Call Center Case Manager

Address: Raleigh *****, USA Phone number: 704-***-**** Email address: ********@*****.***

Khyati Patel

Profile

Experienced training supervisor with over 17 years of expertise in crafting, overseeing, and orchestrating training initiatives to enhance employee competencies and job performance. Collaborate closely with operations to pinpoint training requirements, address processing deficiencies, and resolve system challenges. Provide comprehensive support during program launches and conduct thorough evaluations of training effectiveness, making necessary refinements for optimal outcomes.

Area of

Expertise

Curriculum Buildout

Performance

Improvement Staff Management

Training Mentoring Salesforce Expert

Process Improvement Collaboration

Strengths Microsoft Office Suite Call Center Operations Team Building Project Management Reimbursement Strategic planning HUB Services Knowledge: Medical and Pharmacy

Work

Experience

Mercalis

08/2019 – present MORRISVILLE, UNITED STATES

Spearheaded training initiatives for new employees in roles such as Intake Triage Coordinator, Care Coordinator, Case Managers, Reimbursement Case Manager, and FRM's (Medicare, Medicaid, VA, DoD, Tricare, and Commercial Pharmacy and Medical benefits)

Conducted refresher and skill courses to ensure ongoing excellence in current employees' performance

Developed instructional materials and training programs for market access, patient experience center, and processing teams based on adult learning principles

Regularly updated and modified instructional materials in response to feedback and organizational changes, resulting in a 20% increase in training efficiency and effectiveness

Designed and implemented effective training programs to enhance employee performance

Engaged trainees through interactive workshops and hands-on activities Created customized training materials tailored to specific industries for maximum relevance

Performed comprehensive needs assessments to identify knowledge and skills gaps for future program development

Collaborated with subject matter experts to produce accurate and up-to-date content for training sessions

Evaluated training effectiveness by tracking participant progress and gathering feedback for continuous improvement

Delivered dynamic presentations to diverse audiences to facilitate learning and retention

Mentored and trained over 300 new personnel across various roles Training Specialist

Work

Experience

MCKESSON

01/2016 – 01/2019 ROCK HILL, UNITED STATES

Verified accuracy of patient insurance information to expedite insurance verification processes

Utilized various resources to gather insurance coverage details Updated providers on patient status and documented in Management Information System for easy access by team members Communicated with patients regarding pharmacy benefit coverage and financial responsibilities

Checked patient insurance coverage for specific treatments to ensure accurate payment information

Assisted with prior authorizations for customers receiving same day shipments

Managed incoming calls on insurance line to provide exceptional customer service

Documented patient eligibility, benefits, and out-of-pocket expenses Educated patients on copay assistance programs and other resources to reduce out-of-pocket costs

Patient Benefit Specialist

CVS Specialty Pharmacy

Enhanced team productivity by 15% through comprehensive training and effective supervision of pharmacy technicians, ensuring strict compliance with protocols and procedures.

Maintained a safe work environment by enforcing federal and state regulations, minimizing the risk of errors.

Improved customer satisfaction by addressing concerns, answering questions, and providing knowledgeable advice on prescription medications.

Cultivated strong relationships with healthcare providers to enhance communication and collaborative patient care efforts. Led continuing education initiatives for staff members to promote professional development and enhance skill sets.

Acted as a reliable point-of-contact for insurance companies, swiftly resolving billing issues to minimize delays in patient treatment plans. Fostered a culture of excellence within the pharmacy team through regular performance evaluations, feedback sessions, and goal-setting exercises. Coordinated pharmacy staff schedules to ensure adequate coverage during peak hours, considering workload demands and individual availability. Provided compassionate assistance to patients facing financial difficulties, exploring available resources and payment options. Supervised a team of twenty pharmacy technicians and organized day-to- day assignments.

Recruited, hired, and trained all staff, providing direct supervision, ongoing development, and continuing education.

Developed and updated policies and procedures to maintain compliance with HIPAA, benefits administration, and general liability guidelines. Directed and supervised a team of twenty, enhancing overall performance through coaching, feedback, and skill development opportunities. Team Lead

Education

Oakton Community College

DES PLAINES, IL, UNITED STATES

Elk Grove High School

05/2001 ELK GROVE VILLAGE, IL

Operating

Systems

Microsoft Office Suite Macintosh OS MS-DOS Power-MHS Facets CoverMyMeds OptimizeRx Sales Force/CLS

QuickPath PPT LMS

Languages

Hindi

Native

Gujarati

Native

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