Patreka Patterson

Reviewed and evaluated medical necessity and appropriateness of services per clinical guidelines and payer requirements. Coordinated utilization management activities (prior authorizations, concurrent reviews, and discharge planning support) and maintained compliant, timely documentation.

Initiated authorization requests for input/output services and researched department-specific claims inquiries. Performed eligibility screening, monitored inpatient census, supported transitions of care, coordinated services with community-based organizations, and entered assessments and authorizations into the system.

Processed participant reimbursement requests daily by reviewing submitted materials against applicable guidelines for appropriate reimbursement. Worked to meet production and quality targets, handled payment/denial determinations, and responded to customer/provider claims status inquiries.

Received inbound calls and dispatched roadside assistance for multiple companies while investigating and resolving customer inquiries and complaints with empathy. Ensured superior customer experience by providing service providers with the information needed for timely assistance.

Audited agent cases and call progress to ensure guideline compliance and correct policy adherence. Evaluated calls, graded agents in testing, tracked trends in Excel, and reported mishandled cases to support coaching and quality improvement.

Compiled, sorted, and verified data accuracy before entry, locating and correcting data entry errors. Managed high-volume operations with 75 incoming and 50 outgoing calls daily and heavy data entry of 100+ properties per day.

Handled inbound dealer calls and emails to assist with policy/procedures issues and case openings, driving timely resolution with follow-up through completion. Managed financial assistance and service plan requests, tracked part delays, supported warranty/ESB claim concerns, and processed RAV uploads and webform requests.

Handled customer inquiries efficiently with 100–120 calls per day and an average handle time under 235 seconds while maintaining high customer satisfaction. Resolved difficult customer situations and was promoted after five months to a call center supervisor, leading a team of nine agents.

Processed inbound and outbound call requests (60–100 calls per day) for limousine and greeter services for high-profile clients. Dispatched vehicles, created routes, scheduled and booked reservations using travel software, and handled customer service and account receivable tasks.

Managed phone calls and appointments, performed charting and patient data intake, and uploaded patient charts with physician review. Delivered patient support including vitals, aseptic techniques, injections, venipuncture, rooming, and follow-up via email/mail.

Attended ParkRidge Senior High School in Long Beach, CA from 2004 to 2008.