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Click here or scroll down to respond to this candidateCandidate's Name
Location: Mesquite, Texas Street Address
Education:High School Diploma, H. Grady Spruce High School, Street Address
Professional Experience:Aetna Medicare (Direct) Feb 2024-PresentHealth AdvocateMake 150+ outbound calls daily to Medicare members who need help understanding their health benefits and coverage.Provide personalized support to members by addressing their specific healthcare needs and concerns.Clearly explain Medicare plan benefits, coverage options, eligibility criteria, copayments, deductibles, and network providers.Assist members in scheduling appointments with healthcare providers, ensuring they have access to necessary medical services.Educate members about preventive care, wellness programs, and available resources to support their health and well-being.Dispatch health (Direct) Sep 2020-Feb 2024Senior Customer service representativeHandle incoming calls from patients.Assist patients in scheduling appointments to be seen by healthcare providers.Address patient inquiries and concerns in a professional and empathetic manner.Coordinate and schedule patient visits with appropriate healthcare providers.Handle payment processing accurately and efficiently.Verify patient insurance coverage and benefits.Ensure patients understand their insurance benefits and any potential out-of-pocket costs.Walmart (Part Time) Feb 2022-Jul 2024Account review specialistHandle incoming calls from members whose accounts have been closed.Address concerns and questions related to account closures.Handle cases of returns fraud and chargeback disputes.Process and issue refunds to affected members.Maintain detailed records of interactions and resolutions.Ensure compliance with company policies and procedures during the resolution process.Cornerstone staffing (Direct) Jan 2018-Nov 2019Customer service representativeAnswering calls from physicians, patients, and insurance companies.Addressing inquiries regarding prior authorizations and insurance billing.Providing accurate and timely information about procedures and requirements.Contacting physicians to request prior authorization for medical procedures, treatments, or medications.Contacting healthcare providers to obtain necessary prior authorizations for procedures, treatments, or medications.Silver Leaf resort (Direct) Jan 2016-Mar 2018Quality Assurance leadRegularly monitor and review recorded calls to assess the quality of customer interactions.Evaluate calls based on predefined criteria such as adherence to scripts, accuracy of information, professionalism, and problem resolution.Participate actively in the queue to monitor live calls as they happen.Provide immediate feedback when necessary to address issues in real-time.Collaborate with managers to develop strategies for improving service quality and agent performance.Track agent performance over time to identify patterns and areas for continuous improvement.Garnet hill Rehab (Direct) Jul 2009-Apr 2019Medical recordsEnsure accurate and timely entry of medical records into the EMR system.Scan medical records and integrate them into patients' electronic charts.Maintain an organized system for both physical and digital medical records.Ensure legal compliance and support the legal process with accurate medical documentation.Verify the accuracy and completeness of scanned documents.Organize and maintain both physical and digital medical records.Identify and extract relevant medical records required for legal cases. |
