Lawan Holloway
Raleigh
Summary
Proven Healthcare Customer Service Representative
Healthcare professional known for high standards and impactful results. Background includes managing patient interactions, resolving complex inquiries, and enhancing overall patient satisfaction. Proven team collaborator with flexible approach to changing needs and commitment to achieving objectives. Skilled in communication, problem-solving, and adaptability.
Overview
5
5
years of professional experience
Work History
Healthcare Customer Service Representative
CVS Pharmacy
08.2023 - Current
- Ensured compliance with HIPAA regulations when handling sensitive patient information, protecting client privacy at all times.
- Enhanced patient satisfaction by efficiently addressing and resolving healthcare-related inquiries.
- Managed difficult conversations with compassion and professionalism, helping deescalate tense situations while maintaining a focus on finding resolutions.
- Increased first-call resolution rates by carefully listening to customers'' needs and providing accurate information based on their inquiries.
- Assisted with OTC items.
- Placed OTC orders for members with aetna insurance, aswell as taking payments with secure payment systems.
- Provided benefit information in regards to benefit amounts etc.
- Met customer call guidelines for service levels, handle time and productivity.
- Educated customers about billing, payment processing and support policies and procedures.
- Answered 100 (avg.) calls per day exceeding metrics
- Completed provider/customer insight reports and inputted over 12,000 units of sensitive data.
Healthcare Customer Service Representative
Wellcare Medicaid
08.2020 - 08.2023
- Ensured compliance with HIPAA regulations when handling sensitive patient information, protecting client privacy at all times.
- Managed difficult conversations with compassion and professionalism, helping deescalate tense situations while maintaining a focus on finding resolutions.
- Responded to customer requests, offering excellent support and tailored recommendations to address needs.
- Met customer call guidelines for service levels, handle time and productivity.
- Educated customers about billing, payment processing and support policies and procedures.
- Coordinated effectively with other departments and agencies for seamless delivery of services to Medicaid recipients.
- Developed strong relationships with insurance providers, and pharmacy, facilitating efficient communication for faster resolution of outstanding claims.
- Analyzed trends in denials and rejections to identify recurring issues requiring policy or procedural adjustments.
- Assisted with prior authorization approvals/denials.
- Explain the need for prior authorizations and needed documentation for medication
- Provided excellent customer service by actively listening to customer concerns and empathetically addressing their needs throughout the appeals process.
- Improved customer satisfaction by efficiently handling and resolving appeals in a timely manner.
- Understand the medication needs, reject codes, and medication amounts
- Average 80 calls per day aswell as consistently hitting company metrics monthly.
Education
High School Diploma -
Garner Magnet High School
Garner, NC06-2016
Skills
- HIPAA compliance
- Insurance verification
- Patient confidentiality
- Appointment scheduling
- Medical terminology
- Call center experience
- Data entry proficiency
- Empathy and patience
- Strong interpersonal skills
- Patient payment processing
- Verbal and written communication
100% Customer Satisfactory Award
For providing 100% customer service
Languages
English
Native or Bilingual
Timeline
Healthcare Customer Service Representative
CVS Pharmacy
08.2023 - Current
Healthcare Customer Service Representative
Wellcare Medicaid
08.2020 - 08.2023
High School Diploma -
Garner Magnet High School
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