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Authorization Representative Customer Service

Location:
Greensboro, NC
Posted:
March 24, 2023

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Resume:

Rebekah Deahl

Bristol, TN *****

adv4df@r.postjobfree.com

+1-423-***-****

Authorized to work in the US for any employer

Work Experience

Recruiter/Account Manager

On-Site TM - Remote Delray, FL

November 2021 to Present

Contact doctor's offices to see if they are interested in hosting patient webinars for Earlens hearing device sales. This is the sales account that has been assigned to me. If so I open the account and manage contract terms. I also reach out to other health care providers to see if they would like us to recruit patients for our CCP program. I work with providers to see what "concierge" services they would be willing to offer and how to present this to existing patients. Work with vendors on other projects we can help them launch. *1099 C0NTRACT EMPLOYEE/PT POSITION

Customer Service Representative

JDOTT Communications DBA TMS CALL CENTERS - Remote May 2021 to Present

Currently contacted to work as CSR for Atrio Health Plans. Assist members with understanding plan benefits, accept and process monthly premiums, help with portal issues by resetting passwords or walking members through the portal set-up process. Assist members with finding providers in network with Atrio Health plans, finding which drugs on the Atrio formulary and what member copayment would be for certain drugs. Work with providers to obtain Prior Authorizations so members can receive needed services and medications. Assist members with understanding claims and resubmit claims when necessary to rectify errors. Provide assistance to members that are displeased with anything regarding their healthcare/insurance by guiding them through the grievance process and submitting the necessary paperwork. Help members receive direct member reimbursement for services they have paid out of pocket for but are covered under their plan benefits. Use Dynamics, CMMS, MMIS, MARX, and multiple other software programs.

Grant Writer/Administrator

Mountain Empire Community College - Big Stone Gap, VA December 2018 to May 2021

Seek and apply for multiple grants. I have administered some of the grants I have written, such as going into prisons within a 90 minute radius of the school and teaching GED lessons and basic computer skills, coordinating Dual Enrollment and tracking student progress in the program, and teaching Microsoft Office on campus and remotely to at-risk adults and senior citizens. All grant programs demand strict attention to detail and deadlines, the creation of databases, and monthly reporting to the Vice President of Student Affairs.

Clinical Informatics Specialist

Ballad Health (formerly Mountain States Health Alliance) - Johnson City, TN December 2015 to December 2018

• Designing user interfaces to store and evaluate patient and organization data.

• Creating and implementing a plan to keep the organization’s information, digital security and registries current.

• Troubleshooting software and hardware problems to make sure patient care runs smoothly.

• Reviewing existing systems and suggesting improvements.

• Training staff to remain compliant with the company’s security, data, and patient care standards.

• Analyzing and optimizing data.

• Documenting progress to regularly report to supervisors and stakeholders. Prior Authorization Representative/Receptionist

Johnson City Eye Clinic - Johnson City, TN

July 2013 to November 2015

Greeted patients, entered patient demographics, ensured patients filled out necessary paperwork, answered telephone, filing, kept lobby clean and inviting, accepted and input patient insurance information and filed insurance claims upon patient checkout, took payments from patients, data entry, spreadsheet creation

Filled out Prior Authorization forms and attached supporting documentation and faxed or emailed to patient insurance companies. Followed up if more information was requested. Expedited process for urgent matters. Communicated with patient and provider once PA was approved and received to schedule procedures.

Price Book Manager

Riggs Oil Company - Big Stone Gap, VA

May 2010 to July 2013

Post retail price changes in Pinnacle Price book System, Invoice vendors for advertising and shelf space, Coordinated prices for goods or services, including marketing and competitor analysis, Negotiated and comparing pricing with vendors and product providers, Created cost reports and developed retail pricing for products to ensure profitability, Accepted daily cash deposits from 15 Marathon stores along with all store paperwork, checked for errors through reconciliation of daily paperwork, and prepared bank deposits and new opening bank bags for each store

Family Service Worker II

State of Tennessee Department of Children's Services - Blountville, TN May 2006 to June 2010

Investigated allegations of child abuse and neglect, coordinated activity between the Department and the Sullivan County juvenile court system, attended court hearings as needed and testified when called to do so, worked with families to achieve permanency for children, provided in-home services, transported clients to appointments and participated in meetings and medical appointments when necessary Education

Bachelor's in social work

East Tennessee State University - Johnson City, TN August 2003 to August 2006

High school diploma

Sullivan Central High School

May 2003

Skills

• Serving Experience

• Customer Service

• Sales

• POS

• Pricing

• Individual / Group Counseling

• Medical Receptionist

Certifications and Licenses

food handler certificate

driver's license

Assessments

Retail Customer Service — Highly Proficient

November 2019

Comprehending and responding to retail customer needs. Full results: Highly Proficient

Workplace safety — Expert

March 2021

Following best practices to avoid accidents and injuries. Full results: Expert

Manufacturing fit — Highly Proficient

March 2021

Measures the traits that are important for success in manufacturing roles. Full results: Highly Proficient

Work style: Reliability — Highly Proficient

March 2021

Tendency to be reliable, dependable, and act with integrity at work Full results: Highly Proficient

Retail customer service — Expert

December 2020

Comprehending and responding to retail customer needs Full results: Expert

Cashier skills — Highly Proficient

December 2020

Counting cash, processing transactions, following written procedures, and attending to details Full results: Highly Proficient

Customer service — Expert

January 2021

Identifying and resolving common customer issues

Full results: Expert

Case management & social work — Highly Proficient

March 2021

Prioritizing case tasks, gathering information, and providing services without judgment Full results: Highly Proficient

Attention to detail — Highly Proficient

April 2021

Identifying differences in materials, following instructions, and detecting details among distracting information.

Full results: Highly Proficient

Work style: Reliability — Highly Proficient

March 2021

Tendency to be reliable, dependable, and act with integrity at work Full results: Highly Proficient

Warehouse associate — Expert

July 2021

Assesses the tendencies that are important for success in warehouse roles Full results: Expert

Customer service manager — Highly Proficient

December 2021

Managing customer service representatives and resolving customer issues Full results: Highly Proficient

Customer service fit — Expert

March 2022

Measures the traits that are important for success for customer service roles Full results: Expert

Customer service manager — Highly Proficient

December 2021

Managing customer service representatives and resolving customer issues Full results: Highly Proficient

Mechanical knowledge — Completed

October 2021

Understanding and applying mechanical concepts and processes Full results: Completed

Call center customer service — Expert

December 2021

Demonstrating customer service skills in a call center setting Full results: Expert

Inside sales — Highly Proficient

January 2022

Understanding and responding appropriately in sales scenarios, and performing common sales calculations

Full results: Highly Proficient

Workplace safety — Expert

May 2021

Using safe practices at work

Full results: Expert

Recruiting — Proficient

March 2023

Managing the candidate sourcing and selection process Full results: Proficient

Sales skills — Proficient

March 2023

Influencing and negotiating with customers

Full results: Proficient

Indeed Assessments provides skills tests that are not indicative of a license or certification, or continued development in any professional field.



Contact this candidate