Stacy Williams-VanDyke
Summary
Detail-oriented Patient Access Representative with extensive medical services background and strong work ethic. Managed patient-related accounts receivable. Excellent communications skills and empathetic nature enabled achievement of positive outcomes. Dedicated administrative professional with successful experience in fast-paced office settings and working from home. Hardworking team player with expertise in completing various clerical tasks and offering staff support. Responsible, punctual and productive professional when working with little to no supervision. Capable Patient Representative dedicated to providing superior support for patients in need of reliable information regarding insurance coverage, finance options and documentation requirements. Well-versed in scheduling and database management functions for streamlined communication and reduced correspondence backlogs. Excels at identifying client needs and concerns to improve engagement strategies and overall service.
Overview
8
8
years of professional experience
Work History
Members Advocate
Disable Veterans Solutions
12.2023 - Current
- Work from home position-Utilize various web-based platforms using active listening skills to the customers, policy holders, for Medicaid members in PA.to gain understanding of their needs, clarify information, and offer solutions
- Research complex issues pertaining to the caller's health, status and potential plan options
- Navigate across multiple databases, respond to and resolve on the first call
- Customer service inquiries and issues by identifying the topic and type of assistance the caller is needing- such as benefits, eligibility claims, and financial spending accounts for medical and pharmacy claims and or benefits
- Contact care providers (doctor's offices and or pharmacies on behalf of the members to assist with appointment scheduling or connections with internal specialists of assistance
- Answer or return up to 20+calls a day
Claims Processor I, II
Wisconsin Physicians Services Insurance Corporation
10.2017 - 10.2023
- Work from home position -Military and Veterans Health (MVH) for Tricare claims from receipt through resolution in accordance with MVH regulations, guidelines, and quality standards, with expertise in coordination of benefits (COB), eligibility, and claims development
- Analyze claims to determine if eligibility requirements and claim filing requirements are met and make determinations
- Calculate Other Health Insurance (OHI) COB amounts using the data from claim such as the EOB or prior payment information given
- Identify when to send to other departments based on guidelines
- Process all claim types by determining corrective action to be taken on various types of errors pended by the system and resolving interactive edits
- Review submitted claim information and select correct procedure code and diagnosis code using ICD-10, CPT4, and HCPCS manuals.
Customer Service Representative
HSN
09.2022 - 05.2023
- Work from home position-Answer high volume inbound customer calls 25+ a day
- Problem solves, also assisted customers as much as possible with their orders
- Take payments via credit card or bank account or using HSN card, QVC card
- Assist customers with questions, while making the call a good experience for customers
- Confirmed refunds, taking payments, placing orders, and analyzing account data
- One call resolution
Customer Service Representative
Alorica
09.2017 - 06.2019
- Work from home position-Answer high volume of calls 20+a day for customer having questions and ordering from Evine.com products
- Resolve customer issues with one call resolutions
- Help customers navigate through Evin.com website
- Take payments either by credit card or debt card or gift cards.
Customer Service Representative
Kelly Services-Healthnet Federal Service
10.2015 - 10.2017
- In office position- Choice Program Project receiving request from the Veteran Administration to set appointments or Cancel appointments
- Call patients to determine their needs to find the right provider for their health issues, locate the provider
- Set an appointment using computer software
- Call and confirm the appointment with the Veteran(patient) Follow up on appointments that were scheduled for the Veteran
- Collect the medical documents from the provider and send them to Veteran Administration
- Answer notes from the VA, responding about Veteran's care.
Education
Business Management - Business Management
Everest Community College
Online09.2010
No Degree - Training For Microsoft Office- Office Procedure
Family Investment Center
Newport News, VA05.2002
GED -
Richard Arnold High School
Savannah, GA06.1995
Skills
- NPI Knowledge
- Provider Relations and Member relations
- Modifies and Documents claims by completing and recording forms, reports, logs, and records
- Fluent in computer navigations and toggling between systems while confidently and using compassion and engaging with members
- Prepare reports by collecting, analyzing, and summarizing information, calculating benefits that is due and determine compensation settlement
- Keep members and or claims information confidential
- Medical Terminology
- ICD Codes
- Customer Service
- Collections
- Hobbies
- Affirmations
- Reading
- Self Help videos or books
- Meditation
References
References upon request.
Additional Information
Very fast learner and always willing to learn and adapt to change very well.
Timeline
Members Advocate
Disable Veterans Solutions
12.2023 - Current
Customer Service Representative
HSN
09.2022 - 05.2023
Claims Processor I, II
Wisconsin Physicians Services Insurance Corporation
10.2017 - 10.2023
Customer Service Representative
Alorica
09.2017 - 06.2019
Customer Service Representative
Kelly Services-Healthnet Federal Service
10.2015 - 10.2017
Business Management - Business Management
Everest Community College
No Degree - Training For Microsoft Office- Office Procedure
Family Investment Center
GED -
Richard Arnold High School
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