Aicha Bangoura
Atlanta,MI
Summary
Seasoned professional with over 8 years of customer service and administrative experience, seeking a Claims Analyst role. Skilled in customer issue resolution, record maintenance, and providing technical assistance, honed at Aetna and Hunter College Library. Excel in high-pressure environments, ensuring accuracy and efficiency in transaction processing and customer service.
Overview
12
12
years of professional experience
1
1
Certification
Work History
Health Concierge
Aetna
01.2022 - Current
- Provide personalized assistance to members by addressing inquiries, resolving concerns, and guiding them through complexities of health care plans and services to enhance their overall experience
- Resolved conflicts and addressed concerns promptly, fostering a positive environment for patients and staff alike.
- Completes screen coding and data entry requirements related to systems processes impacting generation and release of member-specific and plan sponsor products (e.g., ID cards, change applications, audit lists, in-force lists, HIPAA certificates and various reports)
- Strong organizational skills to maximize available work time
- Ability to prioritize tasks to ensure job tasks are completed before deadlines.
- Applies medical necessity guidelines, determine coverage, complete eligibility verification, identify discrepancies, and applies all cost containment measures to assist in claim adjudication process.
- Facilitated communication between members and medical professionals, ensuring clarity and understanding for all parties involved.
- Handle telephone and written inquiries related to requests for pre-approvals/pre-authorizations, reconsiderations, or appeals.
- Handled more than 100 daily inbound calls from health plan customers.
Sales Advisor
Hennes and Mauritz Global Flagship
04.2014 - 05.2018
- Enhanced customer experience by delivering attentive service, ensuring needs were met promptly and with a professional demeanor
- Assisted in merchandise management, including stocking shelves and maintaining product presentation to company standards
- Demonstrated effective problem-solving skills by addressing customer concerns, resulting in improved customer satisfaction and retention.
- Provided expert product knowledge to customers, leading to informed purchasing decisions and increased satisfaction levels.
- Handled difficult situations professionally by addressing customer complaints and finding mutually beneficial solutions, preserving long-term relationships.
- Contributed to team objectives in fast-paced environment.
- Performed effectively in self-directed work environment, managing day-to-day operations and decisions.
Library Media Specialist
Hunter College Library
03.2012 - 05.2014
- Delivered technical support for multimedia resources, ensuring patron needs were met efficiently
- Managed the circulation of books, laptops, and audio-visual equipment, while maintaining accurate patron records and coordinating reserve processes.
- Contributed to positive team dynamics by assisting colleagues with tasks when necessary, fostering a collaborative work environment.
- Instructed students and staff in research processes and understanding copyright, fair use and licensing of intellectual property.
- Maintained relevant, organized and correctly catalogued library and technology collection based on careful analysis of student needs.
Fulfillment Associate
Foot Locker Flagship
07.2013 - 11.2013
- Streamlined inventory management by efficiently relocating merchandise from stockrooms to sales floor, enhancing product display and accessibility
- Facilitated daily operations by working collaboratively with team members to meet targets and accurately recording transactions, contributing to the store's customer fulfillment objectives.
- Utilized strong multitasking abilities to manage multiple responsibilities simultaneously during busy periods.
- Increased customer satisfaction by providing efficient and friendly service while handling transactions.
- Worked to meet or exceed special targets for credit card applications, special donations and specific product promotions.
Education
Bachelor's Degree - Cybersecurity and Information Assurance
Western Governors University
Skills
- WPM-50
- HIPAA Compliance
- Medical Terminology
- Fluent in French
- Analytical thinking
- Microsoft Office proficiency
- Insurance policy knowledge
- Data analysis
- Critical Thinking
Certification
IT Support technician, Google 2022
Timeline
Health Concierge
Aetna
01.2022 - Current
Sales Advisor
Hennes and Mauritz Global Flagship
04.2014 - 05.2018
Fulfillment Associate
Foot Locker Flagship
07.2013 - 11.2013
Library Media Specialist
Hunter College Library
03.2012 - 05.2014
Bachelor's Degree - Cybersecurity and Information Assurance
Western Governors University