LaKenya Hairston

Energetic and highly skilled Training and Development Manager with 15+ years of experience supervising with Billing analyst, Training and Customer Service Roles at various levels within the organization. Accomplished in communication, seminar presentations, training needs analysis, developing training programs, learning material, facilitation, tracking learner progress, and evaluation of performance levels. Passionate about making a positive impact via value-based training.

AmeriHealth Caritas PA 

Work from home 

July 2023 Current     

• Gathering, reviewing, and submitting relevant documentation needed for claims processing.
•  Answering questions from doctors' offices, home health care or hospitals on benefits.
•  Gathering, reviewing, and verifying all pertinent information relating to participating healthcare providers.       
• Maintaining a working knowledge of all applicable federal, state, and local laws and regulations regarding healthcare.
• Reprocessing claims 
• Update authorization on claim
• Assist providers with coordinators/supervisors information
• Advice providers if claim paid or denied 
• Look up eft/check information 
• Look up appeal information and advice date appeal received and of upheld decision 

Sedgwick, Leave of absence coordinator 

Work from home 

July 2022- January 2023 

• Review the standard forms completed by the associate health care provider for clarify and completion, and to determine if the condition qualifies for leave under the applicable support new team members 

• Maintain detailed knowledge of the federal Family Medical Leave Act and state-specific leave laws to ensure that the leaves are handled in accordance with these laws. 

• Communicate timely with Walmart associates and the personnel departments at their facilities via telephone and written correspondence to aid with clarification of the leave process.

• Empathize with associates and give compassion when speaking to them.

 Sheffield Financial, Collections     

   Work from home 

   April 2019-June 2022 

● Document all collections efforts in the system of record for each assigned account in accordance with established policies, procedures, and guidelines

● Provide customers with payment arrangement options as well as renewals, due date, and extensions 

● Negotiate with customers to resolve delinquencies 

● Communicate regularly with the Collection Supervisor pertaining to inquiries, complaints, and other calls that require special assistance 

● Provide high level of customer service to customers Amerihealth

 Administrators, Billing Analyst (contract)

 Work from home/Hybrid 

 May 2016 – June 2018 

● Received and responded to inquiries 

Performed processing for assigned groups 

● Prepared weekly claim invoices and monthly administration invoices to ensure client invoices are sent in a timely manner and accurately 

● Sort, log, scan, and file invoices, checks, and other documents 

● Reviewed accounts for billing adjustments & waivers 

● Completed reconciliations and audited invoices 

● Reviewed and resolved maturity bill disputes as required 

● Posted payments to ensure payments and adjustments are properly applied and that payments reconcile to the EOB’s received by payers 

● Ensure of accurate interfaces by monitoring statements to ensure and clean audit process 

● Analyzed and reconciled accounts, perform routine inquiries to reconcile variances general ledger balances 

● Performed payment research and investigation as needed 

● Created and responded to service desk tickets when there is any problems with clients invoices 

● Applied cash applications at the invoice level for assigned clients enter and process lockbox, credit card, ACH, and EFT payments as necessary 

● Processed payments to outside vendor or third-party vendors under payment setup issues 

● Worked in partnership with and provided instruction to claims associates 

● Set up all new clients in all systems/reviewed client’s contract for self-funded business 

● Generated adhock run reports 

● Work from home Comcast Business, Retention Specialist  

    Mar. 2015 – Apr. 2016 

● Handled all orders by obtaining and verifying information 

 Billing questions, cancellation requests, updating customer profiles, processing billing adjustments/drafts, and refunds and renewals 

● Analyzed call center database to correct and update contact log  

● Improved quality results by recommending changes 

● Acquired job knowledge by participating in educational opportunities. 

● Enhanced organization reputation by accepting ownership for accomplishing new and different requests. exploring opportunities to add value to job accomplishments. 

● Renegotiated terms of agreement for renewals 

● Actively listened and identify both spoken and unspoken needs 

● Adapt your communication style to a wide variety of personalities and situations 

 Directv/Life Shield, New Hire Trainer/Manager Collections 

 Feb. 2014–Mar. 2015

 ● Directed 15 – 25 phone agents 

● Identified training needs by evaluating strengths and weaknesses 

● Translated requirements into trainings that will groom employees for the next step of their career path 

● Updated customer information such as phone numbers, e-mail, and addresses 

● Developed or oversaw the production if classroom handouts, instructional materials, aids, and manuals direct structured learning experiences and monitor their quality results 

● Managed a queue of accounts from 60-89 days delinquent 

● Contacted customers via telephone and make arrangements to bring the account current 

● Periodically evaluated ongoing programs to ensure that they reflect any changes 

● Stayed abreast of the new trends and tools in employee development 

● Navigated through multiple Windows-based applications with speed and accuracy. 

Comcast Residential, Customer Account Executive   

Sept. 2012–Sept. 2013 

● Coordinated orders by transmitting information. 

● Identified potential customers by answering product and service questions 

● Settled product or service problems by clarifying the customer's complaint

● Reconciled customer payments 

● Organized customer records by updating account information. 

● Have the resilience needed to efficiently manage a steady stream of customer calls, while balancing performance to meet a variety of metrics 

● Proactively analyzed usage patterns on customer accounts and reach out to customers if a reduction in usage is identified 

● Performed account reviews 

● Educated the customers on how to use certain functionalities and addressing any billing or support complaints 

● Contribute to customer facing help knowledge base as well as any internal procedure documentation

US Airways, Chairman Liaison/Intl Reservationist 

 Jun. 2006 – Mar.2012 

● Arranged and coordinated flight plans, State Senator/Governor, car rentals, and accommodations for domestic/Intl travel 

● Thorough knowledge of geography, fares and tariffs, routings to off-line points and office rules and procedures routings to connections and destinations. 

● Provided effective customer service by communicating information to customers regarding schedules. 

● Handling telephone calls in a professional manner consistent with the established procedures and standards of service escalated customer issues as needed /Transferring calls to various departments for further research.

● Implemented, organized and coordinated client’s itineraries by setting up their domestic/international flight for their travel plans. 

● Conducted research and analyze available flight, computing and compiling competitive fair records 

● Handled and made calls 

● Re-booked and re-accommodated passengers for missed, delayed or canceled flights 

● Monitored daily office procedures to ensure regulatory compliance in accordance with the Federal Airline Association.

 KEY QUALIFICATIONS • Exceptional Communication Skills • Proficient in Microsoft Office Suite (Excel, Word, Outlook) • Certified in Coaching • Motivated Problem Solver • Detail-Oriented • Troubleshooting • SAP, People Soft, CARS, Sales IAD, Facets