Catera Reid
Atlanta
Summary
Detail-oriented Patient Service Representative with outstanding treatment knowledge and stellar communication skills. Successful at coordinating between patients and professionals and offering comprehensive patient education. Committed to organization and time management.
Overview
2
2
years of professional experience
Work History
Customer Service Representative
Everise
GA
12.2024 - 08.2025
- Handle incoming customer calls, chats, and emails to resolve issues, provide product/service information, and process requests for various clients, including healthcare insurance providers.
- Consistently meet or exceed company and client performance standards
- Utilize and navigate multiple software systems simultaneously to manage customer data and interactions
- Addressing health plan coverage, billing, and enrollment
- Responded to inquiries about insurance coverage and medical services offered.
- Handled patient complaints by providing timely and effective resolutions.
- Communicated effectively with healthcare providers regarding patient needs and concerns.
- Maintained accurate patient information in electronic health record systems.
- Collected payments from patients and entered them into the billing system accurately.
- Adhered to HIPAA regulations when handling confidential patient information.
- Verified patient demographic information in order to ensure accuracy of data entry.
- Processed paperwork related to medical claims processing including authorizations, referrals, pre-certifications.
- Ensured that proper follow up was completed after each interaction with a customer.
- Reviewed patient requests for prior authorization and ensured compliance with guidelines.
- Coordinated with healthcare providers to gather necessary documentation for approvals.
- Communicated authorization decisions to patients and medical staff promptly.
- Utilized electronic health record systems to track and manage authorization requests.
- Collaborated with insurance companies to resolve discrepancies in authorization status.
- Coordinated with other departments to obtain additional information needed for prior authorization.
- Reviewed prior authorization requests to ensure accuracy and completeness of required information.
- Responded promptly to inquiries from providers, patients and payers regarding status of prior authorization requests.
- Educated healthcare professionals on how to properly submit a request for pre-authorization.
- Identified reasons behind denied claims and worked closely with insurance carriers to promote resolutions.
- Applied knowledge of Medicare, Medicaid and third-party payer requirements utilizing on-line eligibility systems to verify patient coverage and policy limitations.
- Processed appeals in a timely manner as per policy guidelines.
- Advised provider offices on proper coding practices that are necessary for successful claim submission.
- Coordinated with pharmacy staff to ensure medications requiring prior authorization are processed correctly.
- Educated patients about their insurance benefits and coverage options.
Patient Support Specialist
Labcorp
GA
01.2024 - 11.2024
- Answer inbound calls per day from patients, doctor's office and/or private insurance carriers.
- Initiate payment plans for patients for outstanding balances.
- Routinely utilize multiple resources to resolve patient inquiries while on the phone
- Assisted patients with scheduling appointments and managing inquiries.
- Coordinated communication between patients and healthcare providers.
- Educated patients on lab procedures and test preparation requirements.
- Maintained accurate patient records in electronic health systems.
- Handled insurance verification and authorization for lab services.
- Processed payments for copays and deductibles accurately according to established guidelines.
- Handled incoming phone calls and scheduled appointments.
- Verified patient insurance coverage and eligibility for services.
- Applied general knowledge, front-desk administration skills and clinical skills to patients in hospital, improving response to issues.
Customer Service Representative
Vimo Inc
ga
07.2023 - 01.2024
- Inbound/Outbound Calls
- Deliver the highest level of customer service experience consistently
- Manage customer accounts and provide technical support
- Application Data Entry
- Online chat inquiries as assigned
- Interpret and follow defined procedures and policies
- Creative problem-solving skills
- Flexibility and adaptability to changing projects and updates
- Resolved customer complaints through effective communication and problem-solving skills.
- Provided product information and guidance to enhance customer satisfaction.
- Handled high-volume calls while maintaining professionalism and quality standards.
- Documented interactions and followed up on pending issues for resolution.
- Answered customer inquiries and provided accurate information regarding products and services.
- Assisted customers with product selection, ordering, billing, returns, exchanges and technical support.
Education
Diploma -
Meadowcreek high school
GASome College (No Degree) - Healthcare
South College
Knoxville, TNSkills
- Customer service
- Time management
- Computer literacy
- Communication skills
- Claims processing
- Insurance verification
- HIPAA compliance
- Payment processing
- Data entry accuracy
- Effective communication
- Problem solving
Timeline
Customer Service Representative
Everise
12.2024 - 08.2025
Patient Support Specialist
Labcorp
01.2024 - 11.2024
Customer Service Representative
Vimo Inc
07.2023 - 01.2024
Diploma -
Meadowcreek high school
Some College (No Degree) - Healthcare
South College