Alvina T Hamer
Columbia
Summary
Results-driven professional with expertise in data analysis and project management. Excellent analytical and communication skills, with a proven ability to adapt in fast-paced environments. Committed to continuous improvement and leveraging diverse skill sets to drive team success in collaborative settings.
Overview
13
13
years of professional experience
Work History
Revenue Recovery Specialist
Knowtion Health
02.2025 - Current
- Recovered revenue by following up on patient bills and claims.
- Identified root causes of claims through detailed information analysis.
- Obtained necessary information to successfully overturn claim denials.
- Ensured timely filing guidelines were met for maximum reimbursement.
- Escalated complex accounts to management for effective resolution and progress.
- Discussed root cause issues with management to enhance operational effectiveness.
Patient Access Specialist
AmerisourceBergen
01.2024 - 05.2024
- Enhanced patient experience by providing directions and answering inquiries promptly.
- Verified insurance coverage and collected payments, ensuring accurate financial transactions.
- Maintained precise patient registration records within the electronic health record system.
Care Navigator
United Healthcare Group
12.2022 - 10.2023
- Enhanced patient understanding of healthcare systems through effective guidance and support.
- Clarified diagnoses and treatment options for improved patient resource access.
- Streamlined patient-care team communication by serving as an effective liaison.
- Conducted follow-up assessments with patients to monitor recovery after discharge.
Benefits Verification Specialist
Lifestance Health
01.2021 - 10.2022
- Ensured accurate benefits verification through online portals and phone communication.
- Validated completeness and accuracy of benefits applications and related documents.
- Trained and mentored new employees on company benefits policies and procedures.
- Organized and prioritized tasks to meet service goals efficiently.
Customer Service Representative
Express Scripts
07.2020 - 12.2020
- Promoted high customer satisfaction by resolving problems with knowledgeable and friendly service.
- Assisted Medicare patients with processing prescriptions orders for home delivery services.
Level II Reimbursement Specialist
Hill-Rom Company Inc.
11.2016 - 03.2020
- Verified eligibility and benefits for insurance coverage and prior authorizations.
- Educated patients on payer policies and limitations regarding their coverage.
- Secured out-of-network exceptions on behalf of patients, improving access to care.
- Managed retrieval of necessary medical documentation from healthcare providers efficiently.
- Analyzed healthcare documentation to ensure compliance with payer criteria thoroughly.
- Informed healthcare accounts about documentation processes and federal/state regulations.
Medical Authorization Rep
Coram Health
04.2016 - 11.2016
- Secured authorizations for new patient services, ensuring timely access to care.
- Collaborated with admissions team to gather documentation for authorization approvals.
- Recorded authorization processes accurately in patient profiles for compliance tracking.
- Verified insurance coverage changes related to medication orders promptly and effectively.
- Investigated authorization denials, implementing solutions to improve approval rates.
- Coordinated with branch staff to obtain necessary information on Physician Orders.
Claims Senior Specialist
Allstate Corporate
02.2016 - 04.2016
- Performs clerical duties, including data entry, filing paper documents, email, calendar management, and word processing Handles claim files (locates/requests files, files paperwork, reconstructs missing files moves misfiled documents, sends to other offices, etc.) Retrieves, prints, faxes, or mails supporting documentation to vendors or others as directed Provides back-up for any support functions in the office Investigate prior losses and other information on file and orders reports as needed as direction of adjusters and management Receives, screens and routes incoming telephone calls and other electronic correspondence Contacts or receives contact from customers or other claim related third parties obtain and/or provide necessary file information to comply with quality and process standards.
Claims/Benefits Specialist
Assurant Health
11.2014 - 01.2016
- I assist customers with benefit information for their health insurance and provide information with how their claims have process.
- I respond up to 30-50 calls daily while making sure I deliver satisfactory customer service on each call.
Dietary Aid
The Colony at Eden Prairie
01.2014 - 04.2015
- Enhanced residents' dining experience by preparing and serving nutritious meals.
- Collaborated with dietary manager to develop meal plans for residents' needs.
- Maintained cleanliness and organization in kitchen and dining areas post-service.
- Delivered meals directly to residents' rooms, ensuring timely service and satisfaction.
- Prepared and served snacks to residents, promoting healthy eating habits.
Monitoring Dispacher
Stanley Security
09.2014 - 11.2014
- Performed duties in accordance with Stanley CSS' (Now with Sonitrol) ...
- Reads and records coded signals received in the Monitoring Center from integrated alarm signaling system by accurately interpreting incoming subscriber equipment signals and responding in the appropriate manner which is consistent with company policies and procedures.
Customer Service Representative
Pearson Vue
11.2013 - 08.2014
- I assist candidates with scheduling exam appointments.
- Respond too up to 80 inbound calls daily.
- I deliver extraordinary customer service with each candidate with my confidence and positive attitude.
Pharmacy Help Desk Representative
Connextions Inc.
11.2012 - 10.2013
- Delivered high-quality customer service for pharmacy and pharmacist contacts.
- Managed over 120 inbound pharmacy calls daily with utmost confidentiality.
- Ensured effective communication with technicians and pharmacists for service excellence.
- Enhanced customer satisfaction through consistent support and timely issue resolution.
Education
Diploma -
Terry Sanford High School
Fayetteville, NC2010
Skills
- Organization
- Microsoft Office Software
- Experience with Total Information Management System (TIMS)
- Back-up, Research
- Benefits/ Eligibility
- Clerical, Telephone
- Interpersonal communications, Time
- Interpersonal, Management
- Critical thinking, Word processing
- CSS, Written
- Customer service
- Data Entry
- Database
- Filing
- Insurance
- Leadership
- Excel
- Microsoft Office Software
- PowerPoint
- Word
- Multitasking
- Problem-solving skills
- Problem-solving
- Insurance billing
- Training & development
- Team building
- Critical thinking
- Computer skills
Affiliations
- Member, Professional Women Group and EMBRACE Black American Group, [2018] to Current
Timeline
Revenue Recovery Specialist
Knowtion Health
02.2025 - Current
Patient Access Specialist
AmerisourceBergen
01.2024 - 05.2024
Care Navigator
United Healthcare Group
12.2022 - 10.2023
Benefits Verification Specialist
Lifestance Health
01.2021 - 10.2022
Customer Service Representative
Express Scripts
07.2020 - 12.2020
Level II Reimbursement Specialist
Hill-Rom Company Inc.
11.2016 - 03.2020
Medical Authorization Rep
Coram Health
04.2016 - 11.2016
Claims Senior Specialist
Allstate Corporate
02.2016 - 04.2016
Claims/Benefits Specialist
Assurant Health
11.2014 - 01.2016
Monitoring Dispacher
Stanley Security
09.2014 - 11.2014
Dietary Aid
The Colony at Eden Prairie
01.2014 - 04.2015
Customer Service Representative
Pearson Vue
11.2013 - 08.2014
Pharmacy Help Desk Representative
Connextions Inc.
11.2012 - 10.2013
Diploma -
Terry Sanford High School