Highly-motivated employee with desire to take on new challenges. Strong work ethic, adaptability, and exceptional interpersonal skills. Adept at working effectively unsupervised and quickly mastering new skills.
Overview
11
11
years of professional experience
Work History
Appeals & Grievances Coordinator
Point32Health
02.2024 - Current
Reviewed and triaged appeal requests to determine validity, classification, and next steps in accordance with regulatory guidelines
Prioritized and managed high-volume workload in a fast-paced, deadline-driven environment
Worked both independently and collaboratively to ensure timely issuance of appeals in accordance with regulatory turnaround requirements
Proactively identified high-priority and urgent cases, initiating escalation protocols to ensure timely resolution and adherence to compliance standards
Member Services Representative
Tufts Health Plan
11.2021 - 02.2024
Provided frontline support to members, resolving inquiries and complaints related to benefits, coverage, and services
Applied strong knowledge of HIPAA and privacy regulations to ensure compliant handling of sensitive information
Documented interactions accurately and efficiently to support case tracking and quality standards
Demonstrated strong communication and de-escalation skills while maintaining high customer satisfaction