and commercial customers.
- Counted, verified, and sorted large amounts of incoming and outgoing currency and coins.
- Coordinated pickups and deliveries with armored car services to ensure secure and efficient cash transport.
- Maintained optimal cash inventory levels to support branch operations and minimize disruptions.
- Balanced total vault currency against system ledgers.
- Ordered cash supplies and shipped excess funds to the Federal Reserve.
- Processed large bulk and night deposit from business clients.
Education
Certification - Pharmacy Technician
Calhoun Community College
Tanner, ALAssociate's Degree - Computer and Information Sciences, General
Calhoun Community College
Decatur, ALSkills
- Patient Enrollment & Intake Patient & Caregiver Support Healthcare Customer Service Patient Outreach & Follow-Up Telephonic Customer Service High-Volume Call Handling Patient Education & Communication Healthcare Benefits & Eligibility Pharmacy Benefits Insurance Verification Case Management & Resolution Documentation & Recordkeeping Patient Onboarding Support Dementia & Caregiver Support Problem Solving & Escalation Multitasking & Prioritization CRM & Healthcare Systems Confidentiality & HIPAA Quality & Productivity KPIs Cross-Functional Collaboration
Personal Information
- Title: HEALTHCARE ENROLLMENT SPECIALIST | PATIENT & CAREGIVER SUPPORT | HEALTHCARE CUSTOMER SERVICE
- Work Permit: Authorized to work in the US for any employer
Languages
Bilingual, English
Timeline
Disaster Recovery Specialist
ITCON Services ( Contractor For FEMA)
05.2024 - 12.2025
Prescription Benefit Specialist
Alorica for CVS
12.2022 - 05.2023
Customer Service Representative
DIRECTV
01.2022 - 12.2022
Medical Receptionist
Family Health Care Clinic
05.2018 - 11.2021
Administrative Assistant
River City Center
04.2017 - 06.2018
Commercial Customer Service Representative Call Center
BBVA Compass
10.2015 - 01.2017
Teller II
PNC Bank
01.2012 - 04.2013
Cash Vault and Commercial Teller
Regions Bank
02.2010 - 01.2012
Certification - Pharmacy Technician
Calhoun Community College
Associate's Degree - Computer and Information Sciences, General
Calhoun Community College