Keondra Daniels
Baton Rouge
Summary
Results-driven professional experienced in human resources, healthcare customer service, and call center operations. Expertise in managing high-volume inquiries regarding claims, benefits, and billing, ensuring accuracy and compliance with CMS guidelines. Known for resolving issues efficiently and delivering exceptional customer service.
Overview
5
5
years of professional experience
Work History
HR Personnel Specialist II
East Baton Rouge School System
Baton Rouge
10.2023 - Current
- Maintain and analyze employee records, ensuring accuracy, compliance, and attention to detail
- Investigate and resolve employee concerns, demonstrating conflict resolution and problem-solving skills
- Communicate policies and procedures clearly while maintaining professionalism and confidentiality
- Manage multiple tasks simultaneously, prioritizing workload in a fast-paced environment
Clinical Service Representative
OLOL Children's Hospital
06.2023 - 10.2023
- Coordinated patient services, admissions, and discharges to enhance patient flow and satisfaction
- Communicated effectively with providers and staff to facilitate seamless patient care operations
- Managed patient records, ensuring accuracy and compliance in documentation and data verification
- Demonstrated strong organizational skills while handling multiple administrative tasks
Customer Service Rep/Care Specialist
Centene Corporation, Upward Health
06.2022 - 04.2023
- Ensured First Call Resolution (FCR) by taking ownership of customer issues from start to finish
- Managed high-volume inbound calls from members and providers about claims, benefits, eligibility, and authorizations, ensuring timely and accurate information delivery
- Guided members through health plan benefits, policies, and procedures to enhance understanding and satisfaction
- Researched and resolved billing and claims discrepancies across multiple systems
- Maintained performance metrics in quality, efficiency, and customer satisfaction
- Recorded all interactions in CRM systems for compliance and reporting, supporting organizational transparency and data integrity
Patient Care Specialist
Fast Pace Health Urgent Care
10.2021 - 04.2022
- Resolved patient concerns with professionalism and empathy, fostering positive patient experiences
- Explained insurance benefits and financial responsibilities, enhancing patient understanding of their coverage
- Verified insurance eligibility and processed billing, ensuring accurate payment information for patients
- Maintained accurate patient documentation using medical terminology
Mental Health Tech II (COVID)
Baton Rouge General
12.2020 - 04.2021
- Documented patient observations and communicated critical updates to medical staff to support timely interventions.
- Maintained composure in high-stress situations to facilitate effective responses and ensure patient safety.
- Maintained compliance with HIPAA and healthcare regulations
Education
Bachelor of Science - Healthcare Management
American Intercontinental University
Chandler, AZ11-2026
Diploma - Dental Assisting
Delta College of Arts & Technology
Baton Rouge, LA05-2018
Skills
- Call center operations
- Claims review and billing inquiries
- Medicare and Medicaid guidelines
- Health insurance verification
- First call resolution
- Conflict resolution and de-escalation
- Microsoft Office suite
- Electronic medical records management
- Customer relationship management systems
- Medical terminology expertise
- Critical thinking and problem solving
- Multitasking and time management
References
- Dr. Mary Leach, Professional Development Specialist, EBR School System, Colleague, 561-581-3261, mary.leach61@yahoo.com
- Dr. LaTonya Guillory, HR Supervisor/Supervisor of Staffing, EBR School System, Supervisor, 225-922-5485, lguillory3@ebrschools.org
Languages
English
Timeline
HR Personnel Specialist II
East Baton Rouge School System
10.2023 - Current
Clinical Service Representative
OLOL Children's Hospital
06.2023 - 10.2023
Customer Service Rep/Care Specialist
Centene Corporation, Upward Health
06.2022 - 04.2023
Patient Care Specialist
Fast Pace Health Urgent Care
10.2021 - 04.2022
Mental Health Tech II (COVID)
Baton Rouge General
12.2020 - 04.2021
Bachelor of Science - Healthcare Management
American Intercontinental University
Diploma - Dental Assisting
Delta College of Arts & Technology