Healthcare benefits specialist

Shanise Alexander

404-***-**** ad5o48@r.postjobfree.com www.linkedin.com/in/shaniseealexander OBJECTIVE

To contribute to the growth of an organization with my professional expertise and develop myself further in the process. EDUCATION

Georgia State University, Robinson College of Business Atlanta, GA Bachelor of Business Administration, Management June 2023 - Present GPA: 3.43

Georgia Perimeter College Clarkston Clarkston, GA

Associates Degree of Science

Overall GPA: 1.92

January 2012 - December 2014

Clayton State University Morrow, GA

Transfer Student

Overall GPA: 3.00

August 2004 - May 2005

Redan High School Stone Mountain, GA

High School Diploma, with Honors GPA:

3.67

January 2004 - December 2004

LEADERSHIP ACTIVITIES

Insight Global Cotiviti Stone Mountain, GA

Medical Records Retrieval Specialist April 2019 - March 2020

• Processed bulk medical record audits on specialty projects, managed up to 30-150+ patient files per call, averaging 35-50 calls per shift, increasing audits of medical records being received by 90% EXPERIENCE

Humana CarePlus Stone Mountain, GA

Inbound Customer Service Representative 2 Remote November 2021 – January 2024

• Supplied information for and submitted medical and pharmacy, authorizations, and referrals with an average amount of 35-50 calls daily

• Provided solutions to members, in collaboration with several external departments leveraging systems; Client Side Image Mapping, Rx nova, Pa hub, Aflac Solutions, Integrated Home Care, and One Home Care, maintaining the required 94% compliance rating

• Explained benefits for medical, pharmaceutical, claims, durable medical equipment, scheduled transportation, or aid with any medical needs for Medicare Advantage eligible individuals ages 65 and older or individuals with special needs

Insight Global Cotiviti Stone Mountain, GA

Medical Records Retrieval Specialist Remote June 2020 - November 2021

• Retrieved medical records on behalf of the client, conducted accuracy audits for Medicare, Medicaid, commercial risk adjustment, RADV audits, and Healthcare Effectiveness Data and Information Set accounts

• Assisted in training new hire employees on different internal systems, skills, and knowledge Insight Global Kaiser Permanente Duluth, GA

Member Services Representative April 2019 - March 2020

• Navigated internal systems, routed callers to correct departments, and contributed solutions to members while staying within quality metric of 100%

• Processed two types of premium and service billing payments system, via checking, debit, or credit for Medicare Medicaid, and commercial accounts, and delivered customer services, and technical support Uhaul Stone Mountain, GA

Customer Service Representative Remote April 2018 - April 2019

• Addressed customer's concerns, product knowledge, reservation and rental assistance for 500+ customers per week

Sitel Turbo Tax Stone Mountain, GA

Seasonal Tax Support Representative Remote January 2018 - April 2018

• Managed customer's tax inquiries for 3 different online products and 4 different software, and applied policies, and procedures, to troubleshoot, resolve product, and tax support customer inquiries Uber Atlanta, GA

Independent Contractor August 2015 - January 2018

• Picked up 1600+ passengers and orders from designated locations and safely deliver them to requested destination

Convergent Public Service Electric and Gas Company PSEG Stone Mountain, GA Customer Service Representative Remote August 2011 - December 2016

• Established new services, payment agreements, explained bills, took payments, meter readings, multi-tasking web-based computer tools, focusing on first call resolution Women's Resource Center to End Domestic Violence Decatur, GA Volunteers in Service to America VISTA August 2010 - August 2011

• Enhanced support needs to find resources to aid with donations and volunteer from potential donors, maintained donor records, donor communication, and follow up correspondence from each donor for one main facility Value City Jonesboro, GA

Sales Associate March 2008 - September 2009

• Executed weekly stock checks in collaboration with shoe department, printing pricing labels, inventory counts, and recovery for shoe department

Comcast Smyrna, GA

Customer Account Executive January 2007 - February 2008

• Sold phone, internet, and cable services averaging an additional 10% sales bonus per pay period, processed payments and payment arrangements

Downtown Locker Room DTLR Decatur, GA

Sales Associate October 2003 - January 2006

• Facilitated with 5 other employees shipments, merchandising, restocking, and pricing Kentucky Fried Chicken KFC Decatur, GA

Crew Member January 2003 - January 2004

• Greeted customers, took orders, and completed customer transactions on cash register with 100% accuracy SKILLS

• Computer: Data Analysis, Microsoft 365 Office; Excel, Microsoft Word, PowerPoint, Access

• Software: Avaya one X, SAP, Salesforce Customer Relationship Management, Cisco WebEx

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