Danesha Fielder

Prior Authorization Representative

Hammond, IN 46320

ad0tin@r.postjobfree.com

+1-773-***-****

Prior Authorization Representative with over 10 years of experience in customer service, healthcare insurance, sales and support, offering polished communication skills. Brings excellent organizational skills and talent for overcoming customer objections. Self-motivated and true team player. Aiming to use my proven skills to fill the position at your company. Willing to relocate: Anywhere

Authorized to work in the US for any employer

Work Experience

Prior Authorization Representative

BroadPath - Hammond, IN

January 2021 to September 2023

• Handle inbound telephone and written inquiries from pharmacists and doctors regarding prior authorization by screening and reviewing requests based on benefit plan design, client specifics and clinical criteria.

• Provide information to clients, participants, pharmacists and doctors regarding participants pharmacy benefit, drug coverage and provide accurate procedures for medication exceptions.

• Facilitate resolution of drug coverage issues and pro-actively address, research and resolve issues while maintaining accurate and complete documentation of all inquiries for continuous improvement.

• Work collaboratively with other associates and supervisor to ensure that best practices are shared.

• Other special projects as assigned.

Customer Support Specialist

ResultsCX - Hammond, IN

August 2018 to December 2020

• Worked with customers and internal teams to resolve complex technical issues and maintain high customer satisfaction.

• Provided technical support within SLA, ensuring a high level of professionalism and customer satisfaction.

• Followed the escalation process: promptly identify cases to be escalated and assured cases were prepared for escalation (thoroughly investigated and documented)

• Took ownership of technical issues, mentor and provide consultations to Tier 1 and work with our Tier 3 Team to resolve more advanced issues.

• Maintained a high level of technical expertise at all times, mentor and provide consultations to Tier 2 Support Analysts.

• Enforced Tier 2 processes and ensure top performance and adherence to KPIs.

• Took ownership of escalated issues (Tier 2 level) and work with our Tier 3 Team to resolve more advanced issues when necessary.

• Participated in the Support organization’s internal projects. Delivery Route Driver

Courier Express One(Amazon) - Chicago, IL

May 2018 to April 2019

• Communicated regularly with Supervisor for delivery route details and changes.

• Inspected and loaded delivery trucks and picked up customer returns.

• Logged mileage, stops, orders and carton counts for each route.

• Maintained trucks while in use and inspected vehicles and mechanical tools before and after long haul drives.

Lead Sales Associate

Levy Restaurants-United Center - Chicago, IL

August 2016 to April 2019

• Monitored sales floor and merchandise displays for presentable condition, taking corrective action such as restocking or reorganizing products.

• Logged reports, expenses, receipts and sales documents into digital database.

• Opened and closed store independently and prepared nightly bank drop for manager.

• Offered each customer top-notch, personal service to boost sales and customer satisfaction. Customer Service Representative

Walmart - Chicago, IL

November 2012 to April 2016

• Maintained customer satisfaction with forward-thinking strategies focused on addressing customer needs and resolving concerns.

• Communicated with vendors regarding backorder availability, future inventory and special orders.

• Investigated and resolved customer inquiries and complaints quickly.

• Responded proactively and positively to rapid change. Education

Some college in General Studies

Chicago State University - Chicago, IL

August 2011 to December 2011

High school diploma in General Studies

Corliss High School - Chicago, IL

September 2007 to June 2011

Skills

• Software troubleshooting (2 years)

• Customer service (10+ years)

• Customer support (10+ years)

• Problem management (5 years)

• 50 wpm Typist

• Microsoft Office (10+ years)

• Call center

• Healthcare management (2 years)

• Benefits Administration

Contact this candidate