Rameria Hines

Seasoned Team Lead who effectively uses excellent communication skills to train, grow and develop team members; seeking entry-level position with growth opportunities.

Team Lead / Tier II Specialty Representative - Kaiser Permanente - Duluth, GA

(2016-11 - 2025-12)

• Work with workforce management to ensure we maintained the correct staffing to fit the business needs for our specialty scheduling
• Help remote and non-remote employees
• Assist with calling members to provide member recovery and improve member retention
• Assist in the new hire process by training new agents, answering questions and helping them improve their individual key performance indicators
• Direct Team Lead over 40+ agents
• Answered phone calls for the purpose of assisting customers with scheduling appointments, escalations, claims questions and/or benefits
• Coach & empower my team to improve & maintain their quality scores to 98% or higher, Monitoring & enforcing essential call center metrics & KPI’s daily.
• Used EPIC, QGenda, Availity and Fluency to effectively schedule members for doctor’s appointments
• Use excellent communication and de-escalation techniques to calm irate members and find resolutions to their concerns
• Worked with management on multiple projects to improve video visit scheduling, specialty access & scheduling and improving the SharePoint site clarity for agents
• Kept detailed and accurate records for each call while continuing to follow HIPPA guidelines
• Used strong problem-solving skills to accurately interpret, explain, and clarify benefits, eligibility and delivery system services utilizing internal software systems

Front Office Specialist - ENT Specialist of Conyers - Conyers, GA

(2015-07 - 2016-11)

• Check in/Check out patients, registering, Answer inbound calls with the purpose of scheduling appointments and provide information regarding medical procedures
• Use Allscripts practice management and Allscripts clinical EHR software to keep detailed records of patient accounts and manage claims,verified insurance, collect copays
• Entered patient charges and procedure codes (ICD-9, 10/CPT codes) per physicians’ requests
• Schedule, reschedule and cancel appointments
• Provide education to patients regarding medical procedures
• Use Meditech for clinical charting
• Call patients to remind them of their appointments
• Review patients’ insurance forms for accuracy then submit insurance claims as needed

Patient Access Specialist - Clearview Regional Medical Center - Monroe, GA

(2014-07 - 2015-07)

• Provided excellent customer service during every patient encounter
• Recorded patient financial information into the patient database
• Obtained patient demographic and third party information with a high degree of accuracy
• Preformed financial collections and provided patients with receipts
• Provided and explained legal, ethical and compliance related documents to patients at the time of registration
• Admit patients having services into the healthcare system
• Completed annual compliance training to maintain compliant with company requirements

Team Lead / Patient Service Specialist - Benevis LLC (Kool Smiles/Resolution Dental) - Marietta, GA

(2012-09 - 2014-07)

• Worked with upper management to ensure appropriate changes were made to improve call center processes
• Trained staff on how to improve customer interactions
• Direct team lead over 15+ specialists
• Answered both inbound calls with the purpose of confirming or creating dental appointments
• Addressed patient inquiries, complaints, and concerns in a timely and accurate fashion
• Greet and check in/out patients in a timely manner
• Assemble charts with new patient paperwork upon appointment time
• Gather and verify insurance information such as: PPO, DMI, HMO, MEDICAID
• Collect and process co-payments by cash, check or credit card.
• Schedule, cancel and confirm appointments accordingly
• File records and maintain the front office area

Customer Service Representative - Ryla Teleservices - Kennesaw, GA

(2009-03 - 2012-09)

• Took inbound and outbound calls for the purpose of acquiring new health plan members and collecting premium payments
• Consistently met deadlines by resolving an average of 550 inquires each week
• Assisted patients with choosing a new insurance plan
• Mastered customer service representative duties and was chosen to be a lead trainer
• Completed voluntary customer service training to enhance my customer service skills and improve productivity
• Trained all incoming representatives on how to assist the patients while maintaining speed & accuracy in the patient data base
• Kept a detailed record of all patient interactions in the patient data base

Health Unit Coordinator - Cleveland Clinic - Cleveland, OH

(2005-08 - 2009-03)

• Admitted, discharged and/or transferred patients
• Used Epic system to enter patient data and schedule appointments
• Gathered and updated demographic and insurance information for billing purposes
• Followed standard procedures for verifying and collecting insurance and copays
• Entered STAT orders as requested by the charge nurse
• Entered patient charges and procedure codes (ICD-9, 10/CPT codes) per physicians’ requests
• Completed all front office duties such as filing, scanning, or faxing documents
• Maintain HIPPA compliant by securing and organizing all patient information
• Answered multiple phone lines for the purpose of assisting patients with questions and transferring to different departments as requested

Diploma - Maple Heights High School (2001-06)