Summary
Overview
Work History
Education
Skills
Certification
Remote Ready
Timeline
Generic

Lauren Kaapa

Pooler

Summary

Detail-oriented and motivated healthcare support professional with over 10 years of customer support experience. Knowledgeable about behavioral health program requirements, support strategies, and skill-building techniques. Focused on helping patients improve well-being and functioning by preventing substance abuse and improving confidence. Aspiring to advance a career in psychology, with a focus on addiction, combining hands-on support experience with academic knowledge to help drive patient-centered care and recovery outcomes. Hardworking, reliable, and dedicated.

Overview

9
9
years of professional experience
1
1
Certification

Work History

Fidelis Main Line Agent

RESULTS CX
12.2024 - Current
  • Provided detailed support to Medicare and Medicaid members by resolving benefit, eligibility, and prior authorization inquiries.
  • Accurately processed medical and pharmacy claims using platforms such as Salesforce, Evernorth, Medhok, and Express Scripts.
  • Conducted needs assessments and escalated urgent cases to clinical teams or case managers.
  • Assisted with pharmacy benefit inquiries, OTC card usage, and formulary exceptions.
  • Handled sensitive member data while maintaining strict HIPAA compliance.
  • Utilized CRM platforms to update records and document member interactions in real time.
  • Communicated complex insurance and clinical policy information in a compassionate, easy-to-understand manner.

WellCare Outbound Sales Agent

RESULTS CX
04.2024 - 12.2024
  • Reached out to Medicare-eligible individuals to assist with enrollment and plan selection.
  • Delivered exceptional customer service and met sales targets through clear communication and benefit education.
  • Identified member needs and matched them to suitable plan features.
  • Used Salesforce and other CRM platforms to track performance metrics and customer outcomes.
  • Adhered to CMS and company compliance guidelines when providing product information.
  • Demonstrated ability to de-escalate concerns and provide first-call resolution.

Office Supervisor

Josh Collins Heating & Air
Guyton
01.2016 - 01.2022
  • Managed and streamlined daily office operations, ensuring smooth workflows.
  • Supervised customer service and scheduling, and trained new staff on company procedures.
  • Coordinated technicians and maintained accurate invoicing and QuickBooks data.
  • Improved customer satisfaction through prompt resolution of service-related issues.

Education

B.A. - Psychology

Southern New Hampshire University
Manchester, NH
06.2026

Skills

  • Behavioral Health & Patient Intake
  • Addiction Recovery
  • Crisis Intervention Training
  • HIPAA Compliance & PHI Handling
  • Health Insurance & Claims Processing
  • Data Entry & Medical Documentation
  • Microsoft Office Suite, Teams, Zoom
  • Time Management & Critical Thinking

Certification

  • Crisis Call and Behavioral Support Training, 2025
  • HIPAA Compliance Training
  • Data Protection and PHI Security

Remote Ready

True

Timeline

Fidelis Main Line Agent

RESULTS CX
12.2024 - Current

WellCare Outbound Sales Agent

RESULTS CX
04.2024 - 12.2024

Office Supervisor

Josh Collins Heating & Air
01.2016 - 01.2022

B.A. - Psychology

Southern New Hampshire University

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Lauren Kaapa