Customer Messaging & Online Assistance Specialist
Resume:
TAI Y. HOLLAND
************@*****.***
PROFESSIONAL PROFILE
Highly capable, diligent, and resourceful team player with the ability to specialized support for individuals with medical needs. SKILLS & ABILITIES
coordinate
● Minimum of five years experience of proficiency in Microsoft Office, SharePoint, Excel and Outlook. Also, E-Clinical Works and EPIC EMR systems
● Understanding and experience with TruCare
● Customer service excellence
● Care in handling sensitive and protected data
● Organizational efficiency and accuracy
● Typing speed 40-50 words per minute
EXPERIENCE
Patient Care Advocate, Centene
01/2024-01/2025
● Acts as a liaison and member advocate between the member/family, physician and facilities/agencies.
● Acts as the face of WellCare in the member/provider group communities to report barriers in services or care.
● Assesses provider performance data to identify and strategizes opportunities for provider improvement.
● Collaborates with the Provider Relations and Quality Assurance teams to improve provider performance in areas of Quality, Risk Adjustment, Operations (claims and encounters).
● Schedules doctor appointments for members with care gaps to access needed preventive care services and close gaps in care in the provider’s office.
● Provides education to the members, their family and the provider’s office about care gaps identified and barriers to care.
● Conducts telephonic outreach and health coaching to members to support quality improvement, regulatory and contractual requirements.
● Arranges transportation and follow-up appointments for member as needed.
● Documents all actions taken regarding contact related to member.
● Interacts with other departments including customer service to resolve member issues.
● Escalate members with barriers in service or care to the case management team, if appropriate.
● Completes special assignments and projects instrumental to the function of the department. Patient Service Representative/Virtual Patient Service Rep, PIEDMONT URGENT CARE BY WELLSTREET 11/2019- 11/2022
● Assisted patients with their online experience via the BirdEye application (Website chat box)
● Effectively and routinely balanced multiple patients through multiple chat sessions at one time
● Proactively provided solutions and navigation through the company website
● Entrusted as a patient/provider liaison assisting in resolving post-visit issues such as medication requests and prescription resends
● Ensured all patient needs are fulfilled through follow-up interactions via website chat and/or telephone
● Helped guide repeat business by providing excellent, accurate and thorough service
● Assisted with Quality Control and Quality Assurance committees
● Formulized spreadsheets for data sorting and managing worksheets to track patients information.
● Collaborated with providers to maintain quality and risk adjustments
● Face-to-face, telephonic and web chat assistance to patients in a courteous and professional manner regarding insurance and care gap coverage, As well as pre/post-visits concerns or questions
● Scheduled standard COVID-19 and pre-op COVID-19 testing
● Problem resolution and patient retention via the company’s website
● Maintained the readiness of the WellStreet Urgent Care & OccMed reception area
● Performs administrative tasks while adhering to established policies and procedures; enforces standard healthcare regulatory requirements
● Determines patients’ financial responsibility by analyzing health insurance benefits
● Verifies eligibility and relays relevant information regarding billing/collection processes
● Obtains and documents patients’ medical and business documents while maintaining confidentiality; assures HIPAA and OSHA compliance
● Documents all medical interventions through Electronic Medical Record (EMR)
● Provides overall support to physicians, practice manager, and other staff as required Front Desk Operations/Front Desk Lead/Administrative Specialist, GEORGIA FAMILY CARE 07/2018-11/2019
● Coordinated the admission of and discharge of patients
● Documents all medical interactions through Electronic Medical Record (EMR)
● Verified patients' insurance information; provided billing services including the collection of past due balances and lab fees
● Scheduled new and follow-up appointments
● Updated, corrected or review patients charts information in accordance to HEDIS ICD-10 measures and NCQA requirements
● Assisted with referrals to various specialty providers via telephonic or email correspondence
● Collected and retrieved patients information and imputed data onto Excel spreadsheets to track patients information.
● Served as primary liaison between patients and providers
● Educated patients about care gaps in coverage or specific barriers to care
● Trained new members of staff
● Coordinated and executed primary and secondary administrative assignments EDUCATION
Certification in Salesforce 06/2023
Certification in Project Management 06/2022
Susan Miller Dorsey High School 06/1997
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