Christina Trogdon

515-***-****

ad5bc6@r.postjobfree.com

Experience

Rising Phoenix Nutrition

Owner/Operator

● Provide education to individuals geared around a healthy lifestyle; including healthy food choices, exercise recommendations, and support.

● Provide excellent customer service to all exhisting and new clients.

● Provide support for business growth; maintains relationships and seeking new to build clientele

● Able to market business providing an increase in sales and revenue SAEG Ventures LLC, Tampa, FL (Remote)

Sole Contractor-Remote (March 2020-Current)

● Generate Medicare and Medicaid Quality reporting for Clients such as: HEDIS Gap Report, Individual Practitioner Performance Report, Possible Monies Missed Review.

● HEDIS Supplemental Data Submission

● Claims Reconciliation

● Research related to Projects, Upcoming Incentive & Quality uPrograms, and Business Grants. Anthem, West Des Moines, IA

Grievance & Appeals Rep II-Remote (Aug 2019-June 2021)

● Field member grievances via phone: Provide status, instructions, and resolution.

● Review Quality of Care: issues regarding member care both physical and mental.

● Track multiple states regarding Critical Incidents: PEGA, Quality of Care Tracker, and excel spreadsheet. Report Quality of Care issues to DHS for review.

● Assist in state reviews regarding possible negligent care from providers towar i ds members.

● Collaborate with leadership to determine the w.1efficient work flows to maintain management of work volume within each state worked in the central region. Conduct executive decisions for problem solving issues.

● Liaison between member and professional and non-professional peers to bring resolution.

● Inform medical review team of cases needing further review.

● Conduct training of new hires across all applicable systems and departments involving grievance

● Organize and maintain the Central Region (7 states) SharePoint: i.e. training, workflows, department policies and procedures, letters, forms, etc. Anthem, West Des Moines, IA

Community Based Case Manager-Remote (July 2018 – Aug 2019)

● Conducted training of new hires across all applicable systems and departments involving case management. Involved in Anthem’s leadership program HYPE (Healthcare Young Professional Exchange)

● Scheduled and coordinated person centered support plan meetings, admission meetings for members with cost savings in mind. Exceptional leadership and communication skills.

● Collaborated with care team to provide clinical resources and medical care for members.

● Conducted detailed assessments of member’s personal health goals and care plans.

● Provided psychological and emotional support resources to members as well as family members dealing with chronic or acute illnesses.

● Examined and discussed funding issues with patients and family members. Anthem, West Des Moines, IA

Medical Management Specialist (2017 – 2018)

● Assisted Case Managers in authorizing services members’ need to obtain personal health goals

● Fielded member and care team concerns and delegated accordingly.

● Researched billing inquiries and denials for reprocessing. Christina Trogdon

515-***-****

ad5bc6@r.postjobfree.com

● Built and approved member cases and authorizations in company database (FACETS).Lead and assisted various projects in a time sensitive environment for audit and reporting purposes to the state using various programs.

Tradehome Shoes, Fort Dodge, IA

Assistant Manager (2016 – 2017)

● Trained 7-8 sales associated to sell products within the store

● Interviewed/hired new employees

● Created and maintained weekly schedule

● Achieved and maintained 30% store gains, monthly, through personal sales

● Attracted and secured clientele from prior store loss

● Demonstrated excellent customer service

General Nutrition Company (GNC), Fort Dodge, IA

Sales Associate (2016 – 2017)

● Lead sales associate

● Educated customers on store products to help maintain a good healthy regimen

● Lead team in new accounts while helping to maintain and exceed store goals

● Maintained daily balanced cash register

● Demonstrated excellent customer service

Anthem, West Des Moines, IA

Grievance & Appeals Liaison (2015 – 2016)

● Answered calls from members regarding an appeal with a current decision regarding denial of their benefit or for their concerns regarding local physicians

● Researched members’ benefits for a customer satisfactory decision

● Conducted executive decisions for problem solving issues

● Acted as liaison between member and professional and non-professional peers for best resolution of member’s concern

● Presented cases needing medical review from the nurses on our team

● Obtained critical incident information for reporting purposes to the state Education

Southern New Hampshire University

Bachelor of Arts in Management, Concentration in Logistics & Operations Kaplan University, Urbandale, IA – 2004-2005

Associate of Applied Science for Medical Assisting Kaplan University, Urbandale, IA – 2004-2005

Medical Transcription Certificate

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