Appeals and Grievance Coordinator

Keith Johnson

***** ********** ******, ***********, ********** 92683

714-***-**** *************@*****.***

SUMMARY OF QUALIFICATIONS

•An organized, detail-oriented, and conscientious self-starter, able to strategize and prioritize effectively to accomplish multiple tasks and stay calm under pressure

•A highly skilled listener and communicator, able to assess client needs and convey necessary information with clarity and enthusiasm

•Computer skills include: MS Word, Excel, Outlook, and Internet

•Experience in security, banking, healthcare, and customer service

PROFESSIONAL EXPERIENCE

United Healthcare – Cypress, California February 2011 – Present

Appeals and Grievance Coordinator

•Process and distribute incoming electronic mail and documents to appropriate departments

•Set up appeals and grievance cases

•Research member’s account for possible claims or authorizations

•Communicate with members for any additional information needed

•Update member profiles

•Request documentation for legal authorization

Southern California Traffic School – Huntington Beach, California March 2010 – August 2011

Instructor

•Conducted 8-hour traffic school courses

•Prepared course materials and demonstrated using visual aids

•Administered and graded examinations

•Issued official DMV certificates of completion

Universal Protection Services – Santa Ana, California May 2007 – February 2009

Security Patrol

•Frequently patrolled businesses for security of grounds and private property

•Kept hourly log documenting all activities that occurred throughout the day

•Monitored the alarm and camera systems for suspicious activity

•Secured facility doors daily

•Ensured only authorized personnel entered the building

•Accurately updated system information

ASAP Lending – Santa Ana, California July 2005 – April 2007

Lending Officer

•Processed residential insurance claims

•Met daily quotas established to maintain company goals

•Balanced and discussed strategic plans with the Data Entry Clerk Lead to create plans to enhance customer satisfaction

•Investigated and resolved customer concerns in collaboration with respective agencies and other departments

•Provided measurement on volume and trends to determine agency education needs and to improve customer satisfaction and retention

•Assisted in implementing new paperless process which resulted in streamlined operations

•Enhanced customer service ratings for expediting all claims and ensuring a high degree of accuracy

Comerica Bank – Livonia, Michigan May 2001 – June 2005

Photo Copy Retrieval

•Provided quality customer service

•Worked with customers to open various accounts

•Initiated telephone sales and basic investments

•Processed consumer loan applications

•Described products and services to the clients

•Process bank transactions, including subpoenas, account updates, check verification

•Provided support for underwriting activities, including compilation, sorting, interpretation, and verification data

•Processed and distributed incoming and outgoing mail

•Ordered and managed office supplies

•Provided general office duties, including filing, photocopying, and faxing

United States Army – Hanau, Germany March 1995 – June 1998

E4 Promotable Specialist

•Lead Trainer in Bravo Troop

•Security Operations Specialist

•Community relations, and conflict resolution, peace-keeping mission

•Residential and security site manager

EDUCATION

University of Phoenix September 2015

Master of Science in Psychology

University of Phoenix, Costa Mesa, California March 2013

Bachelor of Science in Business Management

ADDITIONAL SKILLS AND INFORMATION

Computer Skills

Healthcare:

•ECAA, ODM, Stellent, AS400, ILead, Stars, Care Core National, Navigator, LG (Letter Generation), RightFax, Sharepoint, IDRS, Fastrieve, NICE, HSR, Care Planner, IDRs, MIIM, CDC Wizard

General:

•Microsoft Outlook, Microsoft Word, Microsoft Excel, Microsoft PowerPoint

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