Brandon Baena
Delta Community Credit Union
MCDONOUGH,GA
7
years of professional experience
Organized Technology Professional experienced in managing multiple priorities while enhancing systems and aligning technical solutions with business objectives. Led projects from inception to completion, contributing to organizational growth and success. Focused on problem-solving, continuous learning, and effective communication to advance team goals and tackle new challenges.
Work History
HMSA
1 Year 1 Month- Self-motivated, with a strong sense of personal responsibility.
- Works effectively in fast-paced environments.
- Proven ability to learn quickly and adapt to new situations.
- Excellent communication skills, both verbal and written.
- Demonstrates respect, friendliness, and willingness to help wherever needed.
- Passionate about learning and committed to continual improvement.
- Manages time efficiently in order to complete all tasks within deadlines.
- Uses effective critical thinking to break down problems, evaluate solutions, and make decisions.
Grievance and Appeals Representative
1 Year 9 Months- Investigated, analyzed, and resolved member grievances and appeals in accordance with CMS and state regulatory guidelines.
- Resolved complex appeals cases, ensuring compliance with regulatory standards and company policies.
- Analyzed appeal requests, identifying trends to improve processes and reduce resolution times.
- Collaborated with clinical, legal, and compliance teams to provide timely and precise responses to member inquiries.
- Collaborated with clinical teams, legal, and compliance departments to ensure accurate and timely responses.
- Delivered empathetic service to members, effectively addressing complex healthcare concerns to enhance member satisfaction.
Inside Sales Specialist
1 Year- Expanded portfolio of independent pharmacy clients, enhancing profitability through strategic promotion of competitively priced generic, brand-name, and OTC products.
- Developed and maintained strong client relationships to drive sales growth.
- Identified sales opportunities and aligned product offerings with client needs, directly contributing to revenue growth.
- Analyzed customer needs to propose tailored products and services.
Call Center Representative
1 Year 10 Months- Managed inbound calls for Medicaid members across Kentucky, Illinois, South Carolina, and Florida, providing prompt and accurate assistance on insurance plan inquiries.
- Facilitated grievance and appeals processes, achieving timely resolutions and enhancing customer experience.
- Delivered critical information and support during COVID-19, assisting members in navigating challenges and resolving related issues.
- Provided critical information and support related to COVID-19, helping members navigate challenges during the crisis and resolving related issues.
Education
Master of Business Administration (MBA) - Project Management
Focused on advanced project management strategies, leadership, and organizational efficiency.
Bachelor's Coursework - Administration, Organizational Behavior and Church Leadership
Focused on organizational management, leadership theory, and strategic administration within church and nonprofit settings.
Bachelor of Arts - Missions and Ministry
- Successfully balanced full-time employment and academic responsibilities, completing a rigorous curriculum in ministry leadership, theology, and community engagement.
- GPA: 3.4
Skills
Positive demeanor
Problem-solving
Attention to detail
Decision-making
Excellent communication
Teamwork and collaboration
Regulatory compliance
Multitasking Abilities
Effective communication
Dependable and responsible
Friendly
positive attitude
Computer skills
Accomplishments
- Collaborated with team of 10in the development of processes for Covid-19
- Used Microsoft Excel to develop inventory tracking spreadsheets.
Timeline
HMSA
Delta Community Credit Union
08.2025 - CurrentRead More
Grievance and Appeals Representative
Humana
09.2023 - 06.2025Read More
Inside Sales Specialist
SmartSource
11.2021 - 11.2022Read More
Call Center Representative
Humana
03.2019 - 01.2021Read More
University of the Cumberlands
Bachelor of Arts from Missions and Ministry
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Boyce College
Bachelor's Coursework from Administration, Organizational Behavior and Church Leadership
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Louisiana State University
Master of Business Administration (MBA) from Project Management
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