Customer Service Intake Specialist
Resume:
D
Samatra D.
Marshall
**********@*****.**
m
Covington, Ga 30016
SUMMARY
I desire to excel as a Clinical Intake Specialist at Humana as a team-player in a people oriented organization where I can maximize my superior customer service skills in a challenging environment to achieve the corporate goals.
SKILLS
Microsoft Word
Microsoft Office
Microsoft Outlook
Microsoft Excel
Typing ability 60 wpm
EXPERIENCE
Clinical Intake Specialist
Miramar, FL
Humana/ May 2008 to Oct 2025
Provide stellar customer service
Outbound calls to engage members and/or providers to verify clinical information Handle new client inquiries and assign them to proper case manager/nurse Document all calls and attach clinical information received Create and send out written correspondence
Coordinate with insurance/case management offices for approval of care Maintain relationships and communicate with referral sources Maintain case files for successful quarterly audits Obtain all necessary clinical information to tailor member's profile according to their needs
Maintain confidentiality, adhering to all HIPAA guidelines/regulations Confer with members by telephone to provide information about services available Research Claims for members and facilities
Notified Providers of Authorization approval decisions. Completed Grievance and Appeals for Providers
Completed Retro reviews for Providers
Worked authorizations for Inpatient Rehab facilities Worked authorizations for Skilled Nursing facilities Notified Providers of Denied authorizations
Worked authorizations for Long Term Acute Care.
Customer Support Specialist
Miramar, FL
JL Audio/ Sep 2003 to Mar 2005
Provided stellar customer service
Maintained and organized critical files and invoices Managed incoming and outgoing calls from customers and vendors Processed customer orders and invoices using purchase orders Data entry
EDUCATION AND TRAINING
High School Diploma
Miami Southridge Senior High
South Miami Heights, FL
ACCOMPLISHMENTS
Star Award, 2014, 2023
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