Call Center Customer Service
Resume:
Tammeron Shields
San Antonio, TX *****
ad3nj7@r.postjobfree.com
#readytowork
Authorized to work in the US for any employer
Work Experience
SAN ANTONIO
Csp Resource Solutions LLC/ Liveops - San Antonio, TX August 2017 to Present
As an IBO, i work in a work from home call center taking inbound calls for multiple clients for customer service, payroll assistance, tax assistance and other duties. LVN Care Manger
Humana At Home - San Antonio, TX
September 2015 to April 2016
Answer questions that come up between doctor visits about health conditions and medicine. Help sort through medical bills and paperwork, coordinate medication and care among providers, helps locate transportation, meals, financial and social services. LVN Intake Specialist (Pharmacy), Aline Staffing Solutions CVS Caremark - San Antonio, TX
November 2014 to January 2015
Responsible for researching drug authorization requests and inquiries. Facilitates quality outcomes and/ or resolutions for the benefit of the members and providers clinical intake specialist expertise to a role where you will receive, research and process electronic, telephonic or facsimile inquiries and prepare correspondence related to pre-authorization, concurrent review, care management and disease management requests for service.
LVN Case Manager Service Coordinator
Healthcare Support Staffing - San Antonio, TX
June 2013 to August 2013
To get members out of expensive long-term care facilities and nursing homes and offer alternative Healthcare options, i.e. 'Home Health' so they can have services in their home's vs in the hospital. Working mostly with pediatric patients/foster care (Medicaid) patients and setting up provider care for them once they are discharged from the hospital to home.
Pediatric LVN
Brit-Tex Nursing Services, INC - San Antonio, TX
August 2011 to September 2012
Specialized in pediatric home care for ventilator dependent patients where duties included gastrointestinal feedings, and medication administration. Worked one-on-one with patients and family members in a home care teaching environment. Provided client care per physician's orders utilizing general nursing theory, skills, and techniques through direct patient care. the Plan of Care by exercising strong Decision making and judgment skills and worked with an interdisciplinary team in weekly case conferences to ensure topnotch quality outcomes for clients with the ability to function autonomously and possess effective time management skills.
Pediatric LVN
MSN Home Health - San Antonio, TX
October 2009 to September 2010
Specialized in pediatric home care for ventilator dependent patients where duties included gastrointestinal feedings, and medication administration. Worked one-on-one with patients and family members in a home care teaching environment. Provided client care per physician's orders utilizing general nursing theory, skills, and techniques through direct patient care. the Plan of Care by exercising a strong decision making and judgment skills and worked with an interdisciplinary team in weekly case conferences to ensure topnotch quality outcomes for clients with the ability to function autonomously and possess effective time management skills.
LVN Contractor OMV Medical Staffing
BAMC - San Antonio, TX
January 2009 to December 2009
Job duties to include Team Nursing, patient assessments, cardiac arrhythmia Monitoring, IV and medication administration, patient teaching on cardiac care and procedures, wound care, and discharge teaching. Utilized internal operating system for lab/ radiology entry and results. Pediatric LVN
Replacements, Ltd - San Antonio, TX
February 2009 to June 2009
specialized in pediatric home care for ventilator dependent patients where duties included gastrointestinal feedings, and medication administration. For vent/trach patients. Health Coach LVN
Heathway's Inc - San Antonio, TX
November 2008 to January 2009
Accurately and efficiently conduct medical record review services Scan relevant components of the medical record to support reviews performed Upload scanned medical records daily, Maintain communication lines with the Outcomes advocate Successfully complete required training, testing and quality assessments. Communicate effectively and professionally with care provider offices, clinics, hospitals, other clinical facilities Travel to medical facilities in a specified area of region from home to complete review services Abide by all HIPAA and associated patient confidentiality requirements LVN Clinical Advisor/Case Management
Cameron Tucker Personnel/ Humana Health Care - San Antonio, TX January 2008 to July 2008
Collaborated with other health care givers in reviewing actual and proposed medical care and services against an established clinical review for criteria. Call center environment included issuance of a letter to providers if the service meets certification criteria, and escalates to manager or Medical Director for review if the service does not meet certification criteria, and may issue denial letters. Maintaining accurate system documentation and meeting documentation requirements established by department. Using multiple computer systems to complete the work. LVN Agency Contractor
All About Staffing Agency/ Methodist NE and Metropolitan Hospital August 2007 to June 2008
Area of expertise to include Med./Sur, Telemetry, ER and ICU. Use of the Meditech operations system for patient documentation and medication administration, other duties include primary care and team nursing, medication administration, IV therapy, wound care, shift assessments and discharge patient teaching.
LVN Contractor
OMV Medical Staffing - San Antonio, TX
March 2007 to December 2007
Job duties to include Team Nursing, patient assessments, cardiac arrhythmia Monitoring, IV and medication administration, patient teaching on cardiac care and procedures, wound care, and discharge teaching. Utilized internal operating system for lab/ radiology entry and results. Medical Review Nurse/Case Manager
Aerotek Scientific/ The Scooter Store - San Antonio, TX March 2007 to August 2007
job duties were to review medical charts, identify correct ICD9 and CPT codes for medical diagnosis that comply with Medicare guidelines to qualify customers for power chairs and its accessories. Used Microsoft Word 2007 and Excel 2003, Outlook Express and the internal operation system for medical review and documentation.
Inbound Queue Associate/LVN
Aetna Healthcare Life Insurance - San Antonio, TX
November 2006 to March 2007
the nurse supports the pharmacy prescription drug program for customers nationwide, as well as work closely with the healthcare providers in handling drug pre-certification requests for non-formulary drugs. The Precertification Nurse evaluates criteria that need to be met before authorizing a drug to be covered that are not on the drug formulary. There is a great amount of interaction with physicians, other medical staff, pharmacists and members.
LVN Contractor
OMV Medical INC - San Antonio, TX
August 2006 to November 2006
Step-down Burn Unit and Telemetry floor. Job duties included patient assessment, extensive wound care, IV therapy, blood draws, medication administration, documentation and charting in CHCS. Utilized Microsoft Word and Outlook Express operating systems. Education
Associate in Liberal Arts in Liberal Arts
St Phillips College - San Antonio, TX
December 2016
Associate in Pre-Nursing in Pre-Nursing
St Philip's College - San Antonio, TX
December 2016
Diploma in Vocational Nurse
Galen College of Nursing - San Antonio, TX
November 1997 to January 1999
Skills
• Benefits Administration
• Nursing Experience
• Case Management
• Time Management
• Sales Experience
• Phlebotomy
• Mentoring
• English
• Office Experience
• ICD-10
• EMR Systems
• Medical Billing
• CPT Coding
• Primary Care Experience
• Typing
• Patient Care
• Medical Office Experience
• Intake Experience
• Critical Care Experience
• Medical Records
• 10 Key Calculator
• Microsoft Excel
• Microsoft Word
• Computer literacy
• Writing skills
• 10 key typing
• Windows
• Contracts
• Computer skills
• Fundraising
• Fraud
• Communication skills
• Microsoft Powerpoint
• Medicare
• Sales
Certifications and Licenses
LVN
CPR Certification
LPN
BLS Certification
AED Certification
Assessments
Basic computer skills — Completed
December 2019
Performing basic computer operations, navigating a Windows OS, and troubleshooting common computer problems.
Full results: Completed
Attention to detail — Proficient
December 2019
Identifying differences in materials, following instructions, and detecting details among distracting information.
Full results: Proficient
Electronic health records: Best practices — Highly Proficient November 2019
Knowledge of EHR data, associated privacy regulations, and best practices for EHR use Full results: Highly Proficient
Medical terminology — Proficient
November 2019
Understanding and using medical terminology
Full results: Proficient
Clinical judgment — Proficient
November 2021
Assessing a patient's condition and implementing the appropriate medical intervention Full results: Proficient
Indeed Assessments provides skills tests that are not indicative of a license or certification, or continued development in any professional field.
Additional Information
Skills
Microsoft Office, Data Entry, CPT10/ ICD9 Coding, Medical Review, Pre-Certification Review/ Pharmacy
(10+ years)
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