My goal is to find a rewarding position, where I can provide a professional atmosphere that allows me to use my current skills while continuing to learn and obtain new, relevant skills. I am a dedicated worker aiming for a position as a team player in a people-oriented organization where I can maximize my customer service experience to achieve the corporate goals.
Overview
3
3
years of professional experience
Work History
Patient Access Specialist
Assist Rx
02.2023 - 06.2023
Ensure cases move through the process as required in compliance with company requirements and the organization's defined standards and procedures; in a manner that provides the best level of service and quality
Conduct benefit investigations for patients by making outbound phone call to payors to verify patient insurance benefit information, navigate complex reimbursement barriers and seek resources to overcome the barriers
Verify patient specific benefits and document specifics including coverage, cost share and access/provider options
Identify any coverage restrictions and details on how to expedite patient access
Document and initiate prior authorization process and claims appeals
Report any reimbursement trends or delays in coverage to management
Patient Care Navigator
Bright Healthcare
06.2022 - 12.2022
Care Navigator specialist helps patients communicate with their healthcare providers so they get the information they need to make decisions about their health care
Care navigators may also help patients set up appointments for doctor visits and medical tests and get financial, legal, and social support
Work one-on-one with clients to encourage continued commitment and adherence to medical treatment, access to social services, improved communication, and prompt re-engagement in care
Member Service Representative
Blue Cross and Blue Shield
09.2023 - 01.2025
Helped large volume of customers every day with positive attitude and focus on customer satisfaction.
Provided exceptional service through active listening, understanding member needs, and offering appropriate solutions.
Enhanced customer satisfaction by efficiently addressing and resolving inquiries and concerns.
Maintained high-quality service by adhering to company policies and standards in all member interactions.
Verified customer identification and documentation for compliant transactions.
Processed account transactions accurately, ensuring proper documentation and timely processing.
Assisted members with account management, including updating personal information and setting up automated payments.
Handled complaints with prompt, courteous service to uphold professional reputation.
Promoted a positive work environment by fostering open communication between colleagues and supervisors.
Skills
Patient Account Specialist
Patient Registration
Insurance verification
Charge entry
Data entry
Billing
Proficient in several medical systems
Multitasking
Excellent customer service
Organized
Detail oriented
Professionalreferences
Marquis Williams, Previous Manager at Bright Healthcare, 816-612-7871
Thomesa Ballow, Previous Supervisor at Bright Healthcare, 816-529-9113
Operations Support Specialist at Heartland Regional Alcohol and Drug Assessment CenterOperations Support Specialist at Heartland Regional Alcohol and Drug Assessment Center