SHAVON THOMAS
Philadelphia,PA
Summary
Dedicated leader and highly motivated team player with first-rate customer service skills, attention to detail, immense problem solving capabilities, impeccable communication and interpersonal skills; along with the desire to consistently exceed customer expectations and meet organizational goals.
Overview
10
10
years of professional experience
Work History
HEALTH ASSISTANT
Accolade
09.2020 - 04.2023
- Answered over 100 high volume calls and mobile messages per day.
- Assisted clients with issues pertaining to their health or health benefits
- Used technology data to gain better understanding of needs clients may not have been voicing
- Actively listen for contextual red flags and uncover barriers and medical issues
- Acted as a health advocate to help members get proper care
- Assisted clients by helping to navigating complex healthcare systems.
- Scheduled appointments, as well as looked into claims to better explain and give members and providers better understanding of what was being charged/ paid for.
- Went over benefits for better understanding of what member's health plan covered.
CUSTOMER SERVICE
Vibra Health Plan
08.2020 - 09.2020
- Answered over 80-90 high volume calls per day.
- Assisted members over 65 with questions pertaining to their upcoming Medicare benefits and provider’s needing member’s plan information or benefit details
- Compared benefits for current and upcoming year, Quoted premiums and accumulators
- Went over claims, contacted providers if there were any discrepancies
- Scheduled rides for members going to appointments all while providing exceptional customer service.
- Handled customer inquiries and suggestions courteously and professionally
RECORD RETRIEVAL SPECIALIST
Magna Legal Services
01.2019 - 01.2020
- Created and put together Subpoenas and Authorizations to obtain medical, billing, radiology, workers comp, employment and EMS records and sent to opposing counsel and facilities
- Conducted facility research to obtain contact info, addresses and proper info for issuing subpoenas and patient authorizations to facilitates, businesses and law firms
- Followed up with records custodians to verify that requests were received and to make sure that records would be sent by date requested
- Created or updated records with new files or information.
- Retrieved, sorted, copied, and filed all documents and paperwork.
- Strictly adhered to confidentiality dictations to safeguard information.
- Scanned images and documents with careful attention to clear scans and to correct document naming conventions.
CUSTOMER SERVICE REPRESENTATIVE
AmeriHealth
09.2018 - 10.2018
- Provided members benefit updates and plan information
- Sent out new cards for members
- Quoted deductibles, copays, coinsurance and out of pocket max for both individuals and families
- Quoted the INN & OON cost sharing for each members
- Assisted with provider and facility look up, both IN and OON
- Assisted with claims.
- Assisted customers in making payments on accounts and setting up payment plans.
- Provided outstanding service to new and long-standing customers by attending closely to concerns and developing solutions.
PATIENT SERVICE REPRESENTATIVE
Penn Medicine
04.2018 - 09.2018
- Scheduled and registered patients in pulmonary department using Epic system. Including returning and new patients, sick visits, follow ups, pulmonary function testing, biopsies and bronchoscopy appointments
- Sent messages to MDs and medical teams from patients, pharmacies, home care nurses, other doctors, facilities and medical equipment companies
- Sent out prescription refills and renewal request
- Sent out pre-authorizations for medications, testing and surgery procedures
- Assisted with bumps (rescheduling patient appointments to meet doctor's new schedule)
- Updated patient demographic information. Including Insurance information
- Assisted with provider look ups as well as facility.
- Supported hospital and clinic operations using customer service skills and detailed system knowledge.
- Referred patients to appropriate professionals and services.
- Checked daily doctor schedules and verified insurance.
TEAM LEAD
Corporate Call Center Inc
08.2015 - 03.2017
- Answered over 100 high volume calls per day
- AEP for BCBS of IL, TX, NM, OK and MT Reviewed customer survey information to prioritize areas of improvement
- Routinely collaborated with department managers to correct problems and improve services
- Assisted in resolving and satisfying client requests and internal operational issues
- Data Entry Faxed and mailed applications out to members
- Enrolled members into available Medicare plans.
- Promoted to leadership position in recognition of strong work ethic and provided exceptional customer service.
- Delegated daily tasks to team members to optimize group productivity.
- Monitored team progress and enforced deadlines.
- Directed and supervised team of 80.
RECEPTIONIST
PC Tax Services
01.2013 - 07.2013
- Filed paperwork and organized computer-based information
- Wrote reports, executive summaries and newsletters
- Screened personal and business calls and directed them to appropriate parties
- Sourced and ordered office equipment and supplies
- Organized and attended meetings, including compiling all documents and reports ahead of time
- Executed basic banking and bookkeeping tasks.
- Greeted incoming visitors and customers professionally and provided friendly, knowledgeable assistance
- Confirmed appointments, communicated with clients, and updated client records
- Kept reception area clean and neat to give visitors positive first impression
- Answered phone promptly and directed incoming calls to correct offices
Education
High School Diploma -
Hope Charter High
Philadelphia, PA06.2012
Skills
- Proven written and oral communication skills
- Expert in handling office equipment
- Internet savvy
- Proficient in managing business correspondence with expertise in Microsoft Suite
- Ability to organize work priorities
- Excellent customer service orientation
- Knowledge of filing and updating records
- Ability to research and analyze data effectively
- Strong ability to use business software
- Light bookkeeping knowledge
- Demonstrate ability to remain self-motivated
- Ability to work independently and as part of a team
- Excellent organizational skills
- Able to manage stress
- Knowledgeable of MEDICARE Supplements, MAPD, PDP, and COC applications
Timeline
HEALTH ASSISTANT
Accolade
09.2020 - 04.2023
CUSTOMER SERVICE
Vibra Health Plan
08.2020 - 09.2020
RECORD RETRIEVAL SPECIALIST
Magna Legal Services
01.2019 - 01.2020
CUSTOMER SERVICE REPRESENTATIVE
AmeriHealth
09.2018 - 10.2018
PATIENT SERVICE REPRESENTATIVE
Penn Medicine
04.2018 - 09.2018
TEAM LEAD
Corporate Call Center Inc
08.2015 - 03.2017
RECEPTIONIST
PC Tax Services
01.2013 - 07.2013
High School Diploma -
Hope Charter High
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