Shante L. Brown-Facen
Health Care Service Corporation
Riverdale,IL
Summary
Customer service professional with over 22 years' experience in conflict resolution, data entry, customer relationship management, and enhancing customer satisfaction. Skilled in active listening, problem-solving, and effective communication. Strong team collaborator, adaptable to changing needs, and consistently achieving results. Known for reliability and maintaining high standards.
22
Years of experience
Work History
Customer Advocate II/Learning Coach
4 Years 7 Months- Prepare Medicaid Prior Authorizations for Blue Cross Blue Shield of Illinois & Blue Cross Blue Shield of Texas Providers.
- Keep records of provider interactions or transactions, recording details of inquiries, complaints, or comments, as well as actions taken.
- Review insurance policy terms to determine whether a CPT Code requires prior authorization through the insurance plan or a different vendor.
- Collaborated with internal teams to improve customer service processes.
- Documented provider interactions in the company's CRM system accurately.
- Perform extensive research on all inquiries and concerns to achieve complete client satisfaction.
- Reviewed prior authorization requests for medical procedures and services.
- Communicated with healthcare providers to clarify authorization requirements.
- Maintained accurate records of authorizations and denials for reporting purposes.
- Reviewed prior authorization requests to ensure accuracy and completeness of required information.
- Scheduled patient appointments, diagnostic specialty appointments, tests, and procedures.
- Assist in preparing new hires (NH) Customer Advocates for their role in the business.
- Assist trainees on the floor.
- Provide trainees with call assistance on the floor during the first 4 weeks as a subject matter expert.
- Provide trainees with call assistance via phone/chat through the learning coach line or Teams Chat, answering questions and navigating CAs to become independent and confident in using their SharePoint resources and guides to help complete the prior authorization calls.
- Provide phone support via the assist line when extra support is needed for the CAS team.
Customer Service Representative
5 Years- Answer a high volume of inbound calls.
- Provide product knowledge about various programs to customers.
- Upsell and register new customers for discount programs.
- Retain/Resale products to customers wishing to cancel services.
- Check patient eligibility for provider offices.
- Assist insurance customers with questions regarding policy.
- Submit claim requests for insurance customers.
- Assist customers with billing inquiries.
- Update MOP and resubmit billing via phone.
- Assisted customers with inquiries and product information.
- Resolved customer complaints efficiently and professionally.
- Educated customers on product features and benefits.
- Maintained accurate records of customer interactions and transactions.
- Trained new staff on customer service procedures and practices.
- Answered customer inquiries and provided accurate information regarding products and services.
Contact Center Team Lead
1 Year- Recruited blood donors for special cases amongst all 3 Blood Centers.
- Created daily job performance stats for recruiters.
- Monitored daily stats for the contact center department collection goals.
- Supported the Supervisor/Manager as needed.
- Supervised a Telerecruitment team of 13 individuals.
- Assigned daily job assignments to staff on Saturdays.
- Team Manager on Saturdays and weekday evenings.
- Answered inbound calls from donors.
- Retrieved voicemails, emails, and chats promptly.
- Handled escalated calls when needed.
- Trained new employees for the telerecruitment department
TeleRecruiter
1 Year- Recruited and scheduled blood donors for all 3 Blood Centers.
- Answered inbound calls from donors.
- Placed Outbound Reminder Calls to Donors when needed.
- Trained new employees for the telerecruitment department
Education
MBA - Accounting
BBA - Accounting
Skills
Data Management
Data Accuracy
Microsoft Office Suite
Healthcare Knowledge
Data entry
Provider Relations
Strong Verbal & Written Communication
Detail Oriented
Quick Learner
Problem-Solving/ Conflict Resolution
Analytical Thinking
Customer relationship management
Cross-Functional Collaboration
Team Collaboration/Independent Work
Training Facilitation
Documentation Coordination
Accomplishments
- Received recognition for great customer service and 100% on quality calls.
- Multiple Kudos Calls on behalf of providers for providing exceptional customer service.
- Upskilled in learning the new Guiding Care System for the Texas Medicare Book of Business.
- Upskilled in Faxes for Medicaid.
- Upskilled to become a learning coach to assist new customer advocates.
- Assist peers with mock interview training.
- Department Focus Group Participant.
- Assisted with the Illinois rollout of the Guiding Care System, creating SharePoint job aids to help the Medicaid prior authorization department implement the new system.
- Learning Coach/SME for the new guiding care system for the state of Illinois Medicaid department.
Timeline
Customer Advocate II/Learning Coach
Health Care Service Corporation
01.2022 - Current
Customer Service Representative
Coverdell & Co. Inc.
01.2017 - 01.2022
TeleRecruiter
LifeSource Blood Services, Inc.
01.2015 - 01.2016
Roosevelt University
MBA from Accounting
Robert Morris College
BBA from Accounting