Administrative Operations Specialist

Ta’kasha M. Watson

Tallahassee, FL ***** US

Email: ************@*****.***

Phone number: 850-***-****

Professional summary

Detail-oriented and adaptable administrative professional with over 5 years of experience in customer service, clerical support, and healthcare operations across remote and in-office settings.

Proven success in managing high-volume documentation, reviewing sensitive legal and healthcare data, and supporting eligibility and appeal processes for government programs such as Medicaid, Medicare, and SNAP.

Known for consistently exceeding quality and productivity benchmarks, handling confidential information with accuracy, and delivering exceptional client service. Technically proficient in Microsoft Office Suite, Google Workspace, and integrated eligibility systems, with a strong foundation in healthcare management and administration.

Skills

Administrative & Clerical Skills

Data Entry & Records Management

Document Review & Verification

Case File Management

Scheduling & Calendar Coordination

Front Desk & Reception Operations

Email & Phone Correspondence

Filing & Office Organization

Customer Service & Communication

Client Interaction & Support

Conflict Resolution

Call Handling (Inbound/Outbound)

Complaint Escalation & Follow-Up

Patient & Member Assistance

Empathy & Active Listening

Technical & Software Proficiency

Microsoft Office (Word, Excel, Outlook, PowerPoint)

Google Workspace (Docs, Sheets, Drive)

Integrated Eligibility Systems (e.g., Bridges IES)

Claims Processing Tools

Healthcare/Pharmacy Platforms

CRM & Case Management Systems

Healthcare & Government Program Knowledge

Medicaid & Medicare Regulations

SNAP/Eligibility Determination

RTNO & PHE Processes

Appeal Case Documentation

Medical Terminology Understanding

Professional Experience:

4CI consulting/Deloitte Oct 2023 – Jul 2025

Case Analyst

Reviewed legal documents and identified critical information and issues.

Analyzed and interpreted legal laws and regulations.

Conducted research to support document review and analysis.

Examined documents for specific information as requested by professional sectors for verification purposes.

Acquired necessary documentation for case processing.

Demonstrated deep knowledge of Integrated Eligibility systems and the impact of single data entry processes.

Assisted clients with Medicaid Return to Normal Operations (RTNO) activities following the Public Health Emergency (PHE).

Utilized fact-finding techniques to evaluate Medicaid renewal documents and customer-submitted information in Bridges IES, based on policy and business practices.

Consistently achieved a Quality Assurance (QA) score of 90% or higher.

Managed time efficiently to meet set productivity goals regularly.

Adapted to frequent changes and performed effectively under pressure.

Maximus Aug 2022 – Jul 2023

Eligibility Specialist

Determined the eligibility of applicants and recipients for public assistance programs.

Utilized medical knowledge during interactive interviews and fact-gathering sessions.

Maintained up-to-date knowledge of program regulations and procedures for managing multi-program caseloads.

Initiated and processed case changes as required.

Organized and maintained applicant files with accuracy.

Reviewed documents submitted by applicants to verify their qualifications.

Approved, closed, or denied Medicare, Medicaid, or SNAP coverage based on eligibility criteria.

Investigated complaints or denials by contacting customers to gather additional case details.

Documented processes throughout each case and prepared reports for appeal hearings.

Reviewed findings and supporting evidence to determine if eligibility decisions were justified.

CVS Caremark Nov 2021 – Aug 2022

Pharmacy Appeals Representative II

Utilized multiple software systems to complete Medicare appeal case reviews.

Met and exceeded all government-mandated timelines.

Complied with turnaround time, productivity, and quality standards.

Acquired and maintained knowledge of relevant and evolving Medicare Part C, D, and A guidelines.

Processed prior authorization requests from physicians' offices, ensuring compliance with Medicare requirements.

Informed relevant parties of all prior authorization determinations.

Capital Health Plan Jul 2021 - Nov 2021

Medical Receptionist

Served patients by greeting and assisting them, scheduling appointments, and maintaining accurate medical records.

Welcomed patients and visitors in person and over the phone in a courteous and professional manner.

Provided comfort and support to patients with anxieties, addressing their questions while maintaining a calm and organized reception area.

Maintained daily operations by adhering to established policies and procedures.

Contributed to team efforts by assisting coworkers and participating in cross-training as needed.

Multi-tasked effectively by managing front-desk operations and phone inquiries simultaneously.

Scheduled PCP (Primary Care Provider) meetings to discuss updates and changes in practice.

Coordinated biweekly or department-directed meetings as required.

CSNI Jun 2020 to Jan 2021

Data Entry Clerk

Modified and processed insurance claims with a focus on accuracy and efficiency.

Obtained and verified information to ensure data integrity.

Entered data into internal systems, ensuring consistency with source documents.

Processed an average of 20 claims per hour while maintaining quality standards.

Resolved or denied claims based on policy guidelines and documentation review.

Continuum Global Solutions Nov 2019 to Jun 2020

Claims Processor

Processed insurance claims efficiently and in accordance with company policies.

Modified existing claims based on updated or corrected information.

Obtained and verified claim details to ensure accuracy and completeness.

Demonstrated strong research and interpersonal skills to support claim resolution and customer communication.

Trulieve Dec 2018 – Nov 2019

Agricultural Specialist

Researched crops, collected agricultural data, and assisted growers in implementing best industry practices.

Performed repetitive tasks including climbing ladders and working on elevated platforms as part of crop inspection and maintenance.

Entered data into systems with speed and a high level of accuracy to support operational reporting and decision-making.

Conduent/Xerox Apr 2017 to Dec 2017

Customer Service Representative

Resolved customer complaints via phone, email, mail, and social media in a timely and professional manner.

Customers contacted customers to verify account information and address service-related issues.

Greeted customers warmly and identified the purpose of their inquiry or call.

Processed account cancellations, upgrades, and modifications based on customer needs.

Assisted with the placement of orders, refunds, and product exchanges.

Provided accurate company information and answered product-related inquiries.

Handled payment information and collected relevant details such as addresses and phone numbers.

Acted as a gatekeeper to ensure customers were directed to the appropriate departments or resources.

California Marketing Group Feb 2016 – Apr 2017

Customer Service Agent

Received inbound calls, including transferred sales leads and inquiries from current and potential customers.

Persuaded potential customers to complete and submit magazine subscriptions.

Answered customer questions regarding product details, company policies, and account issues in a timely manner.

Assisted customers with technical issues related to the website and escalated unresolved concerns to management.

Performed basic account maintenance, including updates and troubleshooting.

Met Quality Assurance (QA) requirements and consistently achieved key performance metrics.

Navigated multiple computer applications simultaneously while effectively multi-tasking.

Publix Oct 2014 - Jun 2015

Cashier

Greeted customers upon arrival and provided information about products and services.

Responded to customer complaints and resolved issues promptly and professionally.

Processed payments for purchases, including cash, credit card, and check transactions.

Bagged, boxed, and wrapped purchased items as needed.

Identified product prices using memory or barcode scanners.

Transactions enter into the cash register and provide accurate totals to customers.

Sorted and counted currency and coins, reconciled cash drawers at the beginning and end of shifts.

Issued receipts, change, trading stamps, and gift cards.

Performed customer service duties as required to support overall store operations.

Ensured daily cash account management and accurate record-keeping.

Maintained and cleaned the checkout area and ensured organized displays.

Proactively resolved customer complaints to enhance satisfaction and loyalty.

Opened and closed tills as part of shift procedures.

Trained and supported new cashiers to ensure accurate and efficient operations.

Maintained up-to-date knowledge of store inventory and sales activities.

Keep the work area clean, safe, and customer-ready at all times.

Education:

East Gadsden High School – Quincy, FL (June 2014)

Ultimate Medical Academy - Healthcare Management and Administration (March 2022 to March 2024)

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