Referral Specialist Carrier Associate

Alton L. McCauley

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

Graham, NC *7253

919-***-**** (c)

**************@*******.***

Objective

A highly motivated, hardworking and customer service oriented individual, seeking a position with an organization, where I can utilize my experience as well as ascertain additional experience that consistently contributes to the success and growth of the company.

Experience

Client Service Representative,

February 2019-Present, Ciox Health Chapel Hill NC 27514

Receives incoming requests for information and responds to requests by opening mail, assisting walk-ins and telephone inquiries, and retrieving facsimile inquiries in a timely manner.

Date stamps all requests and highlights pertinent data to facilitate processing.

Validates requests and authorizations for release of medical information according to established procedures and

HIPAA guidelines.

Completes release of information requests including retrieving patient’s medical charts and returning charts,

copying/scanning medical records accurately and correctly, according to requests, established procedures, and

established standards of quality and productivity; and electronically transmits medical record to processing operations.

Performs quality checks on all work to assure accuracy of the release, confidentiality, and proper invoicing.

Maintains equipment in excellent operating condition (inside and out) and troubleshoot equipment issues with

assistance from the Help Desk department.

Provides excellent customer service by being attentive, respectful and professional at all times; insures

understanding of customer request and follows-through as promised; being proactive in identifying and addressing

member concerns, or problems.

Demonstrates helpful and effective telephone etiquette and customer service skills by providing appropriate

information to callers.

Maintains a neat, clean, and professional personal appearance and observes the dress code established by the

Company or the member facility.

Maintains a clean and orderly work area, insures that records and files are properly stored before leaving area, and

insures adequate supplies to meet customer requests.

Maintains working knowledge of the current state laws regarding fee structure, and HIPAA regulations as well as

facility policies and procedures in regards to release of information.

Ability to maintain regular attendance and punctuality as scheduled. Notifies Manager, Operations and/or Supervisor

if unable to adhere to daily schedule.

Adheres to all Company time and attendance policies or applicable law covering meal breaks and rest periods.

Records all accurate work hours in the Company’s designated time keeping system daily and adheres to the

Company’s overtime policy and procedures for requesting time off or change in schedule.

Works within scope of position and direction; willingly accepts assignments and is available to take on additional

member facilities and assist with ROI backlogs.

Referral Specialist,

April 2014-February 2019, Duke Health. Durham NC 27707

Coordinate appointment requests received via telephone/ electronic medical record and or fax.

Determine most appropriate provider, service, and location for appointment

Reschedule patients from canceled clinics

Provide support to office staff

Make changes to provider schedule templates for specific date changes

Rural Carrier Associate,

November 2013- April 2014, United States Postal Service, Cary NC 27513

Responsible for collecting and sorting mail for various routs

Responsible for the safe delivery and collection of the U.S. mail

Selling stamps, supplies and money orders

Reported suspicious concerns with safety and security issues to management.

Handled escalations and customer complaints.

Ensure the practicing of superb quality and excellent customer service.

Team Lead,

January 2012-November 2013, Trial Card Incorporated, Cary, NC 27513

Supervised various groups of agents within the call center.

Managed high call volume phone lines

Ensured all agents followed company policies and were HIPPA compliant

Produced weekly and monthly production reports. Handled employee discrepancies.

Reported suspicious concerns with patient accounts and security issues to management.

Handled escalations and patient complaints.

Monitored the calls of agents to ensure the practicing of superb quality and excellent customer

service.

Education

Future Truckers of America• Aug 2021 graduate• Asheboro NC

-Certified Drivers License : Class A

Jordan High School• May 2001 graduate• Durham, NC

References

Upon Request

Contact this candidate