Summary
Overview
Work History
Education
Skills
Timeline
Generic

Ayina Sumani

Chicago

Summary

Results-driven Customer Service Professional with over 7+ years of experience, specializing in communication and customer satisfaction. Skilled in managing high volumes of inbound calls while fostering positive, long-lasting relationships with customers. Proficient in utilizing CRM systems to optimize service processes and deliver efficient customer support.

Overview

7
7
years of professional experience

Work History

Customer Support Specialist

Inspira Financial
12.2024 - Current
  • Processed and verified member enrollment data and balance inquiries within the COBRA department, ensuring accuracy and compliance.
  • Investigated complex customer data discrepancies and account issues to identify root causes and implement accurate resolutions.
  • Compiled and analyzed customer data to generate reports on feedback and trends, aiding management in process improvements.
  • Performed precise data entry for account maintenance.
  • Assist in the appeals process for denied claims, researching and providing necessary documentation to support resolutions.
  • Managed patient inquiries via telephone and email regarding insurance benefits and billing, providing clear and concise information to enhance understanding.
  • Assisted in resolving claim issues related to billing and reimbursement inquiries.

Clinical Coordinator

Medical Health Centers
02.2024 - 12.2024
  • Develop and manage the master schedule for all 3rd and 4th-year medical student clinical rotations. This includes placing students in specific hospital departments and ensuring they meet the required clerkship durations as mandated by the curriculum.
  • Collaborate with various affiliated hospitals and clinical sites to ensure current and valid affiliation agreements are in place. This involves tracking expiration dates and initiating the renewal process.
  • Maintain accurate records of student placements, rotation dates, and contact information for preceptors and clinical sites. Utilize a database or scheduling software to manage and track all scheduling-related data.
  • Ensure that student evaluations are completed in a timely manner by preceptors at the end of each rotation. This may involve sending reminders to faculty and clinical supervisors and tracking the return of evaluation forms.
  • Verify that students have completed all necessary compliance requirements before they begin their rotations at a new site. Coordinate with the student affairs office to track these requirements.
  • Address unexpected scheduling conflicts, such as a preceptor's sudden absence or a student needing to reschedule a rotation. Find alternative solutions to minimize disruption to the student's education and the clinical site's operations.


Quality Improvement Coordinator

Labels Unlimited
01.2020 - 01.2024
  • Documented and reported issues with compliance, standards of care, and quality assurance requirements.
  • Developed quality improvement plans, policies and operational guidelines.
  • Assessed ongoing operations against standards.
  • Evaluated competency of clinical staff, documenting performance, and recommending improvements.
  • Established and tracked quality department goals and objectives.
  • Determined quality department standards, practices, and procedures.
  • Developed quality planning for multiple new product launches by verifying customer requirements and implementing in design and production.
  • Tracked quality issues with external customers, suppliers, and internal plant operations.
  • Specified quality requirements of raw materials with suppliers.
  • Recorded, analyzed, and distributed statistical information.
  • Scheduled and chaired quality review meetings to review effectiveness of performance mitigating risk, improving throughput and achieving customer satisfaction.

Caregiver

Homewatch CareGiversInc
07.2018 - 01.2020
  • Developed plans for respite care when needed based on availability of family members or other caregivers.
  • Assured proper nutrition by preparing meals, grocery shopping and monitoring food consumption levels.
  • Assisted elderly clients with activities of daily living, such as bathing, dressing and grooming.
  • Respected the rights of each individual client while maintaining confidentiality of all personal information.
  • Transported clients to doctor appointments and other errands using wheelchair accessible vehicles.
  • Monitored vital signs, including blood pressure, temperature and pulse rate.
  • Provided emotional support for clients who were experiencing depression or anxiety due to their illness or disability.
  • Ensured compliance with all applicable laws, regulations and standards governing home health care services.

Education

Associate of Arts - Business Administration

Moraine Valley Community College
Palos Hills, IL
05-2026

James Madison High School
Remote
05-2018

Skills

  • Insurance Benefits Verification
  • Prior Authorizations
  • Microsoft Office Suite (Word, Excel, Outlook)
  • Medicare Part A, B, C & D
  • Commercial Payers Policies
  • Insurance Plan Knowledge (PPO, HMO etc)
  • HIPAA Compliance
  • CRM Software
  • Medical Terminology
  • Case Management
  • Service ticket management
  • Intermediate ICD /CPT Codes
  • Call Metrics
  • G Suite
  • Email management

Timeline

Customer Support Specialist

Inspira Financial
12.2024 - Current

Clinical Coordinator

Medical Health Centers
02.2024 - 12.2024

Quality Improvement Coordinator

Labels Unlimited
01.2020 - 01.2024

Caregiver

Homewatch CareGiversInc
07.2018 - 01.2020

Associate of Arts - Business Administration

Moraine Valley Community College

James Madison High School

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Ayina Sumani