VonShea Thompson
Pearland,TX
Summary
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.
Overview
15
15
years of professional experience
Work History
Intake Representative - Remote
Evicore
06.2022 - 06.2023
- Verify members eligibility
- Answer verification calls with questions and concerns from health insurance companies on behalf of members
- Promptly transfer Review of Service calls which cannot be completed via formal script to Clinical First Level Reviewer of Medical Reviewer for completion
- Work with sites, patients and physician's office to investigate and resolve any pre-certification questions or concerns and preempt unanticipated issues
- Accurately update patients' information for Prior Authorizations
- Maintain required productivity and QA standards
- Document in patient account record to identify actions taken on account
- Review accounts for appeal requests and forward appropriately
- Maintain courteous and professional attitude with customers and coworkers
- Interact with other staff members to obtain additional information and clarification needed to resolve customer concerns
- Identify problem accounts and escalate as appropriate
- Gathers information, assesses caller needs, research and resolves inquiries and documents calls
- Provides clear and concise information regarding eligibility, claim status and provider enrollment status.
- Answered phone calls from multiple physicians and medical facilities submitting prior authorization request, and handling patient inquiries
- Offered compassionate and attentive guidance to patients during moments of crisis and trauma
Customer Service Representative
Randstad
01.2021 - 06.2023
- Identify and address customer concerns by providing additional information as needed
- Provide assistance with scheduling services
- Verify insurance coverage for services
- Address customer needs which may include complex benefit questions, resolving issues, and educating members
- Handle 30-40 inbound calls daily from members in fast-paced environment
- Record details of inquiries, comments or complaints, transactions or interactions and takes action in accordance to it
- Escalate unresolved and pending customer grievances
- Decisions are typically focused on interpretation of area/department policy and methods for completing assignments
- Work within defined parameters to identify work expectations and quality standards, but has some latitude over prioritization/timing, and works under minimal direction
- Follow standard policies/practices that allow for some opportunity for interpretation/deviation and/or independent discretion
- Absorb, retain and explain working knowledge of product plans and general Medicare information
- Assist callers quickly and professionally by fielding inbound calls to sell health insurance plans with Bloom's sales techniques
- Place outbound calls for member outreach
- Provide accurate information to prospects using Bloom's quality and compliance standards
- Communicate effectively with prospects and plan members over phone, and in-person with co-workers and management personnel
- Proficiently work with Windows and comfortably navigating between websites to assist callers requesting information
- Handle calls in efficient, effective, yet courteous and accurate manner
- Research and provide answers to telephone calls from UI recipients in regards to claim status
- Complete new application while interviewing individuals and entering information into system
- Deliver information to clients in timely and professional manner ensuring that each client receives white glove customer service.
- Answered constant flow of customer calls with minimal wait times
- Actively listened to customers, handled concerns quickly and escalated major issues to supervisor
- Handled customer inquiries and suggestions courteously and professionally
- Answered customer telephone calls promptly to avoid on-hold wait times
- Updated account information to maintain customer records
Customer Service Representative
Alorica
03.2008 - 12.2015
- Initiate and receive calls from patients requiring additional information on completing order
- Provide customers with white glove customer service during interaction
- Tech support for devices
- Complete and document sales orders with accuracy
- Navigate through multiples systems and programs.
- Answered over 60 calls per day
- Responded to customer requests for products, services, and company information.
- Offered advice and assistance to customers, paying attention to special needs or wants.
- Maintained customer satisfaction with forward-thinking strategies focused on addressing customer needs and resolving concerns.
- Updated account information to maintain customer records.
- Answered customer telephone calls promptly to avoid on-hold wait times.
- Actively listened to customers, handled concerns quickly and escalated major issues to supervisor.
- Handled customer inquiries and suggestions courteously and professionally.
Education
Health Information Management / Medical Billing -
San Jacinto College
Houston, Texas05.2024
Some College (No Degree) - Health Information Management
Southern New Hampshire University-Online
Hooksett, NHSome College (No Degree) - Basic Courses
Lamar State College-Orange
Orange, TXHigh School Diploma -
West Orange-Stark High School
Orange, TX05.2000
Skills
- Detail -Oriented
- Great de-escalating skills
- Verification for Inpatient and Outpatient facilities
- Excellent Communication and Interpersonal Skills
- Medical Terminology
- Active listening skills
- ERO system
- Data Entry
- Knowledge of CPT & ICD 10 Coding methodologies
- HMO/PPO authorization process
- Active Listening
- Problem-Solving Abilities
- Medical Terminology Knowledge
- Problem Resolution
- Microsoft Office Suite
Timeline
Intake Representative - Remote
Evicore
06.2022 - 06.2023
Customer Service Representative
Randstad
01.2021 - 06.2023
Customer Service Representative
Alorica
03.2008 - 12.2015
Health Information Management / Medical Billing -
San Jacinto College
Some College (No Degree) - Health Information Management
Southern New Hampshire University-Online
Some College (No Degree) - Basic Courses
Lamar State College-Orange
High School Diploma -
West Orange-Stark High School
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