LETTISHIA ACTWOOD
Vicksburg
Summary
Proactive and goal-oriented professional with excellent time management and problem-solving skills. Known for reliability and adaptability, with swift capacity to learn and apply new skills. Committed to leveraging these qualities to drive team success and contribute to organizational growth.
Overview
2026
2026
years of professional experience
Work History
Case Management Specialist
Merit Health River Region
02.2022 - Current
- Helped improve LOS with early discharge planning from admission and discharging to facilities.
- Implemented discharge plans and other support functions for patients of different ages and families, resulting in defined clinical, satisfaction, and financial outcomes.
- Strong administrative and data entry skills. Work under pressure, multitasking, and being self-directed.
- Performed numerous tasks simultaneously, with minimal errors.
- Knowledge of medical terminology, ICD-10, and CPT daily coding, and utilization reviews on patients.
- Use excellent customer service skills and interrelationships with ancillary departments that are essential.
- Run daily reports, and enter daily patient DRGs.
- Fax and receive clinicals for daily review for expected quality of care.
- Check and submit for verification/authorizations for VA, MDOC, and multiple other patient insurance verifications, as well as for patients discharging from the hospital to home health, skilled nursing facilities, long-term care facilities, and more.
- Discuss medical information with patients and their families.
- Arrange services for the transition of care to home health or facilities.
- Collaborate with physicians, nurses, social workers, and other healthcare team members to ensure proper quality of care.
- Monthly medicare and managed medicare auditing on Important medicare forms and patient choice forms.
Customer Care Specialist
Walgreens Photo Online
01.2021 - 01.2022
- Responded to telephone inquiries, providing quality service to customers and associates inquiring about using the online site, products, log-in issues, and the status of orders.
- Processed refunds and resubmitted customers' orders as needed.
- Listened attentively to callers' needs to ensure a positive experience.
- Accessed multiple systems to look up information and availability of products and stores.
- Resolved problems on the first call, and avoided escalation of issues. Recommend solutions within the customer's budget, and actively follow up with all customers as needed.
- Requested escalation for unresolved issues.
- Resolved customer inquiries through multiple communication channels, enhancing overall satisfaction.
- Collaborated with team members to streamline order processing and improve response times.
- Utilized CRM software to track customer interactions and maintain detailed records.
Benefits Advocate & Authorizations
Humana Insurance Company
2016 - 01.2020
- Answered customers' questions to help guide and educate them on selecting the best benefits plan options, maximizing the value of their health plan benefits.
- Helped them understand select providers in their area. Built lasting relationships with Humana members.
- Received documents and resolved customer inquiries by using established best practices.
- Directed customers to the correct departments, if needed.
- Advocated for clients' benefits, ensuring accurate enrollment and timely access to resources.
- Resolved client inquiries through effective communication and problem-solving strategies.
- Evaluated existing benefit programs for effectiveness, making recommendations for enhancements as needed.
- Reviewed documentation for accuracy and completeness, facilitating timely approvals.
- Maintained compliance with HIPAA regulations, safeguarding sensitive patient information during the authorization process.
Education
Associates - Accounting, Business Administration
Brown Mackie College
Dallas, TX01.2006
Diploma - undefined
Greenville High School
Greenville, MS01.2003
Skills
- Office Management
- Data Entry
- Spreadsheets
- Excel
- Accounts Payable
- Accounts Receivable
- Care Management
- Auditing
- Insurance Coverage Verification
- Excellent Communication
- Attention to Detail
- Kronos
- Availity Essentials System
- HMS
- CRM
- Cerner
- Morcare
- Careport/NaviHealth
- Regulatory compliance
- Discharge documentation
- Patient communication
- Proficient in Oracle
- Ensocare
Timeline
Case Management Specialist
Merit Health River Region
02.2022 - Current
Customer Care Specialist
Walgreens Photo Online
01.2021 - 01.2022
Diploma - undefined
Greenville High School
Benefits Advocate & Authorizations
Humana Insurance Company
2016 - 01.2020
Associates - Accounting, Business Administration
Brown Mackie College