Akiela Simpson
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Customer Service Specialist at Healthfirst
Lewisville, Texas, United States
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Résumé
Jobs
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Support RepresentativeHealthfirstJul 2024 - Current (2 years 3 months)Assist members with explanation of benefits (EOBs), billing inquiries, and claims coverage details. Process monthly premium payments over the phone while ensuring accuracy and compliance. Educate members on coverage, benefits, deductibles, and co-pay information. Provide clinical support, including coordination of durable medical equipment (DME) and authorization requests. Help members locate home care providers and schedule healthcare services. Communicate with providers, pharmacies, and insurance vendors (dental and vision) to resolve issues. Support members with primary care provider (PCP) changes and medical record documentation. Troubleshoot member concerns through effective problem-solving and call handling. Maintain detailed and accu- Customer Experience SpecialistAlliance OneSep 2020 - May 2024 (3 years 9 months)Reviewed transactions, opened and closed account reports to verify accuracy, and kept information current. Processed customer service requests via phone support and email support. Properly diagnosed customer needs and proactively educated about features and benefits of products and services. Satisfied customer queries over phone and email to maintain positive patient-provider relationships. Maintained customer database by entering any new and updated customer and account information. Documented customer correspondence in CRM to track requests, problems, and solutions.
- Account SpecialistVytos PharmacyFeb 2018 - Aug 2020 (2 years 7 months)Trained new hires on products, services, best practices, and protocols to reduce process gaps. Documented customer and physician correspondence in CRM to track medical equipment requests. Upheld quality control policies and procedures to increase customer satisfaction and complete billing approvals. Assisted customers with making payments or establishing payment plans to bring accounts current. Utilized medical terminology to confirm coverage, complete medical billing, and fill out documentation. Ordered medical equipment, tracked medical equipment, and kept records of stock using spreadsheets. Maintained customer database by entering any new and updated customer and account information. Worked with internal teams to understand business nee
- Certified Nursing AssistantGrapeTree Medical StaffingJun 2015 - Feb 2018 (2 years 9 months)Took vital signs and assisted with basic patient care activities and with procedures ordered by physician. Helped patients tend to personal care, activities of daily living, and transfers and transport. Adapted to unanticipated situations and developed new plans due to travel mishaps and unexpected events. Used budgeting and planning skills by financing, scheduling, and organizing the trip / activities. Met the needs of all assigned patients and ensured the utmost safety and well-being of the residents. Completed daily logs documenting patient condition and activities.
- Customer Service SpecialistHealthfirst
Education
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- Associate of Science, Health/Health Care Administration/ManagementUltimate Medical AcademyDec 2024 - Jun 2026 (1 year 7 months)