Anyeli Ciriaco
Miami
Overview
6
6
years of professional experience
Work History
Membership Rep III
Elevance Health
04.2022 - Current
- Planned and facilitated remote training and development sessions for over 20 new hires
- Performed routine metrics adherence monitoring and reported to leadership team
- Conducted regular reviews of departmental policies and procedures to ensure compliance and effectiveness
Membership Representative II
Elevance Health
04.2020 - 04.2022
- Implemented new and updated processes in response to regulatory changes, ensuring adherence to the Medicare managed care manual, and Part D enrollment guidelines
- Verified enrollment statuses, updated records, and resolved enrollment system rejection; effectively addressed a wide range of enrollment inquiries via phone, mail, and email
Membership Rep I
Elevance Health
04.2019 - 04.2020
- Verifies enrollment status, makes changes to records, researches and resolves enrollment system rejections
- Ensures accuracy and timeliness of the membership function
- Responds to inquiries concerning enrollment processes
- Maintains enrollment database
- Determines eligibility and applies contract language for each case assigned
- Performs error output resolution for electronic eligibility and processes error discrepancy list
- Screens all forms and data for all paperwork received from Sales
- Makes request to Sales or Brokers for missing information and/or forms needed for new group or re-class of existing group
- Thoroughly documents inquiry outcomes for accurate tracking and analysis
- Develops and maintains positive customer relations and coordinates with various functions within the company to ensure customer requests and questions are handled appropriately and in a timely manner
Education
Bachelor of Science - Nursing
Florida National University
Hialeah, Florida08.2017
Associate Of Arts - Pre Nursing Associate’s Degree
Miami Dade College (Padron Campus)
01.2015
Skills
- Administrative Support
- Project Coordination
- Effective Implementation
- Technical Proficiency
- Task prioritizing
- Problem-solving
- Teamwork
- Self-Motivated Work
- Detail-Oriented Approach
- Proficient in Two Languages
- Medical terminology
- Experienced in Microsoft Office
- Data Entry
- Customer Service Excellence
- Multicultural environment
Licensuresandcertifications
- RN, Florida State Board of Nursing, RN9674394
- Basic Life Support (BLS), 02/01/26
Timeline
Membership Rep III
Elevance Health
04.2022 - Current
Membership Representative II
Elevance Health
04.2020 - 04.2022
Membership Rep I
Elevance Health
04.2019 - 04.2020
Bachelor of Science - Nursing
Florida National University
Associate Of Arts - Pre Nursing Associate’s Degree
Miami Dade College (Padron Campus)