Ayanna Millin
Sicklerville,NJ
Summary
Gifted professional skilled in providing compassionate support to individuals facing stress and confusion while seeking benefits information. Proven ability to navigate complex systems and deliver clear, actionable guidance in accordance with regulations and departmental guidelines. Adept at managing various communication channels, including telephone calls, emails, letters, and in-person inquiries, ensuring each interaction is handled with care and efficiency. Committed to empowering clients by fostering understanding and accessibility within the benefits process.
Overview
4
4
years of professional experience
1
1
Certification
Work History
Member Relations Specialist - Medicare
Jefferson Health Plans
Philadelphia, Pennsylvania
04.2025 - Current
- Coordinated communication between members and healthcare providers.
- Answering member inquiries about Medicare coverage, benefits, eligibility, and claims.
- Adhering to HIPPA laws & regulations
- Obtaining Prior Authorizations & verifying insurance
- Explaining plan options and helping members understand their rights, costs, and available services.
- Resolving issues related to billing, claims, and service access by coordinating with internal departments or providers.
- Maintaining compliance with CMS (Centers for Medicare & Medicaid Services) regulations and company policies.
- Documenting interactions accurately in the system for tracking and follow-up.
- Educating members on preventive care, resources, and programs available under their plan.
- Increased membership renewals through proactive outreach and engagement strategies.
- Trained new team members on best practices for managing member relations, improving overall department performance.
- Streamlined the onboarding process for new members, ensuring a positive first impression of the organization.
Pip Examiner
Geico
Marlton, USA
08.2024 - 12.2024
- Investigate medical necessity and determine causation for personal injury claims.
- Consult with involved parties to gather the necessary information.
- Secure medical information and review insurance contracts, reports, and billing documents.
- Evaluate the validity of personal injury insurance claims.
- Enforce compliance with laws and regulations governing financial and securities institutions.
- Conducted thorough investigations to assess claim validity and resolve discrepancies.
- Collaborated with adjusters and legal teams to support claim resolution processes.
Contact Center Representative - Credit Card
TD Bank
Mount Laurel, USA
01.2024 - 08.2024
- Processed and reviewed credit card applications ensuring compliance with company procedures.
- Provided expert advice to customers regarding credit card products, services, and services.
- Resolved customer inquiries promptly and professionally, addressing their concerns and providing solutions.
- Processed payments and transactions accurately and efficiently, adhering to established procedures.
- Demonstrated strong communication and interpersonal skills, effectively interacting with customers and colleagues.
Licensed Account Representative
NJM Insurance Group
Hammonton, USA
05.2023 - 12.2023
- Provided exceptional customer service by assisting with policy inquiries, resolving issues, and providing guidance on coverage options.
- Utilized CRM software to effectively manage customer interactions, track claim progress, and maintain comprehensive records.
- Demonstrated strong multitasking abilities by handling multiple customer inquiries and administrative tasks simultaneously while maintaining a high level of accuracy and efficiency.
- Processed policy applications and renewals, ensuring accuracy and compliance with regulations.
- Educated clients on policy features, benefits, and claims processes to enhance understanding.
- Improved overall agency efficiency by contributing to the development of internal procedures and guidelines for daily operations.
Intake Screener
Center For Family Services
Voorhees, USA
02.2022 - 06.2022
- Screened individuals for eligibility, ensuring they met the criteria for receiving services.
- Collected demographic data and maintained accurate records, contributing to data-driven decision-making and program evaluation.
- Provided empathetic support and guidance to individuals navigating the intake process, fostering a sense of comfort and understanding.
- Utilized intake forms efficiently and effectively to gather essential client information.
- Ensured accurate record-keeping, maintaining detailed and organized client files to facilitate seamless service delivery.
- Conducted initial assessments to determine client needs and eligibility for services.
- Guided clients through complex paperwork, enhancing understanding of available resources and services.
Education
High school or equivalent -
Highland Regional High School
Blackwood, NJ6 2015
Skills
- Claims processing
- Document processing
- Account management
- Policy analysis
- Problem-solving
- Data entry
- Microsoft office
- Insurance regulations
Certification
Producer’s License - Personal Lines
Timeline
Member Relations Specialist - Medicare
Jefferson Health Plans
04.2025 - Current
Pip Examiner
Geico
08.2024 - 12.2024
Contact Center Representative - Credit Card
TD Bank
01.2024 - 08.2024
Licensed Account Representative
NJM Insurance Group
05.2023 - 12.2023
Intake Screener
Center For Family Services
02.2022 - 06.2022
High school or equivalent -
Highland Regional High School