LACHANDA BERRY

816-***-****

Kansas City Mo *****

SUMMARY

Provided customer service over the phone.

Verified insurance eligibility and benefits of patients.

Verified insurance information for accuracy and completeness and resolves discrepancies as needed.

Verified Customers documents to prevent fraud.

Successfully handled mail order and help desk.

Provided specialized service to help patients to manage conditions such as diabetes, asthma, and high blood pressure.

Responsible for explaining to the customer what the insurance will pay and the customer copay.

Took inbound calls from members to answer questions or provide information so that they better understand their coverage and options.

Offered the solutions needed to help simplify customers’ health care experience.

Provided information about prescription refills, order status, and insurance coverage.

Communicated any financial responsibilities and/or additional information to patients.

Obtained verbal and written authorization for medical treatment from appropriate sources.

Prepared, maintained and recorded records of inventories, receipts, purchases and deliveries, using a variety of computer screen formats.

Successfully handled mail order and help desk.

Provided specialized service to help patients to manage conditions such as diabetes, asthma, and high blood pressure.

Responsible for explaining to the customer what the insurance will pay and the customer copay.

Took inbound calls from members to answer questions or provide information so that they better understand their coverage and options.

Offered the solutions needed to help simplify customers’ health care experience.

Provided information about prescription refills, order status, and insurance coverage.

Candidate is local to Kansas City, MO.

Candidate is available to interview with 24 hours’ notice and can start within a week notice.

SKILLS

MS Office Suite.

EXPERIENCE

Charter Spectrum, Kansas City Oct 2022 Present

Fraud Investigator

Leverage appropriate resources to support the identification and initiation of fraud or abuse investigations, and ensure relevant information is appropriately collected, analyzed, and documented.

Request additional caller documentation when required for investigation.

Bring resolution to fraudulent claims by employing tools that detect and disrupt fraud schemes

Utilize defined metrics for tracking and reporting

Adapt procedures, processes, tools, equipment and techniques to accomplish the requirements of the position.

Assist team leader/managers with escalated calls, emails, and corporate escalations.

Quest Diagnostics, Lenexa, KS Jun 2020 - Jul 2022

Technical Services Representative

Reviewed, analyzed, diagnosed, and resolved support inquiries related to MyQuest and QuestDirect using established guidelines and processes.

Understood and complied with security and support policies and procedures.

Performed assessment analysis to identify root cause as well as scope of problem and escalate recurring issues to management.

Maintained proficiency in applications and product expertise to serve as an internal consultant in multiple applications and functionalities.

Followed up with customers via phone call and email to answer questions.

Documented all pertinent details of support inquiries in the system to ensure complete and accurate records.

Provided customer service over the phone.

Apria Healthcare, Overland Park, KS Oct 2014 - Aug 2019

Customer Service Representative/Insurance Filer

Conducted supervisory duties to ensure team productivity levels are up to standard (team of 10-15 customer service representatives).

Verified insurance eligibility and benefits of patients.

Obtained verbal and written authorization for medical treatment from appropriate sources.

Verified insurance information for accuracy and completeness and resolves discrepancies as needed.

Obtained clinical information needed for order processing or reimbursement.

Contacted patients to: advise them of the order placed on their behalf and to confirm all patient demographic information.

Communicated any financial responsibilities and/or additional information to patients.

Provided customer service over the phone.

Verified customers documents to prevent fraud.

Alliance Data, Merriam, KS Aug 2008 - Sep 2014

Team Lead

Aided in oversight of 25 collections representatives.

Ensured the team consistently meets goals and quotas.

Ensured accurate phone time usage amongst collections representatives.

Coached call handle time, scripting, and quality customer service.

Collections Representative

Received and recorded information concerning loss, theft and destruction of charge cards.

Issued reward checks to merchants and other people who turned in lost or stolen charge cards.

Kept records of customer's charges and payments.

Take payments from customers to make a payment.

Credit checks on credit card increase.

EDUCATION

High School Diploma 1986

Ruskin High School.

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