Healthcare Services Management
YOLANDA C. EVERETTE
SENTARA HEALTH PLANS
Chesapeake,VA
21
years of professional experience
Customer service and healthcare professional with a background in patient registration, benefits support, insurance verification, and HIPAA-compliant communication. Brings strong documentation, scheduling, and problem-resolution skills, along with experience training new team members, supporting clinic operations, and helping maintain accuracy, teamwork, and customer satisfaction across high-volume environments.
Work History
CSR
2 Years 3 Months- Respond to internal and external customer questions via telephone regarding insurance benefits, provider contracts, eligibility, claims, appeals and grievances.
- Handled calls from all lines of business (LOB) for daily operations, fostering trust with members and providers regarding health plans.
- Protect members' PHI by following the HIPAA laws and guidelines for each call.
- Maintained high quality and adherence to performance levels to uphold company customer service and quality standards.
- Supported team members by cultivating collaborative relationships and modeling effective communication and teamwork.
- Trained and shadowed new team members, providing resources to address questions on managed care and systems.
CUSTOMER CARE REPRESENTATIVE II
1 Year 1 Month- Responded to internal and external customer questions via telephone and written correspondence regarding insurance benefits, provider contracts, eligibility, and claims.
- Receive and place follow-up telephone calls / emails to answer customer questions that are routine in nature. Use computerized systems like NetworX for tracking, information gathering and troubleshooting with authorizations and CPT and DX codes.
- Documented inquiry outcomes to ensure accurate tracking and analysis, while coordinating with various functions to address customer requests promptly and maintaining positive relationships.
- Analyzed customer inquiries to identify effective solutions, enhancing service delivery.
- Researched and analyzed data to resolve operational challenges and customer service issues, delivering requested information to internal and external customers.
- Protect patients' PHI by following the HIPAA laws and guidelines for each call.
- Conducted outbound calls to customers regarding ZipDrug services.
- Operates a PC/image station to obtain and extract information, documents, activities, and changes from the database.
Patient Access Representative
10 Months- Welcomed patients and families, addressed inquiries, directed arrivals to appropriate service areas, and facilitated scheduling, pre-admission, discharge, and waiting-room updates for outpatient vascular interventional center and surgery preparation and recovery center.
- Coordinated scheduling, pre-admission, and discharge processes while supervising and updating families on patient information in waiting rooms.
- Supported patient registration from start to finish by verifying identity, matching the correct medical record, reviewing schedules and physician orders, and entering demographic and insurance details into an electronic health record.
- Reviewed regulatory and compliance forms, ensured accurate documentation, and maintained privacy and HIPAA standards during registration.
- Collected co-payments, deposits, and outstanding balances, and processed financial transactions securely.
RETAIL ASSISTANT BRANCH MANAGER
2 Years 11 Months- Promoted to Assistant Branch Manager from Retail Banker II in 8 months because of exceptional performance and leadership skills.
- Provided leadership, direction, and training to all employees, facilitated the onboarding process for new hires. Promoted employee retention.
- Developed and executed branch sales and marketing projects that drove revenue growth and improved service quality.
- Managed consumer and business relationships for financial accounts, collaborating with bank departments to address client needs.
- Implemented operational plans that enhanced efficiency and profitability across multiple locations.
- Served as the Treasurer on the E-Board for Dream Dap Inc. a non-profit organization that provides down payment assistance to single parents purchasing a home.
CEO/Owner
12 Years 10 Months- Directed transition from family day care home to full-service center, while ensuring operational needs were met and childcare continued at a high level.
- Managed personnel, facilities, systems, policies, and payroll processes while overseeing operations of successful child care center, including data entry and spreadsheet creation.
- Handled hiring, management, and professional development of employees; conducted regular performance reviews to ensure compliance with CDC requirements and implemented organizational strategies to enhance morale and productivity.
- Ensured safety of children and staff by developing effective lesson plans and facilitating parent conferences and communications.
PATIENT CARE SPECIALIST SPCCS
- Delivered clinical and non-clinical support within a clinic environment, ensuring exceptional patient experience through complex administrative tasks that facilitated patient care delivery.
- Scheduled appointments and outpatient procedures, coordinating referrals, resources, and pre-authorizations, while ensuring clear communication with patients and accurate documentation for billing.
- Supported practice operations through scheduling meetings, preparing correspondence, maintaining notes/minutes/files, and responding to inquiries from patients, providers, and insurance companies.
- Employ a high level of initiative and independent judgment to make decisions about appropriate prioritization and handling/routing of incoming requests and difficult problems
Education
BS Degree - Health Services Management
- 2019-2021 - Dean's List
- 2019-2021 - Honor Roll
High School
Skills
Claims processing
Insurance verification
Authorization coordination
HIPAA compliance
Patient registration
Appointment scheduling
Patient assessments
Case management
Documentation expert
SQL expertise
Healthcare software expertise
Software proficiency
Audits. Inventory and Documentation
Compliance Regulations
Quality improvement
Records management
Effective communicator
Effective communication
Team collaboration
Team building
Staff Training & Development
Employee training
Attention to detail
Problem resolution
Problem-solving skills
Interpersonal communication
Interpersonal skills
Customer service
Transporting patients
Time management abilities
Organizational skills
Medical terminology
Medical terminology knowledge
Care plan development
CPR certification
CPR certification
Patient assessment
Time management abilities
Custom
- Transfer Student Ambassador
- CHAA Certification
- Billing and Coding
- BLS Certification
- CPR & First Aid Certification
- Sentara Ambassador
Timeline
PATIENT CARE SPECIALIST SPCCS
SENTARA
08.2025 Read More
CSR
SENTARA HEALTH PLANS
05.2023 - 08.2025Read More
CUSTOMER CARE REPRESENTATIVE II
CARELONRx
04.2022 - 05.2023Read More
Patient Access Representative
SENTARA NORFOLK GENERAL
06.2021 - 04.2022Read More
RETAIL ASSISTANT BRANCH MANAGER
WOODFOREST NATIONAL BANK
07.2018 - 06.2021Read More
CEO/Owner
BABIES N BEYOND
02.2005 - 12.2017Read More
Norfolk State University
BS Degree from Health Services Management
Read More
Maury High
High School
Read More