Rickey Lauderdale
Corinth,TX
Summary
Results-driven professional recognized for high productivity and task efficiency. Expertise in client communication, problem resolution, and process optimization. Proven ability in negotiation strategy development and customer relationship management. Utilizes active listening, empathy, and persuasive speaking to achieve objectives and exceed performance goals.
Overview
30
30
years of professional experience
Work History
Escalations Oversite Representative
Coronis Health
Sykesville, Maryland
10.2023 - Current
- Handling Escalations: Act as the primary point of contact for escalated customer complaints, ensuring timely and effective resolutions.
- Analyzing Issues: Assess customer concerns to determine the best course of action, collaborating with relevant teams as needed.
- Feedback and Reporting: Provide feedback to technicians and management based on escalated cases, helping to improve service quality.
- Process Management: Implement and manage escalation processes to address potential incidents, ensuring adherence to organizational protocols
- Coordinated with healthcare providers for accurate patient documentation.
- Managed patient accounts and ensured timely processing of claims.
- Implemented process improvements to enhance operational efficiency.
- Trained new staff on company policies and procedures effectively.
- Maintained confidentiality of sensitive patient information at all times.
- Collaborated with teams to streamline workflow and improve service delivery.
- Resolved customer complaints in a professional manner while remaining empathetic to their concerns.
- Consistently met daily performance goals set by management team members.
- Demonstrated strong problem solving skills when faced with challenging situations or complex inquiries from customers.
- Collaborated with colleagues in other departments to ensure that all customer needs were met effectively.
- Utilized CRM software to track customer interactions, sales, and progress towards targets.
- Escalated unresolved issues to appropriate departments for further investigation.
- Participated in regular team meetings to discuss performance, strategies, and goals.
Sr. Patient Financial Services Specialist
Infinity Behavioral Health Services
Lauderdale Lakes, FL
06.2020 - 10.2021
- Assumed a pivotal role in laying groundwork for the implementation of the Patient Collections Department which included conducting performance metric testing, streamlining daily workflows, facilitating new employee training and development and presenting insights to higher management contributing to the department’s organizational structure.
- Allocated work assignments to department employees by assessing the workload, distributing tasks among team members and effectively communicating with department employees to ensure a balanced and efficient workflow.
- Verified data, conducted audits and cross-referenced information in specific software systems and insurance portals to ensure accurate completion of all patient account related tasks and follow-ups were completed by the department employees during claims processing.
- Managed provider accounts by performing routine account maintenance and any other form of records that require regular attention and maintenance to ensure provider credentialing information was always valid and up to date to verify services performed were reasonable and necessary.
- Maintained customer accounts by ensuring patient personal identifiable information (PII) or any other form of records that require regular attention and maintenance were updated to ensure all patient claims processed correctly and in a timely manner.
- Collaborated with other teams or departments to obtain required information or support for handling certain accounts to ensure resolution of complex issues during processing of claims.
- Identified areas for improvement, provided feedback, and recognized exceptional performance by monitoring employees' performance and productivity which was provided to management for performance reviews.
- Responded to escalated patient inquiries and/or problems regarding insurance bills, delinquent accounts, requests for negotiated payments and payment plans via phone calls and email communications.
- Responsible for meeting deadlines by ensuring that the assigned work is completed promptly and within specified timelines to produce smooth functioning of the department and overall business operations.
Accounts Receivable Claims Specialist
Infinity Behavioral Health Services
Lauderdale Lakes, FL
02.2016 - 06.2020
- Responsible for reviewing medical claims and identifying outstanding payment issues due to billing errors, denials, or discrepancies in claims submitted to insurance companies or other payers to ensure accurate and timely payment for services provided.
- Monitored aging reports by tracking accounts receivable and identifying accounts with overdue payments to ensure necessary actions to address outstanding balances promptly and prevent potential issues with facilities receiving incorrect billing information.
- Worked with the Team Lead and Customer Service Representatives (CSRs) providing prompt and accurate responses by completing follow up requests with insurance to address questions, concerns, or issues related to billing and payment matters from facilities.
- Handled appeals requests for medical records in situations where claims were denied or disputed and a review of medical records, supporting documentation, and communication with insurance companies was needed to appeal the denied claims and ensure fair reimbursement for provided services.
- Displayed excellent time management skills by handling multiple tasks simultaneously, including navigating various software systems, accessing patient records, and communicating with insurance providers to maintain a consistent workflow and meet daily production targets.
- Proficient in using specific software systems, such as Collaborate CMD, Kipu, Best Notes, Availity, and other insurance portals allowing streamlining of the claims processing workflow and improving overall efficiency.
Support Services Administrative Specialist
Cross Country Home Services
Sunrise, FL
07.2012 - 10.2015
- Claims Credit Processor: reviewed relevant documentation and supporting material submitted by the homeowner to verify and calculate with accuracy credit allowance and processed reimbursements up to $1k in a timely manner.
- Web Correspondence Processor: managed the organization's email inbox by reviewing and acknowledging customer communications via internet emails with immediate resolution communicated if possible or with assurance the customer communication was forwarded to appropriate department for handling.
- General Correspondence Processor: processed state regulated California Denial letters and other General Correspondence letters which included claim options letters, claim summary/history letters and other forms of denial letters ensuring compliance with state regulations and guidelines.
- Customer Survey Satisfaction Auditor: assessed customer satisfaction levels by reviewing, analyzing and evaluating claims based on survey responses submitted by homeowners after claims had been processed but the repairs were yet to be completed to enhance overall customer experience.
Call Center Customer Service Associate
Cross Country Home Services
Sunrise, FL
04.2012 - 07.2012
- Received incoming calls from different sources while displaying excellent communication skills, a customer-centric mindset, the ability to handle various inquiries and situations to deliver outstanding customer service and support contributing to the overall success of the company's sales and service efforts.
- Placed outbound follow-up calls in a professional and courteous manner to accurately provide claim status, resolutions regarding billing inquiries, account updates, or any other customer and service providers concerns.
- Met Quality Assurance Requirements and other key performance metrics by adhering to company policies and maintaining a high standard of customer service achieving performance targets set by the organization.
Administrative ECS Clerk
United Parcel Services of America, Incorporated
Memphis, TN
07.1996 - 07.2011
- Received packages from delivery trucks and ensured they were stored safely in the warehouse until delivered or further processed.
- Accurately recorded incoming packages and outgoing shipments by managing inventory to prevent items from being lost during transit.
- Sorted and identified packages correctly utilizing appropriate scanning and labeling methods to ensure packages were grouped accurately for delivery.
- Collaborated with department management to devise and execute customer satisfaction objectives aimed at enhancing overall customer service experience.
- Ensured sufficient storage space for incoming items utilizing internal logistics planning methods to schedule large incoming shipments.
Hazardous Material Responder and Auditor
United Parcel Services of America, Incorporated
Memphis, TN
04.1997 - 10.2008
- Engaged in yearly training exercises to maintain proficiency in hazardous materials response techniques and protocols regulated by policies of the Occupational Safety and Health Administration.
- Prepared audit reports to summarize findings from hazardous material samples collected for analysis, presenting results and disposal recommendations to management.
- Evaluated hazardous materials to identify risks and determine appropriate response actions.
Co-Chair of Health & Safety Committee
United Parcel Services of America, Incorporated
Memphis, TN
04.1997 - 01.1999
- Enforced strict compliance with relevant health and safety laws, regulations, and industry standards ensuring employee safety and adherence.
- Coordinated weekly health and safety training programs and assisted in developing and reviewing safety policies and procedures to enhance employee awareness and ensure regulatory compliance.
- Reviewed and assessed work methods and procedures focusing on employee body mechanics to proactively address issues and mitigate injury risks.
- Collaborated with HR to develop health and wellness initiatives while maintaining records of incidents and safety-related data for analysis and improvement.
Education
High School Diploma -
Olive Branch High School
Olive Branch, MSCertified Level I -
Huston Reiki
Houston, TX05.2023
Skills
- Escalation management
- Customer service and support
- Customer feedback analysis
- Claims processing
- Retention strategies
- Salesforce CRM
- Data analysis
- Report generation
- Performance metrics monitoring
- Problem solving and resolution
- Negotiation skills
- Collaboration and teamwork
- Microsoft Office proficiency
- Process documentation
- Organizational skills
- Adaptability and flexibility
- Active listening
- Critical thinking skills
- effective communication
Accomplishments
Represented Infinity Behavioral Services at 2016 Moments of Change Conference a networking conference for behavioral health care industry leaders focusing on enhancing quality of service, increasing revenue and maintaining compliance with industry standards.
Timeline
Escalations Oversite Representative
Coronis Health
10.2023 - Current
Sr. Patient Financial Services Specialist
Infinity Behavioral Health Services
06.2020 - 10.2021
Accounts Receivable Claims Specialist
Infinity Behavioral Health Services
02.2016 - 06.2020
Support Services Administrative Specialist
Cross Country Home Services
07.2012 - 10.2015
Call Center Customer Service Associate
Cross Country Home Services
04.2012 - 07.2012
Hazardous Material Responder and Auditor
United Parcel Services of America, Incorporated
04.1997 - 10.2008
Co-Chair of Health & Safety Committee
United Parcel Services of America, Incorporated
04.1997 - 01.1999
Administrative ECS Clerk
United Parcel Services of America, Incorporated
07.1996 - 07.2011
High School Diploma -
Olive Branch High School
Certified Level I -
Huston Reiki