Lavern Ceaser Email & Phone Number

Carrollton, Texas, United States

Monitored the performance of team members to ensure compliance with policies, practices, and approved processes related to monthly, quarterly, and yearly KPI goals. Personnel experience included recruiting, interviewing, hiring, onboarding, training, performance evaluation, and developing team members professional capabilities. Supported compliance with all appropriate policies, procedures, safety rules and DEA regulations to ensure we adhered to the Statement of Work for each client supported. Documented, monitored, and evaluated all performance measures, including reports, critical success measures, end of month reports, duties, and responsibilities to ensure agent and team continued to meet or exceed KPI goals.

Carrollton, Texas, United States

• Assisted supervisor/manager with interviewing potential candidates; provided input for performance management process.• Ensured that customer service representatives are processing all phone, fax, mail, e-mail, and verbal orders from customers.• Provided customers with accurate answers to questions and complaints regarding products and services; if unable to aid, escalated customers to Customer Service supervisor or manager.• Responsible for mentoring, motivating, coaching, and leading a team of Service Professionals.• Made suggestions and recommendations to supervisor/manager to continually improve customer service operations.• Implemented process and procedures to improve customer service response to return request.• Reviewed team analytics and found typical turn around time to fulfill return requests were six (6) months.• Successfully implemented process improvement to respond to return requests within 10 business days.

Unit

• Handled an average of 250 calls per month routine and non-routine issues related to customer accounts, orders, product information, and reporting adverse events related to use of medication.• Responded to general inquiries and requests through incoming customer calls, emails, and faxes related to new account setups, placing orders, and tracking orders using the ERP ordering system.• Requested and reviewed hospital and/or physician’s license to ensure license is active and in good standing, shipping address on account and order matches address on license.• Responded to and investigated customer notifications detailing issues with orders including, but not limited to late arrival, product damage, product overages, and product shortages.• Initiated and tracked quality cases documenting customer notifications detailing issues with orders including missing packing slips, missing orders, product received damaged, product overages, and product shortages.• Led program audits for compliance with company and federal regulations related to controlled substances.• Maintained performance standards by utilizing defined Service Level Agreements with pharmaceutical manufacturers as it related to order processing, reporting issues with orders received, reporting issue with orders not received, monitoring controlled substances from pack and ship to delivery.• Maintained strong product knowledge for clients assigned within the POD to ensure accurate and timely response to inquiries.• Processed credit card payments for programs who required payment processing before orders were released to ship. In the event the payment was returned, worked with the Accounts Receivable department to ensure payment was completed successfully before order was released to ship.

Irving, Texas

• Utilized all available resources to obtain and enter insurance coverage information for ordered services.• Verified patient insurance coverage of medications, administration supplies, and related pharmacy services through proper investigation into either major medical benefits (including Medicare) or pharmacy benefits.• Facilitated the prior authorization process with insurance companies and practitioner office to ensure documentation is submitted accurately to ensure accurate verification and coverage approvals.• Interviewed patients to complete a full Medical Verification for all medications, administration supplies, and related pharmacy services to ensure proper payment.• Notified patients, physicians, practitioners and/or clinics of any financial responsibility of services provided and requested services that are not provided by the facility or covered by insurance.• Facilitated pharmacy and/or major medical claims with insurance companies and practitioner offices and investigated and facilitated prior authorization and any other claim rejections.• Provided notification of urgent orders to the Senior level or Group Supervisor and communicated with other departments when an urgent need for filling a prescription or delivery was necessary.• Placed outbound calls to patients or physicians’ offices to obtain additional information needed to process the script or to notify of delay in processing prescription.• Managed inbound calls from patients, clients, physicians, practitioners and clinics regarding inquiries about services provided, financial responsibility, and insurance coverage.• Maintained expert knowledge of client plan benefit information, prior authorization status, customer service skills, phone and computer databases and online support to ensure accurate and timely response to questions.• Cultivated customer trust by using sound judgement with providing members with information regarding benefit plans to assure accurate claims processing.