Taijah Holmes
Vienna,GA
Summary
Versatile Administrative professional well-versed in healthcare practices, compliance standards and operations. Excellent problem-solver and clear communicator with positive and upbeat personality. Advanced abilities in data entry software. Dedicated Customer Service professional with knowledge of service delivery and proven multitasking abilities. Committed to maintaining professional relationships to increase profitability and drive business results. Dedicated care with excellent experience in industry maintains professional appearance and demeanor and expertly completes assigned tasks with focus on quality. Dependable and quick-learning team player with effective communication and organization skills.
Overview
6
6
years of professional experience
Work History
Customer Service Representative
Cigna Healthcare
Remote
01.2023 - Current
- Advocate for customers health inquiries while advising customers to work with health management programs for their needs
- Educated customers about claims inquiries, understanding and quoting customers benefit coverage, prior authorization status, etc.
- Streamlined communication channels for improved customer experience and faster response times.
- Managed high call volume, consistently maintaining a professional demeanor and prioritizing customers'' needs.
- Collaborated with team members to optimize processes for increased efficiency in handling customer complaints.
- Achieved high service level scores by effectively resolving customer issues during the first contact.
- Trained in All Products such as Facets, Proclaim and IFP( Dental, Medical, and Pharmacy)
- Implemented feedback from quality assurance reviews to continuously refine skills and deliver excellent support.
- Assisted in developing operational procedures that positively impacted overall customer satisfaction ratings.
- Handled escalated calls, successfully deescalating situations while finding solutions to meet client expectations.
- Adhered to company guidelines and protocols while representing the brand professionally during all interactions with customers.
- Provided product knowledge assistance to customers, guiding them towards informed purchasing decisions based on their specific needs.
- Navigated multiple systems simultaneously for efficient information retrieval during live calls with customers.
- Strong understanding of all benefits for each LOB and educating customers about available services, promotions, or discounts; up-selling products when appropriate.
- Maintained a high level of integrity and confidentiality when handling sensitive customer information, ensuring data privacy compliance.
- Supports member inquiries and actively listen to customers including handling concerns quickly and escalated major issues to supervisor.
- Clarified customer issues and determined root cause of problems to resolve product or service complaints.
Medical Assistant
Houston Healthcare
Remote, USA
12.2021 - 09.2022
- Worked with insurance carriers to obtain authorization approvals for medications, supplies and equipment.
- Coordinated post-discharge care by communicating with outpatient clinics, community resources, agencies and families around patients' transitional care.
- Communicated with patients and family members to assist with information, provide literature and direct to community resources.
- Completed weekly scheduling and monthly department reports for case managers.
- Answered telephone calls to offer office information, answer questions and direct calls to staff. A
- Received, recorded and addressed incoming and outgoing communication via telephone and email.
- Organized and maintained patient chart filing system to promote quick data finding for staff.
- Completed administrative patient intakes with case histories, insurance information and mandated forms.
- Contacted hospitals to confirm patients medical histories and prevent inaccurate diagnoses and treatments.
- Accurately completed insurance and Medicaid billing and OASIS documentation for patient visits.
Patient Services Manager
Atrium Healthcare
Remote, USA
02.2019 - 10.2021
- Inputted accurate patient insurance, billing and payment information in POS system.
- Demonstrated exceptional customer service to foster welcoming and professional environment for patients.
- Answered customer telephone calls promptly to avoid on-hold wait times. Managed over 75 customer calls per day.
- Operated POS system to itemize and complete average of customer purchases.
- Recorded actions taken, issues resolved and medical information to effectively manage customer accounts.
- Handled aggressive customers in fast-paced setting in coordination with solid team of customer service associates.
- Followed-through on all critical inter-departmental escalations to increase customer retention rates.
- Increased efficiency and performance by monitoring team member productivity and providing feedback.
- Maintained customer satisfaction with forward-thinking strategies focused on addressing customer needs and resolving concerns.
- Developed and updated policies and procedures, maintaining compliance with statutory, regulatory and local, state and federal guidelines relating to HIPAA, benefits administration and general liability.
Education
High School Diploma -
Dooly County High School
Vienna, GA05.2014
Bachelor Of Health Science - Health Sciences
Albany State University
Albany, GA05.2020
Bachelor Of Science - Nursing
Albany State University
Albany, GA05.2023
Skills
- Advising Patents
- Outcome Planning
- Data Entry Software
- Current Medical Assistant Certification
- Call Transfers
- Document Management and Storage
- Data Entry Accuracy
- Advanced Clerical Knowledge
- Patient Charting
- Managing Multiple Priorities
- Medical Terminology
- Issue and Complaint Resolution
- POS Systems and Ordering Platforms
- Building Customer Trust and Loyalty
- Upbeat and Positive Personality
Timeline
Customer Service Representative
Cigna Healthcare
01.2023 - Current
Medical Assistant
Houston Healthcare
12.2021 - 09.2022
Patient Services Manager
Atrium Healthcare
02.2019 - 10.2021
High School Diploma -
Dooly County High School
Bachelor Of Health Science - Health Sciences
Albany State University
Bachelor Of Science - Nursing
Albany State University