Summary
Overview
Work History
Education
Skills
Timeline
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Ryan Royal

St Louis,MO

Summary

Dynamic Customer Service Specialist with a proven track record at Lumeris, achieving high satisfaction through effective problem resolution and proactive communication. Skilled in data entry and customer relations, I excel in transforming customer challenges into positive experiences. Trained new hires, showcasing leadership and excellent oral communication abilities.

Overview

12
12
years of professional experience

Work History

Customer Service Specialist

Lumeris
06.2018 - 04.2024
  • Achieved high satisfaction rating through proactive one-call resolutions of customer.
  • Provided primary customer support to internal and external customers.
  • Addressed customer complaints and mitigated dissatisfaction by employing timely and on-point solutions. (Grievance)
  • Responded to customer requests for products, services, and company information.
  • Updated account information to maintain customer records.
  • Responsible for responding to all incoming emails to Customers Service.
  • Interact with customers to provide information regarding their medical coverage.
  • Provided training new hires.
  • Ensured necessary documentation's were obtained for prior authorizations.
  • Liaison between patients, pharmacies, providers, and medical staff.
  • Assisted members with finding other providers in network.

Precertification Specialist

Washington University
08.2017 - 02.2018
  • Increased accuracy of submitted claims through meticulous attention to detail in verifying insurance eligibility and benefits.
  • Boosted efficiency within the team by regularly updating coworkers on changes in insurance policies or procedural requirements affecting precertifications.
  • Maintained strict adherence to HIPAA regulations by safeguarding confidential patient information during all aspects of the precertification process.
  • Enhanced interdepartmental collaboration through effective communication with case managers, physicians, and billing departments.
  • Conducted thorough follow-ups with insurance companies, ensuring timely receipt of authorization numbers for approved services.
  • Obtain prior authorization for surgery
  • Review charts and medical policy for appropriate coverage.

•Verify CPT codes

Medical Assistant/Office Coordinator/ Per Cert Rep

St. Luke's Permier Pain Consultants
03.2012 - 08.2017
  • Completed clinical procedures and gathered patient data for interpretation by physician.
  • Kept medical supplies in sufficient stock by monitoring levels and submitting replenishment orders before depleted.
  • Sanitized, restocked, and organized exam rooms and medical equipment.
  • Called and faxed pharmacies to submit prescriptions and refills.
  • Obtained client medical history, medication information, symptoms, and allergies.
  • Scheduled appointments, registered patients, and distributed sample pharmaceuticals as prescribed.
  • Verified patient insurance coverage and collected required co-payments.
  • Answered telephone calls to offer office information, answer questions, and direct calls to staff.

Education

Bachelor Of Arts - Healthcare Management

Missouri College
St Louis, MO
05.2015

Medical Assistance

Missouri College
St Louis, MO
05.2010

Skills

  • Customer Service
  • Good communication skills
  • Customer Relations
  • Call center experience
  • Excellent written and oral communication
  • Problem Resolution
  • Data Entry
  • Follow-up skills
  • Microsoft Outlook
  • Live chat support

Timeline

Customer Service Specialist

Lumeris
06.2018 - 04.2024

Precertification Specialist

Washington University
08.2017 - 02.2018

Medical Assistant/Office Coordinator/ Per Cert Rep

St. Luke's Permier Pain Consultants
03.2012 - 08.2017

Bachelor Of Arts - Healthcare Management

Missouri College

Medical Assistance

Missouri College
Ryan Royal