Shadaya McCall

Customer service oriented professional able to coordinate workflows and communicate effectively with co-workers, patients and staff. Follows policies, procedures and guidelines to ensure consistent quality. Maintains and safeguards patient privacy and confidentiality.

Intake Specialist | Kaiser Permanente Operations - Adapt Health - Remote, MD – Bowie, MD

(2025-09)

• Accurately enters referrals within allotted timeframe as established; meeting productivity and quality standards as established.
• Communicates with referral sources, physician, or associated staff to ensure documentation is routed to appropriate physician for signature/completion.
• Works with leadership to ensure appropriate inventory/services are provided.
• Communicates with patients regarding their financial responsibility, collects payment and documents in patient record accordingly.
• For non-Medicaid patients communicate with patients
• Responsible for reviewing medical records for non-sales assisted referrals to ensure compliance standards are met prior to a service being rendered.
• Follows company philosophies and procedures to ensure appropriate shipping method utilized for delivery of service.
• Answers phone calls in a timely manner and assists caller.
• Reviews medical records for non-sales assisted referrals to ensure compliance standards are met prior to a service being rendered.
• Demonstrates expert knowledge of payer guidelines and reads clinical documentation to determine qualification status and compliance for all equipment and services.
• Works with community referral sources to obtain compliant documentation in a timely manner to facilitate the referral process.
• Contacts patients when documentation received does not meet payer guidelines, provide updates, and offer additional options to facilitate the referral process.
• Works with the sales team to obtain necessary documentation to facilitate referral process, as well as support referral source relationships.
• Must be able to navigate through multiple online EMR systems to obtain applicable documentation.
• Works with the insurance verification team to ensure all needs are met for both teams to provide accurate information to the patient and ensure payments.
• Assume on-call responsibilities during non-business hours in accordance with company policy.

Ride Success Agent - Ride Health - Remote, MD – New York, NY

(2023-05 - 2025-09)

• Verification of insurance, ensuring passenger is covered on policy
• Coordinating transportation services for patients who are unable to drive themselves to medical appointments or treatments.
• Ensure that the right vehicle is available for the right patient at the right time and location
• Serve as a liaison between different departments and people.
• Keep accurate records of all transportation requests, including patient information, pick-up and drop-off times, and billing information
• Keep patients, healthcare providers, and transportation providers informed of the schedule and any changes
• Accept transportation requests by phone or other means from patients, caregivers, or healthcare facilities
• Find available vehicles and drivers to meet the needs of patients, and manage trip schedules

Agent | Night Chaperone - Student Watchers - Hyattsville, MD

(2023-03 - 2024-05)

• Oversees the safety of wards (children and young adults) during travelling events while away from their parents or legal guardians
• Provides wards with information on the expectations of their behaviors and how to keep safe during traveling, and during the time that they will be at their place of residence.
• Monitors wards at events, ensuring that they do not engage in any negative activities.
• Handles any situations that may arise and elevates emergencies to the appropriate authorities.
• Provide feedback on behavior issues

Benefits Verification Specialist/CVS Specialty Pharmacy - Contractor - Continuum Global Solutions/United Call Center Solutions - Remote, MD

(2022-06 - 2024-03)

• Review insurance policy to determine coverage for medication therapy
• Prepare prior authorization forms or related documents and review them for completeness.
• Transmit prescription claims for payment or further investigation.
• Contact insured or other involved persons to obtain missing information.
• Use computers for various applications, such as database management or word processing.
• Complete forms in accordance with company procedures.
• Conduct searches to find needed information, using such sources as the Internet.
• Review work done by others to check for correct documentations, ensure that company format policies are followed and recommend revisions.
• Train or instruct employees in job duties or company policies or arrange for training to be provided.
• Contact or interview claimants, doctors, medical specialists, or employers to get additional information.
• Enter co-payments, reserves and new claims on the computer system, inputting concise yet sufficient file documentation.
• Provide services to customers, such as order placement or account information

Customer Service Rep/Aetna CVS - Contractor - Continuum Global Solutions/United Call Center Solutions - Remote, MD

(2021-10 - 2022-05)

• Managed customer calls effectively and efficiently in a complex, fast-paced and challenging call center environment.
• Accurately documented, researched and resolved customer service issues.
• Improved call center functionality and service capacity by resolving customer complaints efficiently and quickly.
• Addressed and resolved customer product complaints empathetically and professionally.
• Mastery of customer service management systems and databases

Delivery Driver - Mbb Delivery / Amazon - Springfield, VA

(2020-11 - 2021-10)

• Transport and deliver goods and items to clients or business in a safe, timely manner
• Examine and review orders before and after delivery to make sure that orders are complete, charges are right, and clients are satisfied
• Help with the loading and unloading of materials from the delivery vehicle
• Build and maintain a healthy relationship with clients by answering any questions they may have
• Make outbound phone calls and reschedule deliveries with customers if they are unable to receive them
• Completing and submitting logs and reports and handle customer complaints

Server / Cashier / Customer Service - P.F. Chang's - Tysons Corner, VA

(2020-01 - 2020-11)

• Took orders accurately, and entered orders using point of sale computer system
• Stayed familiar with menu items, advised patrons of specials, and answered questions
• Completed opening and closing duties, stocked supplies, accepted payments, and operated cash register
• Worked as a team to meet and exceed guest expectations
• Managed time efficiently to deliver food and beverage items in a fast-paced environment

Assistant - Code 3 Protection Services / ESS LLC. - Hanover, MD

(2016-04 - 2017-01)

Bachelor of Science - Health Services Administration - Strayer University (2028)

Associate of Science Degree - Medical Records Technician - Institute of Medical and Business Careers (2024)

Associate of Science Degree - Medical Billing and Coding - Ultimate Medical Academy (2021)

Associate of Science Degree - Graphic Designs - The Art Institute of Pittsburgh (2019)

High School Diploma - Fredrick Douglas High School (2014)