Customer Service Administrative Assistant
Resume:
Pamela McCall
Research Analyst
Charlotte, NC ***69
******************@***********.***
Highly effective change agent with exceptional production in healthcare support services. Resourceful problem-solver who thrives on challenges and flourishes in high-pressure and fast-paced environments. Results-driven professional with significant expertise in executing organizational healthcare objectives while providing quality customer service various organizations, including non- profit. Reputation for advancing successful customer service initiatives, leveraging core strengths, and working diligently to ensure peak operational performance. Proficient Microsoft Word, Excel, PowerPoint, and Outlook.
Areas of Excellence
Data Entry
Authorized to work in the US for any employer
Work Experience
Research Analyst
Snow Companies - Remote
January 2014 to Present
Research Analyst (Pharmaceuticals/Healthcare)
Key Contributions and Accountabilities:
• Conduct efficient internet-based research into complex subjects (disease states, advocacy, biopharma activity, and others) and provide succinct, technically accurate, and well-documented summary findings and recommendations
• Develop surveys, discussion guides, and other research based tools to capture insights
• Utilize excellent writing skills and independent judgment to condense information quickly and present analysis and conclusions in an efficient, logical manner. Must be able to utilize discretion and judgment to think in the lens of what clients and accounts need
• Focus on tasks until completion and follow multi-step plans without guidance
• Create and maintain documentation on processes for the various categories of client requests
• Develop thoughtful project plans to effectively manage project timelines
• Independently own projects and accept accountability for project outcome
• Interact with business owners and work through submissions/issues using business experience and analytical and communication skills to meet deadlines and achieve a high level of customer service
• Partner with internal groups to ensure insights are used toward current projects in queue and/or to create new projects for optimization
• Foster innovation and pioneer new processes and projects
• Partner with other team members to balance research requests and meet account deadlines
• Measure themes weekly to identify trends and make recommendations to appropriate teams to address issues or opportunities identified in research
Patient Advocate- RAS
Chamberlin Edmonds/Emdeon - Charlotte, NC
July 2012 to April 2014
Support Services/Healthcare)
Key Contributions and Accountabilities:
• Achieved call center operations by assisting callers in resolving account issues by identifying and taking appropriate actions, such as completing required forms to support application process.
• Utilized effective communication skills with other internal resolve application functions to obtain information and/or provide updates regarding claims status.
• Documented and updated the PACE (Patient Advocacy at Chamberlin Edmonds System) based on daily contact of select members of assigned applicant group and application evidence requirements, i.e. work activity, medical condition, third party, beneficiary, contact and demographic data financial, life and health insurance information, employment and salary verification, medical history and documentation where evidence is required.
• Within the scope of available resources identify and take appropriate actions to complete and submit required financial, medical and personal information forms to support the client application process.
• Recognized for demonstrating superior knowledge of application requirements and processes for SSA and DDS programs.
• Effectively managed and identified appropriate escalation points and works with Escalation Team Leader to resolve issues as needed.
Medicaid Caseworker II
County Department of Social Services - Kannapolis, NC April 2009 to July 2012
(Family & Children Medicaid)
Key Contributions and Accountabilities:
• Led efforts in interviewing clients and completing the North Carolina Medicaid applications and ensuring the accuracy of applications prior to submittal.
• Accurately evaluated clients to determine eligibility requirements, complete reviews, and re-evaluate the clients when changes are reported.
• Held accountable for conducting thorough research to verify financial information and all other relevant information provided by the client.
• Acted as a liaison between the client and Internal Resolution Application regarding clients claim status.
• Exhibited additional knowledge by performing daily administrative, clerical, and daily legal compliance documentation.
Medicaid Caseworker/ Site Director (Customer Care Operations) Trinity Medical Services/ Alliance One Inc - Charlotte, NC November 2006 to April 2009
Charlotte, North Carolina November 2006-April 2009 Medicaid Caseworker/ Site Director (Customer Care Operations) Key Contributions and Accountabilities:
• Developed strong rapports with patients by conducting interviews to obtain personal and financial data needed to complete Medicaid applications; or screen patients for Charity Care Assistance.
• Mailed forms and letters or conducted phone interviews with patients not screened during hospitalization.
• Communicated and collaborated with clientele by following up on the case status on behalf of the patient or agency which patient had applied until cases were processed.
• Confirmed eligible dates of coverage from insurance provider, and billed insurance (Medicaid) once approved and tracked accounts until payments were made.
• Adhered to organizational policies and procedures by complying and submitting end of month reports to management on time for processing.
Program Technician/ Administrative Assistant II (Client Support Services) County Department of Social Services - Charlotte, NC April 2006 to November 2006
Charlotte, North Carolina April 2006-November 2006 Program Technician/ Administrative Assistant II (Client Support Services) Customer Service Representative
Windstream Communications - Charlotte, NC
June 2003 to April 2006
Wireline Residential / Business Department)
Education
University of Maryland University College - Adelphi, MD 2008 to 2010
Skills
• MEDICAID (5 years)
• OPERATIONS (4 years)
• CLIENT RELATIONS (10+ years)
• CONFLICT MANAGEMENT (10+ years)
• QUALITY ASSURANCE (4 years)
• Motivational interviewing
• Case Management
• Research
• Interviewing
• Salesforce
• Databases
• Documentation review
• Public health
• Windows
Additional Information
Interpersonal Skills
Medicaid Knowledge
Quality Assurance
Initiative Driven
Conflict Management
Call Center Operations
Written & Verbal Communication
Client Relations Management
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