Case Management Customer Service

DONNA DO

************@*****.***

PROFESSIONAL PROFILE

Extensive experience in customer service, case management and resolutions by handling difficult situations with adaptability and resourcefulness. Investigate and process analysis procedure with excellent critical thinking skills, also adept in finding innovative solutions to complex problems.

EXPERIENCE

06/2024 to present

10/2023 to 05/2024

01/2021 to 6/2023

Self – employed

Beauty Industry

Surge Support Analyst

Deloitte Consulting

Compiles, reviews and analyzes documents and case management reports

Analyzes and processes complex Medicaid cases by investigating and gathering information to determine the appropriate action plan within a timely resolution or facilitate the case to the appropriate department.

Evaluate data from electronic sources to enter information into computer eligibility system to make corrections and adjustments as needed

Obtain and evaluate information provided by applicants and compute benefits based on eligibility determination

Apply and explain detailed regulations and policies and perform arithmetic functions

Medicaid Eligibility Specialist

Alabama Medicaid Agency

Process new applications and annual redeterminations for Medicare Savings Programs and Family Certification Program for Alabama Medicaid Agency

Interpreting, applying and communicating regulatory guidance to make determination of applicant's eligibility based upon established criteria in compliance with State and Federal laws, rules, and regulations

Investigate, contact, and verify the accuracy of information provided by clients under the Medicaid Programs to determine eligibility

Effectively handle active telephone calls, determining the identity of the caller, obtaining needed information, and responding to caller questions or requests

Properly diagnose customer needs and proactively educated them about the features and benefits of the agency and services.

Liability changes and update budget for Nursing Home cases

Cross trained in multiple departments to know all agency needs and train new employees.

01/2016 to 07/2017

Co-Manager

Citgo

Assist in various human-resource-related activities, including but not limited to coaching, counseling, and performance management

Perform effective coaching and mentorship to various associates in an impactful, collaborative, and consultative manner

Recognize forthcoming customer initiatives and awareness of market trends to keep up with local competitors

Establish effective customer and supplier relationship by ensuring efficient merchandise on the sales floor and in the stock room

Assist with the general maintenance and appearance of the store by ensuring a safe and pleasing environment for both customers and associates

01/2010 to 12/2015

Manager

Marathon

Administer the onboarding process of newly hired employees and first day orientation to acquaint them with the company’s operational procedures and policies

Perform effective formal/informal coaching and mentorship to various associates at all organizational levels in an impactful, collaborative, and consultative manner

Accountable for store cash and all other financial assets, reconciling cash register drawers, preparing deposits, and ordering change from the bank

Assist with the general maintenance and appearance of the store by ensuring a safe and pleasing environment for both customers and associates

Financial research and evaluation by analyzing operating reports and updates superior on business performance, new initiatives, and make recommendations for changes and improvement

University of Alabama at Birmingham

Bachelor of Science- Psychology

Minor in Marketing

EDUCATION

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