Committed job seeker with a history of meeting company needs with consistent and organized practices. Skilled in working under pressure and adapting to new situations and challenges to best enhance the organizational brand.
Overview
15
15
years of professional experience
1
1
Certification
Work History
Pharmacy Help Desk Support
HGS Healthcare
Lithonia, GA
09.2021 - 10.2022
Ensured that providers obtained accurate information on policies and procedures while providing successful resolution to all inquiries.
Maintained knowledge about Independent Health and pharmacy contracts and benefits and education of policies and procedures, departmental reports as well as daily updates.
Analyzed information from the pharmacy claims database and assisted with providing an explanation/resolution for all inquiries.
Communicated effectively with doctors and insurance agencies to resolve prescription cost discrepancies.
Answered 30-50 telephone calls per hour and assisted customers by directing calls to appropriate personnel.
Customer Support Specialist
Working Solutions
Lithonia, GA
01.2019 - 08.2021
Asked probing questions to determine service needs and accurately input information into electronic systems.
Answered incoming calls and emails, providing frontline customer support or assistance with product and service transactions.
Promoted, ensured and provided customer service to customers by demonstrating skills which are consistent with the organization's philosophy of providing extraordinary customer relations and quality service
Resolved 95% of issues with first call and escalated more complex issues to obtain necessary customer support.
Customer Support Agent
Sitel
Lithonia, GA
05.2018 - 12.2018
Managed inbound and outbound calls to ensure all customer and client needs are met.
Promoted high customer satisfaction by resolving problems with knowledgeable and friendly service.
Maintained knowledge of current promotions, exchange guidelines, payment policies and security practices.
Escalated customer concerns, issues and requirements to supervisors for immediate rectification.
Financial Counselor Preauthorization
Gwinnett Medical Center
Lawrenceville, GA
08.2015 - 04.2018
Answered clients' questions regarding details of financial plans and strategies and explained data in easy-to-understand terms.
Advocated for patients by contacting insurance carriers and obtaining necessary benefits information.
Liaised between physician, patient and insurance carrier to verify that each party had necessary information.
Maintained confidentiality of private and sensitive info
Used sound and consistent judgement when analyzing situations
Worked in a collaborative team environment to handle a large volume of claims and telephone calls
Billing Specialist
Skyland Trail
Atlanta, GA
07.2014 - 08.2015
Investigated past due invoices and delinquent accounts to generate revenues and reduce number of unpaid and outstanding accounts.
Input payment history and other financial data to keep customer accounts up-to-date in system.
Assessed billing statements for correct diagnostic codes and identified problems with coding.
Worked directly with clients and senior management weekly to review any potential efficiency opportunities.
Submitted claims to insurance companies and researched and resolved denials and explanations of benefit rejections.
Reimbursement Specialist
McKesson
Norcross, GA
09.2007 - 03.2014
Managed all payments processing, invoicing and collections tasks.
Performed accurate and fully compliant monthly closing processes, accruals and journal entries.
Entered procedure codes, diagnosis codes and patient information into billing software to facilitate invoicing and account management.
Trained new team members on company policies and accounting systems to keep team operations productive and efficient.
Provided prompt and accurate services through knowledge of government regulations, health benefits and healthcare terminology.
Determined medical necessity, using individual insurance carrier regulations.
Education
Some College (No Degree) - Health Information Technology
Strayer University
Washington, DC
Some College (No Degree) -
Georgia Perimeter College
Decatur, GA
Skills
Customer Service
Time Management
Quality Assurance
Pharmacy Operations Support
Relationship Building
Verbal and Written Communication
Critical Thinking
Conflict Management
Addressing Customer Inquiries
Detail-Oriented
Accomplishments
Recognized as Employee of the Month for outstanding performance and team contributions.
Consistently maintained high customer satisfaction ratings.