ADRIEN MULLEN
Elevance Health
Portsmouth,VA
9
years of professional experience
Highly motivated and dedicated IT agile, customer service and data analysis professional that can formulate and apply mathematical modeling and other optimizing methods to develop and interpret information that assists management with decision making, policy formulation, reporting, processing, or other managerial functions.
Work History
ECOB Specialist I II III
6 Years 6 Months- Research complex scenarios and handle complex case research and resolution
- Researching and investigating other coverage for GBD Medicaid membership
- Conduct on-line or phone research to verify member's coverage with other carriers
- Collaborate with multiple internal departments to verify OH leads and analyzes requests in combination with current system data to ensure record is updated accurately
- Work escalated and critical inventory within required turnaround times
- Assist with special projects
- Norfolk, VA
Anthem Health Program Representative
2 Years- Provide initial contact between distinct Care Management programs and specific identified members. Under direct supervision.
- Handle inbound/outbound enrollment and engagement calls with eligible members to provide information regarding program features.
- Provides superior and professional customer service to members.
- Records call details and utilize call scripts as needed based on client requirements.
- Assist members with scheduling preventative health screenings appointments to close gaps of care as needed.
- Initiates referrals and manages consults from clinicians for participants registered in Care Management.
- Gathers information from hospitals, health plans, physicians, patients, vendors, and other referral sources.
- Encourages members to practice in the Quality Management programs by providing information about the program, outlining program features/value, and explaining available services.
- Directs member inquiries to appropriate clinical staff
- Contacts physician offices to obtain demographic information or related data as needed.
Education
Certified Business Analyst , CBA
Medical Assistant
Customer Service
Tech Prep High School Diploma
Skills
Business Analysis
Agile
Reporting and Processing
Healthcare
Medical
Medicaid
Medicare Background
Strong Leadership
Relationship Management
Written and Oral Communication Skills
Facets
Member360
RightFax
Switchboard
Patient Care
Nurse Aide
Claims Review
Comp-Nutrition
CHCS
Proficient with JIRA
ServiceNow
HRS
Skype
Microsoft Team
Word
Excel
Outlook and PowerPoint
Timeline
ECOB Specialist I II III
Elevance Health
01.2020 - CurrentRead More
Anthem Health Program Representative
Anthem Inc
01.2018 - 01.2020Read More
Lake Taylor High School
Tech Prep High School Diploma
Read More
Tidewater Community College
Customer Service
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Everest Institute
Medical Assistant
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Gebeya IT Academy
Certified Business Analyst , CBA
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