Helenikka Williams

**** ***** ****

Austell GA **106

Cell Phone 407-***-****

acxp3t@r.postjobfree.com

Objective: To obtain a challenging position in the Health Care community which would best utilize my leadership, planning and organizational skills.

Qualifications: Over fifteen years of customer service experience; consummate team player, creative problem solver who is dedicated to the highest level of professionalism. Employment History

Aetna Specialty Pharmacy 2012-2016

Claim Benefit Specialist

Reviews and adjudicates routine claims in accordance with claim processing guidelines. Coordinates responses for routine phone inquiries and written correspondence related to claim processing issues.

May facilitate training when considered topic subject matter expert. Applies medical necessity guidelines, determine coverage, complete eligibility verification, identify discrepancies, and applies all cost containment measures to assist in the claim adjudication process. Aetna Specialty Pharmacy 2007-2012

PCC Team Lead

Assistant to team’s supervisor, assign worksheets to team members, responsible for updating team’s productivity spreadsheets and log in/out report sheets. Handle escalated patient issue; work with other department’s managers, supervisors, and Team Leads to review and improve process flows, quality call monitoring, and other duties as assigned.

Provide assistance to the indexing team as needed when work queues are high; adhere to indexing daily metrics when assisting.

Aetna Specialty Pharmacy 2005-2007

PCC Outbound Representative

Duties include insurance verification, creating and routing medication orders for pharmacy department to ship, answering inquiries regarding status of orders placed, contact patients to obtain demographic information, medical history, and insurance information. Communicate with medical offices and facilities to obtain patients’ prescriptions as needed, act as patient advocate to ensure patients’ received world class customer service.

Luthern Haven Nursing home 2004-2005

Certified Nursing Assistant

Responsibilities were taking residents vital signs, provided hands on patient secondary care such as, bathing, easting, dressing, and daily walking with residents. Performed daily preventative care such as reposition bedridden patients to prevent skin breakdown, change bed linens, supplied patients with bed- pans, and disposed of bedpans contents. Assisted nurses with patient care monitoring i.e. monitor patient’s urinary out-put and specimens collection, performed other duties as assigned by managerial and nursing staff.

Career Highlights:

Completed first level Six Sigma Yellow Belt

Successfully crossed trained with indexing (data entry) Successfully crossed trained with Process and Call department Contributed to Team’s success of receiving the most top quality award for 2010-2011 Education

Orlando VO-Tech 2001-2001

C.N.A Certificate of Completion

Evans High School 1995-1999

Diploma General Studies