Shenika Clyburn
Rock Hill
Summary
Dynamic Case Manager with a proven track record at Cencora, excelling in patient support and HIPAA compliance. Skilled in problem-solving and case documentation, I enhanced operational efficiency by training staff and improving communication between patients and providers, resulting in increased patient satisfaction and streamlined processes.
Overview
22
22
years of professional experience
Work History
Case Manager
Cencora
09.2019 - Current
- Provided exceptional customer service, addressing patient concerns promptly and professionally.
- Trained new staff on patient access protocols and electronic health record systems to improve operational efficiency.
- Facilitated seamless communication between patients and healthcare providers to enhance service delivery.
- Managed patient registration processes, ensuring accurate data entry and compliance with healthcare regulations.
- Secured patient information and confidential medical records in compliance with HIPAA privacy rule standards to protect patient's privacy.
- Handled sensitive situations involving distressed patients with empathy maintaining professionalism throughout interactions.
- Verified insurance coverage and obtained necessary authorizations to ensure timely billing and reimbursement.
- Managed high call volume while maintaining a professional demeanor, ensuring accurate communication of information.
- Contacted insurance companies for patient medical billing operations.
- Obtained patient's insurance information and determined eligibility for benefits for specific services rendered.
- Educated patients on available resources, programs, and financial assistance options to optimize their healthcare experience.
Benefit Verification Specialist
AmerisourceBergen
06.2016 - 09.2019
- Conducted comprehensive benefit verifications for patients, ensuring accurate and timely processing of requests.
- Collaborated with healthcare providers to gather necessary documentation and resolve discrepancies in insurance coverage.
- Implemented process improvements that enhanced accuracy and efficiency of benefit verification workflows.
- Trained junior staff on best practices for verifying benefits and utilizing electronic health record systems effectively.
- Ensured compliance with HIPAA regulations during all aspects of the benefit verification process, protecting patient privacy.
Home Health Aide
Travel Aides
08.2014 - 06.2016
- Assisted patients with daily living activities, ensuring comfort and safety in home environments.
- Monitored vital signs and reported changes to healthcare professionals to enhance patient care.
- Administered medications and maintained accurate records to ensure compliance with care plans.
- Developed trusting relationships with patients, promoting emotional well-being and engagement in care processes.
- Implemented feedback from patients and families, refining care techniques to enhance overall satisfaction.
- Helped patients maintain personal hygiene through bathing, grooming, and toileting assistance when necessary for dignity preservation.
- Maintained a clean and safe home environment for patients, reducing falls and accidents.
Front Line Medical Agent
Connexions
11.2011 - 08.2014
- Analyzed market trends to identify opportunities for growth and improve service offerings.
- Led training sessions for new agents, fostering a culture of collaboration and continuous improvement.
- Informed clients of policies and procedures.
- Mentored junior agents in best practices for sales techniques and client engagement strategies.
- Increased customer satisfaction with personalized follow-up strategies.
Customer Support Specialist
Convergys
09.2009 - 06.2011
- Provided exceptional customer support through effective communication and problem-solving skills.
- Assisted in resolving complex customer inquiries using CRM software to track interactions.
- Managed a high volume of inbound calls while maintaining excellent call quality standards and adhering to established procedures.
- Enhanced customer satisfaction by addressing and resolving complex issues promptly and professionally.
- Helped large volume of customers every day with positive attitude and focus on customer satisfaction.
- Provided timely assistance to customers via phone, email, and live chat channels, ensuring a high level of professionalism at all times.
Certified Nursing Assistant
Lancaster Convalescent Center
04.2003 - 08.2009
- Provided compassionate care to patients, ensuring comfort and dignity in daily activities.
- Assisted nursing staff with medical procedures, maintaining high standards of patient safety and hygiene.
- Monitored vital signs and reported changes in patient conditions to enhance treatment effectiveness.
- Documented patient care activities accurately, contributing to seamless communication within healthcare team.
- Trained new nursing assistants on best practices for patient care and facility protocols.
- Provided high-quality personal care services such as bathing, grooming, dressing, and feeding to ensure patient dignity.
- Assisted patients with daily living activities for enhanced comfort and wellbeing.
- Checked patient vitals such as temperature, blood pressure, and blood sugar levels.
- Answered call lights and supported patient comfort and safety by adjusting bed rails and equipment.
- Maintained a clean, safe environment by sanitizing surfaces, changing linens, and disposing of waste properly.
- Reduced fall incidents by implementing safety measures like bed alarms and proper positioning techniques.
Education
Certificate - Nursing
York Technical College
Rock Hill, SC03-2003
GED -
Richland County School District
Columbia, SC06-2000
Skills
- Problem-solving
- Case management
- Time management
- Case documentation
- Documentation and reporting
- Organization and multitasking
- Active listening
- Email and telephone etiquette
- Positive attitude
- Data entry and analysis
- MS office
- Patient support
- Patient assessment
- HIPAA compliance
- Verbal and written communication
- Clear communication
Timeline
Case Manager
Cencora
09.2019 - Current
Benefit Verification Specialist
AmerisourceBergen
06.2016 - 09.2019
Home Health Aide
Travel Aides
08.2014 - 06.2016
Front Line Medical Agent
Connexions
11.2011 - 08.2014
Customer Support Specialist
Convergys
09.2009 - 06.2011
Certified Nursing Assistant
Lancaster Convalescent Center
04.2003 - 08.2009
Certificate - Nursing
York Technical College
GED -
Richland County School District
Similar Profiles
Kristy L DaleyKristy L Daley
Customer Integration Specialist at CENCORACustomer Integration Specialist at CENCORA
Amanda BentleyAmanda Bentley
Senior Case Manager at CencoraSenior Case Manager at Cencora
Adriane WashingtonAdriane Washington
Benefit Verification Specialist at CencoraBenefit Verification Specialist at Cencora
Nautica AyaquicaNautica Ayaquica
Warehouse Assistant at CencoraWarehouse Assistant at Cencora
Paul RileyPaul Riley
Power and Controls Leader at MycoworksPower and Controls Leader at Mycoworks