Rhanetra Lovejoy-McLaurin
Hammond,IN
Summary
Detail-oriented team player with strong organizational skills. Ability to handle multiple projects simultaneously with a high degree of accuracy. Brings proven track record of success in determining eligibility and resolving complex cases. Works professionally with clients to develop and implement successful strategies for maximizing services and benefits. Skilled in problem-solving and identifying solutions meeting clients' needs.
Overview
10
10
years of professional experience
Work History
Eligibility Specialist
The Indiana Department Of Family & Social Services
04.2024 - Current
- Enhanced client satisfaction by providing timely and accurate eligibility determination for various assistance programs.
- Reduced errors in eligibility determinations by maintaining thorough knowledge of program guidelines and regulations.
- Provided exceptional customer service through prompt response times, clear communication channels, and diligent follow-up practices.
- Ensured compliance with local, state, and federal regulations during all phases of the eligibility determination process.
- Assisted clients with accurate eligibility form, application and document completion.
- Resolved discrepancies with client applications to verify eligibility.
Insurance Verification Specialist
Community Health
06.2023 - 01.2024
- Verifying patients’ policy for Nuc Med testing
- Communication with clinical team for authorization of scheduled testing for Outpatient setting
- Maintaining confidential information regarding our patients' privacy.
- Ensured compliance with HIPAA regulations while managing sensitive patient information during the verification process.
- Assured timely verification of insurance benefits prior to patient procedures or appointments.
- Improved communication between medical staff and patients by explaining insurance benefits and financial responsibilities.
Restaurant Owner
The Soul Siztah’s Cafe LLC
06.2019 - 06.2023
- Managing day to day operations including inventory & coordinating staff
- Adhering to food & safety regulations
- Administering payroll & ensuring customer satisfaction
- Supervised daily restaurant operations, ensuring smooth workflow and timely resolution of any issues that arose.
- Ensured compliance with all health department regulations, maintaining a safe environment for both employees and patrons alike.
- Enhanced financial controls to minimize theft and loss risks, continuously maintaining accurate accounts and cash drawers.
Insurance Verification Specialist
Franciscan Health
03.2014 - 06.2019
- Verifying health coverage to obtain authorization for IP admissions
- Working closely with doctors by providing information from insurance companies.
- Ensured compliance with HIPAA regulations while managing sensitive patient information during the verification process.
- Updated patient records with accurate, current insurance policy information.
- Improved communication between medical staff and patients by explaining insurance benefits and financial responsibilities.
- Managed high-volume insurance verifications within pressured timeframes for productive medical operations.
Education
General Studies- Diploma -
Thornton High School
Harvey, IL06.1994
Skills
- Committed and motivated Administrative Operations Analyst with exceptional Customer relations and decision making skills Strong work ethic with a professional demeanor and great initiative Destined to provide the highest level of team leadership
- Data Entry
- Microsoft Office
- Effective communication skills
- Telephone Etiquette
- Medicaid knowledge
- Eligibility Determination
- Appointment Scheduling
Awards
- Most accurate accounts completed in an 8 hour shift.
- Outstanding Customer Service Award Tier 2
- Efficient Liaison between departments.
References
Available Upon Request
Timeline
Eligibility Specialist
The Indiana Department Of Family & Social Services
04.2024 - Current
Insurance Verification Specialist
Community Health
06.2023 - 01.2024
Restaurant Owner
The Soul Siztah’s Cafe LLC
06.2019 - 06.2023
Insurance Verification Specialist
Franciscan Health
03.2014 - 06.2019
General Studies- Diploma -
Thornton High School
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