Shaprell Malivert
Chiefland,FL
Overview
17
17
years of professional experience
Work History
Healthcare Customer Service Representative
TriWest Healthcare Alliance
Remote, Fl
02.2022 - Current
- Managed inbound and outbound calls to address customer inquiries and concerns
- Facilitated communication between healthcare providers and patients to ensure accurate service delivery
- Resolved complex issues through active listening and problem-solving techniques
- Educated customers on benefits, claims processes, and eligibility requirements for healthcare services
- Developed resources to streamline communication processes, enhancing overall efficiency
- Led initiatives to improve customer satisfaction scores through feedback implementation
- Analyzed customer feedback data to identify trends and recommend service improvements
- Ensured compliance with HIPAA regulations when handling sensitive patient information, protecting client privacy at all times.
- Enhanced patient satisfaction by efficiently addressing and resolving healthcare-related inquiries.
- Managed difficult conversations with compassion and professionalism, helping deescalate tense situations while maintaining a focus on finding resolutions.
- Increased first-call resolution rates by carefully listening to customers'' needs and providing accurate information based on their inquiries.
Remote Operations Manager
KSM Logistics LLC
04.2017 - Current
- As Co-owner and the logistics operations manager of KSM Logistics LLC, I manage a team of shippers, receivers, drivers, and other employees.
- Organizing all transportation needs for the organization’s product.
- Collaborate with freight companies to plan deliveries and shipments.
- Coordinate product inventory and storage within warehouses and other logistics sites to optimize efficient inventory movement.
- Utilize logistics software, use analytical skills to optimize schedules for shipments and deliveries and maximize cost-effectiveness.
- Work closely with commercial shippers to make deals for a lower shipping cost.
Remote Insurance Specialist II
BroadPath Healthcare Solutions
01.2017 - 06.2019
- Provide support to medical billing staff, clarifies and verifies details of insurance coverage with private or government carriers and offers information to patients before medical services are provided.
- Tracks physician referrals and provides necessary details to billing staff, maintain heavy phone interaction and demands top customer service and problem-solving skills in working with physicians, claims processors, medical charges and patients.
- Assist members with multiple tasks pertaining to their health insurance, and initiated prior authorizations.
Hybrid Insurance Verification Specialist
Aetna Specialty Pharmacy
Orlando, FL
10.2014 - 08.2015
- Ensure that healthcare providers accurately bill insurance for services rendered, verifying patient insurance coverage, obtaining pre-authorization, and confirming deductible and co-payment details.
- Communicate with insurance companies, patients, and healthcare providers to resolve discrepancies, update records, and ensure proper billing.
- Accuracy is crucial to prevent claim denials and facilitate smooth reimbursement processes, attention to detail, knowledge of insurance policies, and effective communication skills to navigate the complexities of healthcare billing.
Patient Care Coordinator/ Insurance Specialist
Walgreens Specialty Pharmacy
Orlando, FL
02.2014 - 10.2014
- Conducts monthly staff meetings with the care team.
- Monitors delivery of care by completing patient rounds, documenting care, and maintaining communication for transfer/discharge plan.
- Educates patients and their families on the care plan; provides details related to treatments, procedures, medications, and continuing care requirements.
- Evaluates outcomes of care with the interdisciplinary team by measuring intervention effectiveness with the team.
- Protects self, co-workers, and patients by following policies and procedures to prevent blood-borne and airborne diseases.
- Respects patient’s rights by maintaining their confidentiality.
- Maintains quality service by establishing and enforcing organizational standards.
- Maintains patient care database by entering new information as it becomes available.
- Contributes to team effort by accomplishing related results as needed.
Customer Service Professional / Dispatcher
Bright House Networks
Maitland, FL
10.2009 - 01.2012
- Coordinates the movement of goods and materials while working with shipping companies, truck drivers, and other logistics providers to ensure that shipments arrive on time and in good condition.
- Manage freight loads, schedules, and driver logs, and provide shipping updates to customers.
- Assist customers with billing information, upgrade customers, starting new customer services, troubleshooting issues, scheduling trouble calls, taking payment over the phone, etc.
- Assisting technicians with assigning customer equipment, troubleshooting over the phone, assisting technicians with directions, etc.
Pharmacy Help Desk Representative
Connextions
Orlando, FL
10.2008 - 11.2009
- Provide clerical support and support to the pharmacy staff. This position is responsible for the customer service of the pharmacy, which includes receiving customer requests and resolving any customer problems and concerns, referring to supervisory staff when necessary.
- Processing sales and operating the Pharmacy’s POS system.Work directly with customers in person and on the phone. Assist with organization of the Pharmacy.
- Assist pharmacists with correct processing information to fill prescriptions and giving accurate insurance information such as BIN PCN and GRP number.
Education
Bachelor's degree - Business Administration
College of Central Florida
08.2026
AS - Human Services
Columbia College
Orlando, FL01.2015
Diploma - undefined
Temple Christian School
Palatka, FL05.2006
Skills
HIPAA compliance
Insurance verification
Patient confidentiality
Appointment scheduling
Medical terminology
Call center experience
Claims processing
Data entry proficiency
Follow-up skills
Medical billing
Policy adherence
Stress tolerance
Empathy and patience
Healthcare industry
Patient payment processing
Insurance claims follow-up
Patient eligibility verification
EHR management
Multitasking and organization
Customer service
Insurance billing
Problem-solving
Team leadership
Payment processing
Timeline
Healthcare Customer Service Representative
TriWest Healthcare Alliance
02.2022 - Current
Remote Operations Manager
KSM Logistics LLC
04.2017 - Current
Remote Insurance Specialist II
BroadPath Healthcare Solutions
01.2017 - 06.2019
Hybrid Insurance Verification Specialist
Aetna Specialty Pharmacy
10.2014 - 08.2015
Patient Care Coordinator/ Insurance Specialist
Walgreens Specialty Pharmacy
02.2014 - 10.2014
Customer Service Professional / Dispatcher
Bright House Networks
10.2009 - 01.2012
Pharmacy Help Desk Representative
Connextions
10.2008 - 11.2009
AS - Human Services
Columbia College
Diploma - undefined
Temple Christian School
Bachelor's degree - Business Administration
College of Central Florida