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Meqele PetersMP
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Meqele Peters

@meqelepeters

Detail-oriented healthcare representative with expertise in patient services.

United States
Message

What I'm looking for

I am looking for a role that values patient-centered communication and offers opportunities for professional growth.

I am a detail-oriented and compassionate healthcare representative with extensive experience in patient scheduling, financial clearance, and insurance verification. My career has been marked by a proven ability to thrive in high-volume call center environments while maintaining professionalism, accuracy, and compliance. I am currently seeking a Patient Service Center Representative II position where I can leverage my expertise in eligibility verification, pre-registration, and patient-centered communication.

In my current role as a Coverage Determination Representative II at CVS Health, I perform patient financial clearance by verifying insurance eligibility and benefits, managing patient scheduling, and ensuring compliance with pre-registration processes. My previous positions have equipped me with a strong understanding of insurance verification for specialty medications and outpatient services, as well as the ability to resolve coverage discrepancies effectively. I pride myself on providing a positive patient experience through efficient communication and accurate documentation.

Experience

Work history, roles, and key accomplishments

CH
Current

Coverage Determination Representative II

CVS Health

Jan 2023 - Present (2 years 8 months)

Performed patient financial clearance by verifying insurance eligibility, benefits, and coverage limitations. Managed patient scheduling across systems, performed documentation indexing, and followed up on pre-registration compliance.

CH

Behavioral Health Advocate

Cigna Health

Sep 2024 - Dec 2024 (3 months)

Served as first point of contact for patients and providers, offering guidance on eligibility, authorizations, and benefit usage. Coordinated with internal systems to ensure timely and complete appointment registration.

PH

Prior Authorization Specialist

PhilRx

Apr 2024 - Jun 2024 (2 months)

Scheduled procedures and conducted insurance verification for specialty medications and outpatient services. Collaborated with billing to resolve coverage discrepancies and secure upfront payments where applicable.

UH

Prior Authorization Associate

United Healthcare

Jun 2023 - Dec 2023 (6 months)

Completed pre-registration activities including patient demographic verification, insurance review, and benefit coordination. Assisted with collection efforts, provided payment options, and processed financial counseling referrals.

DR

Customer Success Representative

DrugScan

Feb 2022 - Sep 2022 (7 months)

Provided real-time claim support and appointment information updates to patients and providers. Handled call documentation, claim delay research, and escalated inquiries using Windows-based applications.

Education

Degrees, certifications, and relevant coursework

York CUNY logoYC

York CUNY

Bachelor of Science, Psychology

2017 - 2021

Completed a Bachelor of Science in Psychology, focusing on foundational psychological principles and research methodologies. Gained a comprehensive understanding of human behavior and cognitive processes.

Tech stack

Software and tools used professionally

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Meqele Peters - Coverage Determination Representative II - CVS Health | Himalayas