Teranicia Greely
Forney,Tx
Summary
MEMBER CARE ADVOCATE | HEALTHCARE NAVIGATION SPECIALIST
Compassionate professional with 4+ years of remote experience supporting members across medical, dental, and life insurance. Skilled in high-volume inbound calls, end-to-end member support, and resolving claims, billing, and benefits inquiries with accuracy and compliance. Committed to delivering accessible, equitable, and solution-driven member experiences.
Overview
8
8
years of professional experience
Work History
Customer Service Representative
Qualfon
03.2022 - 12.2025
- Handle 60–80+ inbound and outbound calls daily, assisting members, providers, and vendors with insurance, billing, and other inquiries.
- Own the end-to-end member journey, researching and resolving complex cases involving claims, billing discrepancies, benefits coverage, and eligibility.
- Achieve first-call resolution whenever possible by utilizing all available resources and internal systems to minimize member effort.
- Educate members on services, preventive care, coverage options, and available benefits to support informed decision-making.
- Guide members to appropriate dental resources, including provider options, ensuring continuity of care.
- Document all interactions accurately within CRM and EHR systems while maintaining strict HIPAA compliance.
- Collaborate with cross-functional teams to escalate and resolve complex cases efficiently and effectively.
Patient Support Specialist
TTEC
04.2021 - 08.2023
- Assisted patients with appointment scheduling, referrals, and access to primary and specialty care services.
- Provided emotional support to patients navigating complex or difficult health situations.
- Maintained accurate, thorough documentation of all interactions while safeguarding confidential information.
- Served as a liaison between patients, families, physicians, and other healthcare professionals to facilitate clear communication.
- Coordinated referrals from primary care providers to specialists.
- Prepared documents related to patient care, such as prescriptions, treatment plans, and discharge summaries.
Customer Service Representative
Globe Life Insurance
01.2018 - 03.2021
- Provided customer service, including greeting customers and answering questions.
- Conducted thorough risk assessments on potential clients, accurately determining appropriate policy rates and terms.
- Developed customized life insurance plans based on client needs and financial goals.
Education
Associate of Arts - Medical Billing and Coding
Ultimate Medical Academy
Clearwater, FL07.2023
High School Diploma -
RICHWOOD HIGH SCHOOL
Monroe, LA05-2013
Skills
● Patient Communication
● Appointment Scheduling
● Billing and Coding Knowledge
● Insurance Verification
● Medical Terminology
● Conflict Resolution
● Meticulous Attention To Detail
● Electronic Health Records (EHR)
● HIPAA Compliance
● Multi-Line Phone Systems
● Time Management
● Problem Solving
● Customer Relationship Management (CRM)
● Team Collaboration
● Patient Advocacy
● Data Entry
LANGUAGES
English-Fluent
AWARDS
High Academic Honors Recognition / Dean's List / Honor Roll.
TECHNICAL & SYSTEMS
- High-Volume Inbound Call Handling (60–80+ calls/day)
- VoIP Phone Systems (Contact Center Platforms)
- CRM & Case Management Systems
- Electronic Health Records (EHR) / EMR
- Medical Billing & Coding (ICD-10, CPT, HCPCS)
- CMS 1500 & CMS 1450 (UB-04)
- Google Workspace (Docs, Sheets, Gmail, Calendar) Microsoft Excel & Word
- EPIC
- QuickBooks
CORE SKILLS & EXPERTISE
Healthcare Navigation & Member Advocacy
- End-to-End Member Journey Ownership
- Health Insurance Benefits & Coverage Education
- Claims, Billing & Prior Authorizations
- Medicare, Medicaid & Third-Party Payers
- Managed Care Plans (HMO, PPO, POS)
- Continuity of Care Coordination
- First-Call Resolution
Timeline
Customer Service Representative
Qualfon
03.2022 - 12.2025
Patient Support Specialist
TTEC
04.2021 - 08.2023
Customer Service Representative
Globe Life Insurance
01.2018 - 03.2021
Associate of Arts - Medical Billing and Coding
Ultimate Medical Academy
High School Diploma -
RICHWOOD HIGH SCHOOL