Kim Davis

ad2hfw@r.postjobfree.com • **** Kirby Parkway, Memphis TN 38138 • 901-***-****

Administrative Professional

Skilled Professional with experience in Underwriting, Case and Care Management, Office, and Project Management. Knowledgeable of Medicare Plans, Insurance, Medical Terminology, Human Resources, Policies and Procedures and Technology. Promotes excellent verbal and written communication skills and customer service. Practices good business acumen and work ethics. Highly organized, analytical, and initiative taking.

• Life and Health Underwriting

• Insurance Services

• Office Technology

• Team Leadership

• HIPPA/HITECH Compliance

• Project Management

• Care Management

• Workflow Management

• MSP Compliance

Career Experience

Sr. Customer Service Representative, TCML, Remote – 03/25/2022 – Present Provides senior level support for a government program. Reviews, approves or denies applications based on program criteria. Responds to program related inquiries received through the dedicated phone system. Assists service providers by researching databases to determine customers eligibility status. Troubleshoots online system issues. Provides training for new agents. Resolves enrollment issues and complaints. Utilizes Okta, Service Now, CRM, NLA, MAX, Microsoft Teams and other software applications as needed. Compliance Investigator/Contractor, SSIP, Remote – 05/2021 – 07/2021 Functioned as point of contact for Research & Development, Marketing, Logistics, Regulatory Affairs, Quality, Operations, and external bodies. Participated in risk analysis for all reported complaints (Triage). Monitored quality, completeness, and timeliness of complaint investigations. Performed data analysis and trending of filed complaint data to identify improvement opportunities. Collaborated closely with medical advisor(s) and medical investigation team to quantify risk. Prepared written reports for customers. Medical Underwriter/Contractor, Health Care Support, Remote – 10/2020 – Present Evaluates applications for potential risk and decision cases based on Company guidelines. Reviews office notes, medical records, charts, and data sets to determine eligibility and premiums. Utilizes various underwriting tools and systems such as SharePoint, COMPASS, Genesys, and other software applications as needed. Life/Health Underwriter/Contractor, Examination Management, Inc., Remote - 8/2016 to 1/2019 Provided underwriting support to the underwriting team, reviewed Life and Medicare Part B applications based on Company guidelines for potential risks, adequate coverage, and premiums. Transcribed APS summaries based on medical histories, office and hospital visit data, chart reviews and consultation information. Researched medications, diagnosis, medical terminology, and abbreviations. Performed audits. Kim Davis

P a g e 2

Care Manager, Elect Home Care, Remote - 4/2011 to 11/2017 Managed projects and events, field employees, schedules, client inquiries, on-call and after-hour call center for busy home health care provider. Verified benefits and obtained payors authorizations. Analyzed processes for improvements. Directed business development efforts to secure new business and enhance client services. Tracked and monitored employees’ attendance. Oversaw payroll, accounting, reporting activities, phone assessments, intake, and case management.

Provider Relations Specialist, Coalition America, Atlanta, GA - 1/2010 to 7/2010 Managed recruitment and enrollment of new healthcare providers, including negotiating out-of-network service rates. Collaborated directly with providers, communicated, and educated on contract and fee schedule information. Analyzed managed care data for assigned territories. Processed complex claims, appeals and billing. Assisted with member services.

Associate of Arts in Business Administration

American Inter-Continental University, Hoffman Estates, IL Education