Chanel Pomare-Latimer
Boston
Summary
Personable and dedicated Customer Service Representative with extensive experience in health care industry. Solid team player with upbeat, positive attitude and proven skill in establishing rapport with members and patients. Motivated to maintain customer satisfaction and contribute to company success. Articulate, enthusiastic and results-oriented with demonstrated passion for building relationships, cultivating partnerships and growing businesses.
Overview
21
21
years of professional experience
Work History
Senior Patient Finance Coordinator
Boston Children's Hospital
09.2022 - Current
- Maintained compliance with regulatory requirements through diligent record-keeping and thorough documentation practices.
- Facilitated cross-functional collaboration by working closely with other departments on financial matters.
- Collaborated with team members to coordinate complex projects, successfully meeting deadlines without compromising quality.
- Gathered and collected all financial information for business and verified accuracy in system.
- Met weekly with department managers to discuss financial information according to current needs.
- Provided exceptional customer service, addressing inquiries from both patients and healthcare providers promptly and professionally.
- Ensured compliance with HIPAA regulations by maintaining strict confidentiality in handling sensitive patient information.
- Verified eligibility and compliance with authorization requirements for service providers.
- Improved patient satisfaction by efficiently processing prior authorization requests and ensuring timely responses.
- Streamlined workflow for faster approval turnaround times, handling high volume of insurance verification tasks.
- Collaborated with healthcare providers to expedite the process of obtaining necessary medical documentation for approvals.
Member Support Specialist
Tufts Health Plan
04.2017 - 09.2022
- Resolved intricate problems related to claims concerning both members and providers.
- Ensured compliance of claim adjustments with designated plan benefits.
- Coordinated efforts across contracting, case management, enrollment and multiple internal departments.
- Collaborated with pricing vendors such as Cigna, Zelis, and PHCS to secure rate agreements for out-of-network providers.
- Facilitated solutions for complex issues in partnership with Member and Provider services.
- Providing timely cost estimates to members for future services.
- Partnered with Training & Development to instruct Member Services representatives in claims processing and workflows.
- Trained across various internal systems and service functions to support coworkers with achieving essential coverage targets.
Member Services Team Lead
Tufts Health Plan
05.2013 - 04.2017
- Led team of 12 to 15 Member Services Representatives successfully.
- Delivered ongoing coaching and training to team.
- Educated new employees on workflow procedures and call handling.
- Worked in conjunction with L&D to create training materials for US Family Health Plan phone queue.
- Facilitated resolution of complex benefit and claim discrepancies involving members and providers.
- Managed diverse call queues related to pharmacy benefits, HMO plans, PPO options, and specialty services.
- Navigated challenging situations with composure while utilizing internal knowledgebases.
Member Services Representative
Tufts Health Plan
01.2012 - 05.2013
- Serviced 50-60 inbound member and provider calls daily.
- Provided side by side training to teammates.
- Trained new hires on workflows and phone queues.
- Worked with members and providers to resolved escalated benefit and claim issues.
- Subject matter expert on US Family Health Plan & Steward employer group queues.
- Displayed strong telephone etiquette, effectively handling difficult calls.
- De-escalated problematic member concerns, maintaining calm, friendly demeanor.
Assistant to Director of Rehab
Neville Center @Fresh Pond
07.2008 - 09.2010
- Registered patients for short- and long-term rehab stays.
- Verified insurance eligibility.
- Assisted physical & occupational therapists patient care.
- Ensured patients received proper DME upon discharge.
- Handled incoming and outgoing mail, email and faxes.
- Oversaw purchasing and inventory to retain physical assets.
- Implemented billing procedures, audited and reconciled accounts and recorded transactions.
Administrative Assistant
Brigham's & Women's Hospital
08.2005 - 07.2008
- Assistant in the Weight Loss Management Program.
- Registered patients for outpatient visits and inpatient surgeries.
- Verified insurance eligibility.
- Managed weekly weight loss meeting registration and product sales.
- Maintained inventory in supply closet to prevent shortages.
- Organized and maintained filing and document management systems by coordinating, archiving and purging files.
- Directed patient communication to appropriate department personnel.
- Arranged travel and hotel accommodations for domestic business meetings and trips.
- Verified operation of office equipment by completing preventive maintenance requirements and calling for repairs.
Inpatient Admissions Coordinator
Boston Children's Hospital
09.2003 - 07.2005
- Registered patients for inpatient stays, and outpatient lab work.
- Confirmed demographics and insurance eligibility.
- Collected upfront copays and deductibles.
- Prepared death certificates.
- Helped patients with admissions process and adhered to state and federal laws.
- Organized and participated in health fairs to raise awareness of organization's mission and services.
- Handled insurance claim duties and verified that each met standards of admissions.
Education
Bachelor’s Degree - Business And Health Administration
Southern New Hampshire University
New Hampshire06.2023
MA - Medical Assisting
Bryman Institute
Brookline, MA02.2000
Skills
- Data evaluation
- Microsoft Office expertise
- Member support
- High-energy attitude
- Report creation
- Cross-functional collaboration
Education and Training
true
Timeline
Senior Patient Finance Coordinator
Boston Children's Hospital
09.2022 - Current
Member Support Specialist
Tufts Health Plan
04.2017 - 09.2022
Member Services Team Lead
Tufts Health Plan
05.2013 - 04.2017
Member Services Representative
Tufts Health Plan
01.2012 - 05.2013
Assistant to Director of Rehab
Neville Center @Fresh Pond
07.2008 - 09.2010
Administrative Assistant
Brigham's & Women's Hospital
08.2005 - 07.2008
Inpatient Admissions Coordinator
Boston Children's Hospital
09.2003 - 07.2005
Bachelor’s Degree - Business And Health Administration
Southern New Hampshire University
MA - Medical Assisting
Bryman Institute
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