Sonjia Culp
Buford,Ga
Summary
Offering foundation in analytical thinking and passion for maintaining high standards, eager to learn and grow in quality-focused environment. Brings understanding of quality assessment principles and knack for data analysis. Ready to use and develop analytical skills and attention to detail in Quality Auditor role.
Overview
25
25
years of professional experience
Work History
Referral Specialist2
Elevance Health/Carelon Medical Benefits Management
02.2022 - Current
- Facilitate clinical referrals, enhancing stakeholder communication and patient care efficiency
- Streamline insurance verification, achieving faster pre-authorization for imaging exams
- Coordinate with physician offices to improve referral accuracy and data completeness
- Manage escalated referrals, optimizing team workflow and reducing response times
- Maintain detailed referral records, supporting transparency and accuracy in processes
- Meticulously processed complex referrals, maintaining high accuracy standards while meeting productivity goals in a fast-paced environment
- Provided empathetic guidance to patients and healthcare providers, facilitating smooth navigation through the intricate pre-authorization process
Customer Service Representative
CVS Health/Aetna Medicare
05.2021 - 02.2022
- Resolved Medicare queries, ensuring member satisfaction and trust.
- Enhanced customer experience through attentive listening and empathy
- Prepared files, letters and notices.
- Consistently met performance metrics while maintaining high-quality customer service, balancing efficiency with compassionate member care
- Responded to customer requests for products, services, and company information.
- Improved customer satisfaction levels by providing timely, accurate, and empathetic support during the claims process.
Lead Medical Assistant
Pediatric Associates of North Atlanta
06.2014 - 05.2021
- Managed patient scheduling, enhancing efficiency and satisfaction with measurable improvements
- Trained staff, boosting team performance and ensuring seamless operations
- Administered vaccines and tests, maintaining accurate records and ensuring patient safety
- Coordinated vaccine supplies, effectively managing inventory to prevent shortages
- Led medical team, optimizing patient flow and coordinating successful Vaccines for Kids program
- Implemented improved patient flow strategies, reducing wait times and enhancing overall clinic efficiency and patient satisfaction
- Provided compassionate care, prioritizing patient needs while managing multiple responsibilities including customer service and medical procedures
Medical Assistant
American Family Care
09.1999 - 05.2014
- Managed patient interviews, boosting flow efficiency and improving care delivery
- Conducted venipuncture and X-rays, ensuring precise lab specimen preparation
- Handled supply orders, maintaining inventory for optimal resource availability
- Authorized drug refills, liaising with pharmacies to enhance prescription accuracy
- Conducted thorough patient evaluations, prioritizing treatments based on critical analysis of care needs and urgency
Education
Accounting Diploma -
Lanier Technical College
Winder, Georgia12.2020
Certificate of Credit Microsoft Excel Application Professional -
Lanier Technical College
Winder, GA12.2020
Certificate of Office Accounting Specialist -
Lanier Technical College
Winder, Georgia08.2020
Medical Office Assistant/Medical Assistant -
Virginia College At Birmingham
Birmingham, AL05.1999
Skills
- Customer Service
- Scheduling
- Auditing
- EMR
- Microsoft Excel
- Claims
- Data Entry
- Medical terminology
- Documentation
- Pre-authorizations
- Bookkeeping
- Insurance verification
LANGUAGES
English
Native
Timeline
Referral Specialist2
Elevance Health/Carelon Medical Benefits Management
02.2022 - Current
Customer Service Representative
CVS Health/Aetna Medicare
05.2021 - 02.2022
Lead Medical Assistant
Pediatric Associates of North Atlanta
06.2014 - 05.2021
Medical Assistant
American Family Care
09.1999 - 05.2014
Accounting Diploma -
Lanier Technical College
Certificate of Credit Microsoft Excel Application Professional -
Lanier Technical College
Certificate of Office Accounting Specialist -
Lanier Technical College
Medical Office Assistant/Medical Assistant -
Virginia College At Birmingham
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