Open to opportunities

Qumekia Caston

@qumekiacaston

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Healthcare claims and intake specialist focused on compliance and patient support.

United States

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What I'm looking for

I seek a healthcare-focused role where I can apply claims and intake expertise, maintain regulatory compliance, support patients empathetically, and contribute to streamlined workflows and improved outcomes.

I am a detail-oriented healthcare professional with extensive experience in medical claims processing, behavioral health intake, and customer support across federal and private healthcare environments. I consistently manage high-volume intake, resolve discrepancies, and maintain meticulous documentation in CRM and EHR systems.

Throughout my career I have ensured HIPAA and regulatory compliance while collaborating with cross-functional teams to streamline workflows and improve adjudication and client retention. I have developed client education tools, handled sensitive federal program inquiries, and escalated complex cases appropriately.

I bring empathetic service to diverse populations, strong data-entry and verification skills, and a track record of improving intake accuracy and client engagement. I am seeking opportunities to leverage my healthcare administration and claims expertise to support operational excellence and patient-centered outcomes.

Experience

Work history, roles, and key accomplishments

Medical Claims Processor

VNS Health

Oct 2024 - Jul 2025 (9 months)

Managed high-volume data entry and intake of medical claims for multiple providers, resolved denials and discrepancies, and ensured HIPAA and CMS compliance while streamlining adjudication workflows.

Claims Processing HIPAA Data Entry Cross Functional Collaboration

Retention Specialist

H&R Block

Feb 2024 - Oct 2024 (8 months)

Conducted client intake and retention outreach, developed educational onboarding materials, collected user feedback for software optimization, and documented interactions in CRM while providing IRS-compliant guidance.

CRM Onboarding Educational Content Customer Outreach Feedback Documentation

Customer Service Representative

MOHELA

Oct 2023 - Jan 2024 (3 months)

Delivered inbound/outbound support via chat, phone, and email, performed borrower intake for repayment plans, updated account data, and processed forbearance/deferment requests while educating customers on federal programs.

Customer Support Intake Process Account Management Identity Verification Repayment Plans Communication Documentation

Customer Service Representative

Internal Revenue Service

Feb 2023 - Sep 2023 (7 months)

Guided taxpayers through document intake and filing requirements, managed clerical intake and digital recordkeeping, and resolved filing, payment, and account discrepancies.

Taxpayer Support Data Entry Record keeping Compliance Clerical Customer Education

Clerical Support

Internal Revenue Service

Jun 2022 - Dec 2022 (6 months)

Processed and sorted mail and tax documents per IRS procedures, entered and verified taxpayer information with high accuracy, and maintained digital and physical filing systems.

Data Entry Document Management Scanning Attention To Detail

Customer Service Representative

FEMA

Oct 2020 - Apr 2022 (1 year 6 months)

Processed intake for federal disaster aid applicants, verified documentation, guided applicants through eligibility and application submissions, and logged cases into secure intake systems for follow-up.

Disaster Aid Intake Case Logging Security Systems Documentation Customer Support

Behavioral Health Technician

Heartland Center for Behavioral Change

Jul 2017 - Oct 2020 (3 years 3 months)

Conducted intake assessments in outpatient and inpatient settings, documented treatment plans and clinical notes in EHR, triaged mental health crises, and educated clients and families on treatment compliance.

EHR Triage)Behavioral Health Support Treatment Planning Patient Education Clinical Documentation