Altamease Hayes-Perkins
addymw@r.postjobfree.com 941-***-****
Career Summary
Well-rounded Professional seeking to join the team of an established company where, I can offer my talents and abilities to help you meet your company goals. Past Roles of mine include close to 10 years of Legal Management experience, Supervisor of Customer Service, Medical Billing experience, as well as several years of practice in Data-Entry/Clerical roles. Key Skills & Knowledge Areas
Leadership & Management
Staff Training & development
Customer Relations
Grievances & Escalations
Medical Terminology
Insurance Verification
Data-Entry & Typing Skills
Office Equipment Operations
Proficient in the use of computers and technology
High-volume inbound & outbound calls
Team Player
Work Experience
Orthonet, LLC
3/2019- Current
Contract Assistant
Develop a professional relationship with physicians office and managed care payor personnel Educate providers on client's processes for treatment review Coordinate selected registration, scheduling, faxing, billing and reporting for contracts which include logging, verifying and entering data
Research appropriate benefit documents to provide preparation for Case Managers Assure that information and compliance expectations are communicated to providers to meet the state regulations timeframe
Develop and maintain medical records to assure all information is received, legible, recorded and filed in the appropriate manner
Convey Health Solutions 3/2016- 3/2019
Supervisor
Resolve escalated Grievance calls from Members/Non-Members/Pharmacies/Physician’s Conduct Supervisor callbacks when resolution was not gained during initial call Communicating of job expectations
Enforce Policy & Procedures
Conduct One on One Meetings with Team Leads and Member Service Advocates to ensure he/she is following Policy & Procedures and stays abreast with all new information Monitor calls by Side-jacking to identify reasons for areas of opportunities in Quality and overall performance/Check for outliers in all areas where goal is not met Adjust/Approve missed punches in ADP
Submission of Time-Off Request
Conduct Performance Reviews
Ensure all employees are following their assigned breaks/Lunches to stay within the Schedule Adherence
Follow-up on email requests
Review Error Report
Approve/Deny Pharmacy Overrides
Maintain detailed documentation for process, procedure, performance, behaviors and incidents Convey Health Solutions 09/2014 – 3/2016
Licensed Health Insurance Agent/Mentor
Enrolled Medicare/Medicaid qualified individuals in a Prescription Drug Plan Explained the benefits of each prescription Drug Plan available Provide information regarding the Formulary/ Tiers for medications Informed members/potential members of drug cost
Specified whether a particular medication was/was not covered under plans available Advised individuals of their Co-Pay, Deductible and Out-of-pocket expenses they would incur under each plan
Inbound/ Outbound Call Customer Service
Document all call information according to standard operating procedures Entered/Verified personal information
Maintained patient and proprietary information
Resolved pharmacy issues from members, providers and pharmacies: determine the cause of the issue, select and explain the best solution to solve the issues Submit requests for Prior Authorizations, Quantity Limit, Step Therapy and Non- Formulary Exception requests
Provest, LLC- 1st 08/2007- 02/2014
Shift Team Leader (Supervisor)
Direct and coordinate the production operations for a Process Service Company that processed and delivered legal documents for subpoena, wage garnishment, foreclosures, and pretrial cases.
Managed the processing of Affidavits that serviced our Independent Contractors Recognized and resolved problems affecting production including schedules, staff and quality Followed up on issues current or past in a timely manner to ensure resolution Proofed Affidavits for quality and accuracy
Monitored staff's performance
Conducted and identified training needs of my staff Fostered and reinforced a Customer Service culture within my staff Maintained detailed documentation for process, procedure, performance, behaviors and incidents
Responded and accurately answered correspondence through verbal, written or emails Optimized staff's performance through written goals and expectations Verified and Approve time in ADP