Meqele Peters
@meqelepeters
Detail-oriented healthcare representative with expertise in patient services.
What I'm looking for
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
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.
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.
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.
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.
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
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.
Availability
Location
Authorized to work in
Job categories
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