Laurie Trane

279-***-****- cell

**** ********* **.

Rancho Cordova, CA 95670

Email: ad2ou2@r.postjobfree.com

SUMMARY OF QUALIFICATIONS

Accomplished ability to effectively clarify information in one-on-one and group situations

Advanced computer skills- Word, Excel, Access, PowerPoint, and Medisoft

Experience in handling customers inquiries via phone, email and personal interaction

Respondent and negotiable toward customers to ensure quality satisfaction

Able to type 50+ WPM and able to ten-key 10,000+ KPH

HIPPA Guidelines and Compliances, CPR trained

Multi-phone lines, Copy/Fax Machine, Verify Information, and Data Entry

EDUCATION

Associate in Applied Science Degree in Medical Office Assisting Oct 2009-July 2010

Heald College, Rancho Cordova, CA

3.87 GPA

Associate of Arts Degree in Medical Assisting July 2004-April 2008

Heald College, Rancho Cordova, CA

• HIPAA certified

• CPR certified

• Student of the Quarter

EXPERIENCE

Pacific Staffing. May 2023-Janurary 2024

SHEA SERA 2 Program

Answer incoming calls from current applicants and their landlords about the status of their application for rental/utility assistance, advise them if any documents were missing and were needed, communicated with caseworker as needed to help application continue processing, process incoming documents via email and uploaded them to the application and notified caseworker as needed, sent necessary escalations when application had entered the court system, responded to applicant /landlord that documentation had been received and forwarded to the correct department/person, I referred to outside agencies for additional assistance.

Answered incoming calls from potential applicants on what our program offered and walked them through how to set up their tenant profile and apply for our program on our online website.

Answered incoming calls from landlords and walked them through how to set up their landlord profile and how to certify using their portal and uploading any needed documentation for applications to process for payment.

Wollborg Michelson November 2021-March 2022

Delta Dental

Answer incoming calls from members and provide coverage type and status using CDMMIS, provide dental office referrals, assist in setting up appointments, provide status updates/denial reasons for TARs including reaching out to Dental Office as needed to verify what is needed/missing and help them understand their coverage especially if they have more than one dental plan.

Answered incoming calls from providers and confirmed coverage type, provided history, also provided status of TARs and clarified denial reasons and provided coverage for specific codes/full benefit breakdowns.

Placed detailed notes for every call in MACES to document what the call was for and what action I took to address their needs.

Aerotek September 2020- February 2021

Centene IFP Enrollment Team

Entered applications received via fax, email or mail into enrollment system for medical, vision and dental plans to generate membership.

Reached out to brokers or members as needed for missing information to process enrollment.

Certified August 2019-March 2020

May 2018-March 2019

Delta Dental of CA-Federal Government Programs

Answered incoming calls from Providers and members and provided eligibility and claim status using IMBS, provided benefit information and verified coverage of procedure codes.

Processed enrollment and payments over the phone for the Veteran Affairs Dental Plan.

Fulfilled requests for mailings of cards, benefit booklets and coverage letters via email or mail.

Placed detailed notes for every call in MACES to document what the call was for and what action I took to address their needs.

Aerotek Oct 2017-April 2018

BlueShield of CA-IFP Project

Answered incoming calls from members and advised of their eligibility using Facets, advised them of their benefits and co-pays, and advised them of their doctor options and assigned their PCP as necessary.

Processed monthly premium payments.

Placed detailed notes for every call in Facets to document what the call was for and what action I took to address their needs.

Processed reinstatements/terminations, refund requests and addressed billing inconsistencies by utilizing the appropriate procedure, department or entity such as Covered California for our On-Exchange or Billing for those who purchased directly from BlueShield.

Contacted Doctor offices, Medical Groups, Urgent Cares and Hospitals to gather status updates for members.

Faxed eligibility documents as necessary so services could be obtained.

Provided Prescription Drug eligibility and assisted in obtaining authorizations as necessary and explaining the process to members so they understood the process as well.

Ranstad Oct 2016-July 2017

Maximus- MassHealth

Answered incoming call from members of Massachusetts Medicaid program and provided education on eligibility status using State databases.

Educated members on how to use their benefits and covered services and medications.

Educated them on what documents are needed to remain eligible and how to submit them.

Advised of health plan enrollment options and enrolled members as needed and advised of timeframes and referrals to plans as needed.

Assisted in finding participating providers and dentists and provided contact information to members as needed.

Averaged a 99% or higher on QAs and was the top call taker on team.

TennCare- June 2017

Assisted in processing massive back log of applications and redetermination packets.

Entered supporting documentation into member file so application could be processed.

Organized all documents and confirmed that they were complete, legible and in order.

Forward all incomplete or ineligible documents to correct department to contact member to resubmit.

Processed returned mail so that member could be contacted to complete material so they did not lose their health coverage.

MMC Staffing Nov 2015-Aug 2016

Maximus- HCO Project

Answered incoming calls and determined Beneficiaries eligibility with MEDS

Educated Beneficiaries on which Managed Care Plans are available in their county

Enrolled/transferred beneficiaries in the plan option of their choice using CRM

Referred beneficiaries to website or requested informative materials via mail

Referred beneficiaries to EW or other agencies as needed for help with eligibility

Processed or assisted beneficiaries in filing exemptions/EDERs as necessary.

Averaged a 98% or higher on QAs and was consistently the top performer on team for calls handled.

Ajilon Nov 2014-April 2015

Denti-Cal

Answered incoming calls for covered benefits and referrals

Contacted dental offices to schedule first time appointments

Attended to member complaints and escalated them as needed for further investigation

Received Rock Star award Feb 2015 for 98% Compliance

Nanny/Housekeeper-Rancho Cordova June 2009- Nov 2014

Pick up children as needed

Prepare Meals, do light housekeeping, and plan daily activities

APPLEONE-Sacramento, CA Sept 2012-Aug 2013

York

Answered phone calls from customers and contractors about claim status

Contacted Claims Adjustors via email and phone calls on customer/contractor behalf for updates

Created Claims for property damage and contacted customers via phone or email with adjustor information

Teledirect

Took reservations for seminars and input customers information

Took customer information for lawsuit leads

Conducted outbound patient surveys for Optimum and Freedom Medicare Plans and registered people for their Medicare seminars and input their contact information

AeroTek- Rancho Cordova, CA May 2012-Aug 2012

BlueShield of California CSC

Contact hospital, surgical center, or hospice to see if member is still in house or discharged

Document each phone call and either close out encounter or tickle for follow-up

Enter patient information, procedure, and facility of fax into encounter form for tracking

Load IPA authorizations into encounter forms so they can be processed and claims paid

Kelly Services- Sacramento, CA Nov 2010-Feb 2011

Health Net Medicare Part D CSR

Answer phone calls and assist them with their concerns and document the call and outcome

Call Pharmacy’s to assist members who are having trouble getting medication cover

Assisting Doctors/Pharmacies with what is covered and how/if something else can be covered

Received 4 Kudo awards for outstanding customer service

I was in the top 2% for call volume (2 min a day call wait, over 80+ calls a day)

VOLUNTEER WORK

Volunteers of America January 2019-Present

Provide birthday parties as needed at both the Mather and Bannon Street shelters

Provide and decorate the shelter in selected theme, provide cupcakes and goodie bags, provide activities/games for party time and presents for the children celebrating that month.

Jr. Giants Team Parent via RCPD PAL Program June 2011-Present

Assist coaches with practice i.e. lead children in stretches, catching and hitting practice

Lead children and parents in the post-practice warm up i.e. upcoming deadlines, game info and weekly words

Weekly communication with parents via email/phone of what is coming and updates on children’s progress

Assist coaches during game time i.e. organizing batting line up, base coach and motivating children

Won the Willie Mac Award 2018 for outstanding service for the Rancho Cordova League.

Contact this candidate