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Verification Specialist Service Representative

Location:
Charlotte, NC
Posted:
February 21, 2023

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Resume:

Khaylyn Glenn

803-***-****

advg32@r.postjobfree.com

SUMMARY OF QUALIFICATIONS

Dedicated and focused; able to prioritize and complete multiple tasks and follow through to achieve any goals assigned to me. Punctual and detail oriented individual

Fast learner with the ability to excel in a busy environment

An independent and self-motivated professional with excellent communication skills; able to grow positive relationships with clients and colleagues at all organizational levels.

Computer skills include MS word, excel, PowerPoint, outlook

Customer Service and Healthcare/ Insurance Training Skills

Lead and created program and process training for a team of over 100 associates.

Contributed to increasing the overall Quality of my team by 40% in one year.

Extensive experience with Case and Project Management directly related to multiple Product Launch.

Strong knowledge of medical terms, CPT and HCPCS codes, referral procedures and policies such as Medicaid, Medicare, and Private Commercial Plans.

Worked closely with provider’s offices, Field Reimbursement Managers, Sales Representatives, and customers regarding medical insurance.

Over 14 years of customer service experience.

Experience with working on a newly FDA approved drug with an Unclassified HCPCS code.

Completed Medical terminology courses as well as a medical internship.

Proficient in MS Word, Works, PowerPoint, Excel, Word Processing, Aspect, Internet, Patient plus Database and Salesforce database.

Extensive knowledge and experience working with diagnosis and treatment plans.

EDUCATION

University of Phoenix

oBachelor of Science in Health Management-Currently enrolled

Kaplan University

oAssociates of Applied Science in Medical Office Management

oJuly 2015- Graduated

oGPA: 3.44

Honors

oDean List-2013-2014

oAlpha Beta Kapa Honor Society

EXTERNSHIP EXPERIENCE (5/2015-6/2015)

Ace Medical Group- Rock Hill, SC

Checked in patients at the front desk.

Answered the phone.

Scheduled patients for the proper appointment.

Compiled medical records and charts.

Operated computer software and office equipment.

Verified patient’s insurance

Assisted patients to their appropriate appointment room

PROFESSIONAL EXPERIENCE

Iqvia- Quality and Training Manager (06/2022-Current)

Lead Team trainings for current team members and new hires.

oLead Trainer on a New System launch and New Hires training of 100 associates.

Create training content for Internal team and Sales team.

oContent specific to a new medication launch within a new CRM environment (Fusion). Content was used to train Field Reimbursement team on the process.

Owner of all process documents, job aids and learning material for the team.

Facilitate Quality Call and File Audit reviews.

Handle Client and Customer escalations and provide complete documentations of issue and resolution.

Contribute to Associate quarterly evaluations and performance reviews.

Provide team updates to Sr. Management during weekly meetings.

Assist with monitoring and improving team moral and engagement.

Lead and assist with team meetings and update reviews.

Monitor task list work to maintain contractual service level agreements.

Lash Group-Special Project Liaison (09/2019- 06/2022)

Lead Team trainings for current team members and new hires.

oLead Trainer on a New System launch and New Hires training of 100 associates.

Create training content for Internal team and Sales team.

oContent specific to a new medication launch within a new CRM environment (Fusion). Content was used to train Field Reimbursement team on the process.

Owner of all process documents, job aids and learning material for the team.

Facilitate Quality Call reviews with the Client contacts as well as associates.

Use Customer Relationship Management (CRM) systems to complete and submit phone metrics reports to Client contacts and clarify any questions that arise.

Handle Client and Customer escalations and provide complete documentations of issue and resolution.

Contribute to Associate quarterly evaluations and performance reviews.

Provide team updates to Sr. Management during weekly meetings.

Assist with monitoring and improving team moral and engagement.

Lead and assist with team meetings and update reviews.

Monitor task list work to maintain contractual service level agreements.

Completed an Interim SPL roll from 12/2018-09/2019

Lash Group- Patient Access Specialist (04/2016- 09/2019)

Research alternate coverage options

Assist patients, provider, caregivers’ payers, and pharmacies who contact ViiVConnect

Ensure patient healthcare benefits cover the required products

Maintained patients records by updating account information

Verifying patient insurance coverage

Process all program enrollment forms

Provide product-specific coding and billing support

Provide prior authorization (PA) support

Follow-up on missing information items.

Lash Group- Benefit Verification Specialist (11/2015-04/2016)

Ensure patient healthcare benefits cover the required products

Maintained patients records by updating account information

Verifying patient insurance coverage

Knowledge of a CPT and Diagnosis coding

Citi Financial – Customer Service Representative 2 (3/2014-5/2015)

Attracted potential customers by answering product and service questions; suggesting information about other products and services.

Opened customer accounts by recording account information.

Maintained customer records by updating account information.

Resolved product or service problems by clarifying the customer's complaint; determining the cause of the problem; selecting and explaining the best solution to solve the problem; expediting correction or adjustment; following up to ensure resolution.

CERTIFICATION

Basic Life Support-Provider Level



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