Ayeisha Clark

928-***-****

Objective: I would like to work in a competitive yet fun environment that will give me the

benefit of job satisfaction as well as the chance to enhance my job performance. I am

looking for a workplace with opportunities for advancement within their team and a positive

Atmosphere and unique culture.

Work History:

Complaint Specialist// Quality Control Representative

Upgrade Inc.

February 2022- January 2024

●Processing Complaints

●Reviewing and Investigating calls for complaints

●Corrective Coaching

●Compliance

●Communicating with the Lines of Business

●Testing and Implementing Updated Policies and Procedures

●New team member Training and Up-skill training

●Updating Training Material

●Planning and executing team-building activities

●Active listening

●Improving the quality of employees' experience

Loan Advisor

Upgrade Inc.

August 2021- February 2022

●Processing payments

●Call De-escalation

●Verification of account information

●Card Disputes

●Triaging calls

●Investigating accounts for fraudulent activity

●Verifying transactions and purchases

●Adding and updating personal information

●Providing general information about accounts

●Servicing suspended and locked cards

●Acting with integrity

●Making sure the customer has a great experience

●Calculations of possible Per Diem

Customer Service Rep 1

Sonora Quest Laboratories

May 2019- May 2021

●HIPAA verification

●Working with the patient and the client to resolve the issue

●Using all resources to fix the problem for the client and patients

●Adjustments based on Explanation of Benefits

●Monitor patients accounts

●Adding and updating Diagnosis Codes

●collecting deductible payments, collections payments from debit cards, and credit cards, and ach

●using pay connex

●Auditing Medicare records, BCBS Records, AHCCCS

●Scanning audits to representatives

●Pulling medical records for audits

Prior Authorization Specialist

CVS Health

February 2019- March 2019

●Verbal Prior Authorizations

●Hipaa Verification

●Triaging of Calls to correct departments

●Answering Inquiries about Prior Authorizations and Criteria Forms

●The average inbound call frequency is between 50 and 100 calls per day during non-peak

●Obtaining information from Doctors for authorization and verbally providing Authorization approval or decline

Customer Service Rep/ Call Center

Med Impact

November 2018-February 2019

●Initiate Verbal Prior authorizations

●Verification of Patient Benefits and EOBs

●Pharmacy Troubleshooting and Overrides

●HIPAA

●EMR Processing

●Medications/ Formulary Lookup

●Test Claims

●Inbound calls average between 60-200 per day

●Medicare Part D prior authorizations

Patient Care Coordinator

Senderra Rx Pharmacy

August 2017 to November 2018

●Scheduling deliveries

●HIPAA Verifications

●Protection of the patient's PHI

●Collecting Co-pays

●Providing excellent customer service

●Making Outbound calls to the patients

●Data entry

●Implementation team

Education:

Flint Central High School- Diploma Obtained

Genesee Area Skill Center

Skill Highlights

●Genesys: Pulling calls, viewing Rep information and call duration, viewing transcript, type of interaction and internal start and stop time of recordings

●Jira: Pulling claims, researching tickets, opening, reassigning and closing tickets

●Microsoft Office knowledge

●Medical Terminology

●EMR: Scanning documents into charts, checking in and out patients, requesting and verifying appointments

Strengths

●Adaptability

●Responsibility

●Input

●Empathy

●Developer

Contact this candidate