Vellina Datts
Philadelphia,PA
Summary
Organized and dependable individual successful at managing multiple priorities with a positive attitude and build relationships within a diversified, demanding and fast-paced settings. Taking on added responsibilities to assist in positively impact company goals and success.
Overview
13
13
years of professional experience
1
1
Certification
Work History
Customer Consultant Coach
Exelon (PECO)
10.2023 - Current
- Provide assistance with training, coaching and evaluation of customer handling skills and transaction accuracy.
- Ensure employee compliance with Company Regulatory policies and procedures.
- Aid internal and external customers by performing research and providing answers when requested.
- Develop individual improvement plans for CSR's as required.
- Conduct On-the-job training (OJT) and On-the-job evaluations (OJE)
Customer Consultant
Exelon (PECO)
11.2022 - 10.2023
- Assist customers with Start, Stop and Transfer of service
- Scheduled repair and inspection of services
- Processed and amended related work orders
- Sympathetic customer issue/concerns when appropriate by listening to customer's needs, using negotiation & persuasion skills to generate favorable solutions
- Demonstrated strong communication skills through explanation of products and services
- Resolved challenging customer issues: billing, services orders, and meter troubleshooting, before forward to appropriate departments
- Demonstrated ability to respond to emergencies and manage stressful situations
- Ability and willingness to work effectively and productively in changing environments
- Managing difficult and non-difficult customers utilizing soft skills
- Provide information to customers regarding outages, restoration time and repair status
- Respond to electric and gas emergencies from customers and municipalities regarding outages and public safety issue.
Travelers Aid
Travelers Aid International
09.2022 - 05.2023
- Providing accurate information and first-class level of service to all airport customers.
- Supporting the needs of passengers and staff in customs and border protection hall, facilitating organized lines and clear directions
- Communicating with passengers during high-volume times at designated desks, in customs, and/or as a mobile presence throughout the terminal; assist passengers requesting extra support through the airport, including both face-to-face and when necessary with technology supported, virtual assistance;
- Assisting passengers who encounter travel disruptions or who are stranded
- Assess needs and provide appropriate direction and referrals; maintaining records of passengers assisted and providing feedback about trends to Travelers Aid Program Manager and PHL customer experience team; staying abreast of airport projects or events that may impact the traveling public.
Pharmacy Claims Specialist
HUMANA
03.2020 - 12.2021
- Pharmacy Technicians assist pharmacists in practicing palliative care for hospice patients in our Call Center
- Produce quality of work that is above the industry average
- Provide superior customer service to our hospice partners
- Proficient in current technology system(s) to perform the following tasks: enter patient admissions, change an active patient to discharge/deceased status, transfer patients, and update demographic changes, process refills, and documenting as needed
- Assist callers with customer service issues including FedEx package tracking and completing the CS report form to report all service failures
- Assist local pharmacies with adjudication of claims
- Assists pharmacist with fulfillment of orders at applicable sites and other duties as assigned
- Ability to respond to high volume inbound calls in a timely and effective manner
Benefit Representative
TRICARE
06.2018 - 03.2020
- Process and correct enrollment discrepancies between CHCS and DEER
- Assign primary care managers to TRICARE customers
- Verify eligibility information for remote beneficiaries
- Provide education and enrollment information to customers on the phone and in person
- Handle faxed enrollment forms
- Research and interpret benefits, policies, and procedures to military staff, remote site points of contact, and other resources
- Maintain electronic system/paper files and data integrity
- Provide customer service to the Military Treatment Facility Commander and/or the TRICARE Area Office staff as directed by the TOP Regional Lead, Deputy Program Manager, or Program Manager
- Serve as liaison between the TRICARE Regional offices and TRICARE beneficiaries for transitional/portability assistance
- Collect, process, retrieve, and disseminate transfer information to support the TRICARE active-duty portability process
- Conduct off-site briefings such as enrollment briefings, fairs, or other functions when directed by the TOP Regional Lead
- Determine the appropriate assistance levels and when call forwarding, or other referrals are needed to address the customer's question
- Complete all responsibilities and duties in accordance with the Health Insurance Portability and Accountability Act (HIPAA) guidelines to include proper handling of Protected Health Information
Support Service Representative
Acclara
12.2017 - 06.2018
- Retrieve daily ERA's, EFT's, and manual checks for posting to Client(s) system(s) Batch processing of checks or other financial transactions for posting to the appropriate Client(s) system(s) Data entry of cash, adjustment, and/or other transactions to the appropriate Client(s) system(s) Ensure scanning, filing, and/or distribution of A/R correspondence, ERA's, EOB's, or other pertinent documentation is performed daily Maintaining appropriate logs Process internally created mail to ensure sufficient postage is applied and then is taken to appropriate area or repository for pick-up by US Postal Service or other Ground/Air delivery service Perform insurance verification and follow-up telephone calls for various carriers, including, but not limited to Medicare, Managed Care, Blue Cross, and Medicaid Assist A/R Specialists in preparing patient files by verifying completeness and accuracy of information necessary for billing and payment, including, but not limited to patient and guarantor data, insurance information, website inquiry for claims or benefit eligibility, medical record retrieval, billing, etc
- Employ HIPAA safeguards in relation to patient privacy and system security Assist on new or existing projects as needed Client(s) relations
Admissions Coordinator
Eagleville Behavior Health Hospital
08.2015 - 04.2018
- Schedule new admissions; verify insurance, co-pays, and deductible
- Review clinical daily with physician to determine level of care and treat for new admissions
- Scan medical records, clinical and admission paperwork into the system for review
- Answer incoming calls from referral source, staff, and patient's family, insurance companies
- Process all admission request and forward to appropriate departments
- Search patient belongs, retrieve urine sample and take customers to assigned unit
- Utilization Management Coordinator Progeny Health March 2015 to July 2017 Monitor member eligibility; verify customers insurance to ensure necessary procedures are covered using the following systems DPW, Navinet, Jiva, ICUE
- Communicate verbally and/or written prior authorization based on client specification
- Perform outreach calls to hospitals for follow-up clinical information and discharge information
- Process new admissions: this includes update of patient demographics; confirm information
- Maintaining consistent accuracy and documentation of required information which meets risk management, requirements of the department.
Complaint & Appeal Analyst
Aetna Life Insurance Co
06.2011 - 02.2015
- Coordinate all components of complaints and appeals process from Produce document explaining final resolution to members/providers and The Centers for Medicare and Medicaid Services (CMS) Research company, industry, and government policies to ensure Aetna remains in compliance with current regulations Resolve escalated issues and ensure customer satisfaction Maintain heavy caseload while staying organized Identify trends and provide input on potential solutions Persuasive communication; written and verbal Analyze and process appeals
Education
Associate in Arts in Liberal Arts -
Community College of Philadelphia
Philadelphia, PA12.2023
Skills
- Experience with manually inputting data and customer information in database system
- Very accurate keyboarder, with acute attention to detail
- Excellent communications skills; both written and oral
- Exceptional time management skills; able to meet aggressive deadlines
- Provided feedback from to patients regarding orders and insurance issues
- Ability to input data into computer system, while focusing on accuracy
- Ability to multi-task in fast-paced environment
- Active Listening and conflict resolution
Certification
- Government ADP II Clearance with CAC Card, 07/2021
- Government Issued Civilian Identification, 07/2021
Timeline
Customer Consultant Coach
Exelon (PECO)
10.2023 - Current
Customer Consultant
Exelon (PECO)
11.2022 - 10.2023
Travelers Aid
Travelers Aid International
09.2022 - 05.2023
Pharmacy Claims Specialist
HUMANA
03.2020 - 12.2021
Benefit Representative
TRICARE
06.2018 - 03.2020
Support Service Representative
Acclara
12.2017 - 06.2018
Admissions Coordinator
Eagleville Behavior Health Hospital
08.2015 - 04.2018
Complaint & Appeal Analyst
Aetna Life Insurance Co
06.2011 - 02.2015
Associate in Arts in Liberal Arts -
Community College of Philadelphia
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