Sabrina Guillaume
Miami,Florida
Summary
Seeking a fulfilling and responsible position that allows me the opportunity to learn, grow, and expand my mind.
Seasoned Account Specialist with deep knowledge in financial analysis and management of client portfolios. Strengths include strategic planning, customer relationship management, problem-solving and leadership skills. Demonstrated success in enhancing operational efficiency and achieving revenue growth in previous roles. Possess strong analytical abilities with proven track record in implementing effective financial solutions for clients.
Overview
10
10
years of professional experience
Work History
Customer Service/ Retention Account Specialist
IQor
09.2016 - Current
- General customer service skills answering questions troubleshooting questions and retain customers from quitting
Customer Service Representative
Convey Health
Sunrise, Florida
01.2015 - 09.2018
- Conduct thorough reviews and approvals of prescription medication requests to ensure compliance with insurance criteria, focusing on medical necessity and formulary guidelines.
- Collaborate closely with physicians to gather necessary medical information for processing prior authorizations efficiently.
- Liaise with insurance companies to confirm coverage details and effectively resolve authorization issues.
- Patient Interaction:
- Act as the primary point of contact for patients regarding their medication requests and insurance coverage inquiries.
- Provide clear and informative explanations to patients about prescription status, any coverage issues, and necessary documentation requirements.
- Data Management
- Accurately document all interactions, decisions, and outcomes associated with the prior authorization process.
- Maintain detailed records of patient medication authorizations for future audits and reference.
- Code Verification
- Verify the accuracy of Current Procedural Terminology (CPT) codes and International Classification of Diseases (ICD) codes on medical forms to ensure they align with authorization requests.
- Work alongside medical coding specialists to address and rectify any coding discrepancies.
- Compliance and Best Practices
- Keep abreast of changes in insurance policies, medical guidelines, and medication coverage criteria to ensure up-to-date compliance.
- Rigorously adhere to healthcare regulations, privacy laws, and ethical standards to ensure best practices in all processes.
Education
General High School Diploma -
North Miami Beach Senior High School
Miami, FL01.2014
Skills
- Fluent in English
- Fluent in Creole
- Computer literacy
- Software proficiency
- Planning skills
- Organizational skills
- Detail orientation
- Problem-solving
- Complaint resolution
- Due diligence
- Terms negotiation
- Point-of-sale system
- Reporting skill
- Billing issue resolution
- Account investigations
- CRM software
References
- Fritjeana Montinard, 7862784680
- NMSDA Church Leadership Group, Kendra Fils, (786) 322-0003
Timeline
Customer Service/ Retention Account Specialist
IQor
09.2016 - Current
Customer Service Representative
Convey Health
01.2015 - 09.2018
General High School Diploma -
North Miami Beach Senior High School