Customer Service Representative/Lead, Behavioral Health Advocate
Resume:
Terrill Almond
Abington, PA ***** • *******.******@*****.*** • 267-***-****
Professional Experience
Admissions Counselor Hordham Clinic, Horsham, PA
January 2025 to Present
● Reviewed patient referrals from emergency rooms across the state for admission for mental health and substance abuse issues.
● Performed triage process prior to admitting patients.
● Prepared necessary inquiry call sheet, registered patients into CERNA, and facilitated placement into medical units.
● Communicated with other institutions regarding admissions capacity. Community Health Worker Magellan Behavioral Health, Newtown, PA January 2022 to January 2025
● Provided resources to members soon to be discharged from mental health & substance abuse inpatient hospitals including mortgage/rent assistance, housing options, and healthcare.
● Partnered with social workers to ensure accurate referral information.
● Communicated with housing managers and inpatient facilities to confirm eligibility and move-in dates for members.
● Staying in contact with members 7-30 days after discharge from inpatient hospitals. Ensure positive quality of life and any other public assistance they may need. Customer Service Mentor Aetna Medicare, Blue Bell, PA December 2015 to February 2020
● Assisted member services department with pending or terminated plans and urgent issues.
● Submitted retroactive appeals to CMS for approval once entitlement dates were updated.
● Transferred application info to Medicare Intake Database for processing.
● Completed spreadsheet service area benefit updates and reinstated or terminated members per CMS. Customer Service Representative Aetna Medicare, Blue Bell, PA September 2014 to December 2015
● Assisted plan members with COB benefit confirmation & pharmacy pre- authorization.
● Processed monthly premium payments through debit/credit cards and personal checks.
● Contacted medical providers for procedure/diagnosis codes to match claims
● Provided information and confirmation to members in participating service areas to looking to enroll in Medicare Advantage & Prescription Drug Plans.
Customer Service Representative/Lead Inspiritec, Philadelphia, PA October 2013 to October 2014
● Supervised and trained customer service representatives with processing Medicaid applications.
● Communicated with the Department of Public Welfare with status and update concerns. Education
Associate's Degree, Applied Science
Thaddeus Stevens College, Lancaster, PA
Diploma, Business Administration
Penn Wood High School, Lansdowne, PA
Skills and Certifications
● Proficient in Rumba, COMPASS, ICWS, MARX, PNC BIller, FIS, and MEDHOK
● Licensed in Health Insurance Sales in 13 states
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