Britini Medina
Healthcare Member Support and Escalations Specialist
Idaho Falls,ID
Summary
Dedicated professional with a proven track record of delivering high-quality results. Recognized for strong communication and teamwork skills, with a focus on achieving organizational goals and providing exceptional service. Committed to continuous learning and professional development, with diverse experience in healthcare, retail, and customer service. Seeking a role that encourages both personal and professional growth.
Overview
11
11
years of professional experience
1
1
Certification
Work History
Escalation Specialist II
Centene / Wellcare (Remote)
04.2024 - Current
- Ensure high-quality support for Medicare and D-SNP members through active, empathetic engagement.
- Handle case reviews to address escalated issues.
- Utilize a multi-monitor setup to efficiently manage information and resources while working remotely.
- Conducting proactive outbound calls to address member inquiries, provide updates, and ensure ongoing engagement.
- Fostering a caring and professional atmosphere, prioritizing member comfort and trust in all interactions.
- Alleviating member stress by recognizing unique challenges and offering clear communication and tailored solutions.
- Research, analyze, and resolve complex customer inquiries.
- Manage multiple cases simultaneously while providing superior service.
Member Advocate (Remote)
SelectHealth-Murray, UT
11.2019 - 12.2023
- Triaged and researched member situations to ensure effective resolutions and support
- Delivered exceptional customer service, earning consistent positive feedback
- Referred members to appropriate providers, including InstaCare and Mental Health professionals
- Scheduled appointments and coordinated care with suitable providers
- Managed transportation logistics for Medicaid, Medicare, and D-SNP members
- Prepared thorough case reviews to enhance decision-making processes
- Passed monthly audits, ensuring adherence to quality standards
- Assisted in training new employees, promoting a collaborative team environment
- Handled inbound and outbound communications via Web Chat and calls
- Addressed escalated and crisis calls professionally, ensuring member safety
- Operated efficiently within a triple monitor setup while working remotely.
Store Manager
The Cash Store-Idaho Falls, ID
12.2017 - 10.2019
- Delivered exceptional customer service while educating customers on products and rates
- Created and managed personal and title loans, maintaining comprehensive customer files
- Oversaw store operations, including scheduling, inventory management, and financial transactions
- Processed payments and maintained a clean and organized workspace
- Trained and supervised staff, ensuring adherence to company policies and procedures.
Caregiver
MorningStar Senior Living-Idaho Falls, ID
10.2018 - 02.2019
- Worked graveyard shift, assisting residents with individual needs and comfort care, ensuring a clean and safe environment
- Managed medication administration and maintained confidential resident files
- Assisted in post-mortem care
- Provided updates during shift change.
Direct Caregiver
Idaho Falls Group Homes
06.2015 - 07.2017
- Provided compassionate care for individuals with mental and physical disabilities, addressing their unique needs
- Maintained accurate documentation of care, conditions, progress, and concerns
- Assisted with daily living activities, including nutrition and personal hygiene, while ensuring a safe environment
- Responded appropriately to physical, emotional, and developmental needs of clients
- Administered and maintained records of prescribed medications
- Maintained a clean, healthy, and safe environment
- Ensured everything was up to code to pass state inspections
- Familiar with Hoyer Lift
- Drove clients to and from scheduled activities/appointments.
CSR/Manager
Pizza Hut
04.2014 - 03.2015
- Supervised staff while ensuring a clean work area and high customer satisfaction
- Handled order processing, inventory management, and financial transactions
- Prepared various food items
- Dispatched delivery drivers.
Education
Associate of Applied Science - Surgical Technology
Eastern Idaho Technical College
Idaho Falls, ID08-2026
GED -
Eastern Idaho Technical College - Idaho Falls, ID
Idaho Falls, ID09.2017
Skills
Customer Service:
- Complaint Investigation
- Complaint Resolution
- De-Escalation Techniques
- Spreadsheet tracking
- Call Documentation
- Communication Skills
- Triaging, active listening, empathy
Healthcare Knowledge:
- Basic ICD-10, CPT
- Medical Terminology
- Medication Administration
- Patient Care & Safety
- HIPAA Compliance
Technical Skills:
- Microsoft Office Suite (Word, Excel, PowerPoint)
- CRM Software (eg, Citrix, Facets)
- Multi-Monitor Setup Efficiency
- Proficient in Web Chat & Multi-Line Phone Systems
Administrative & Organizational Skills:
- Case Management & Documentation
- Scheduling & Appointment Coordination
- Cash Handling & Inventory Management
- 10-Key Data Entry
Problem-Solving & Analytical Skills:
- Research & Information Gathering
- Case Review & Decision-Making
- Proactive Outbound Calls & Member Engagement
- Attention to detail
Remote Work/Organizational Proficiency:
- Remote Communication Tools
- Time Management & Self-Motivation
- Adaptability in Virtual Environments
- Proven ability to work from home (4 years) and learn new skills as needed
Leadership & Training:
- Team Building & Staff Training
- Conflict Management
- Operational Oversight (Store Management)
Certification
- Assistance with Oral and Expanded Medication Training
- Basic Life Support (BLS)
- Driver's License
- First Aid Certification
- CPR Certification
Timeline
Escalation Specialist II
Centene / Wellcare (Remote)
04.2024 - Current
Member Advocate (Remote)
SelectHealth-Murray, UT
11.2019 - 12.2023
Caregiver
MorningStar Senior Living-Idaho Falls, ID
10.2018 - 02.2019
Store Manager
The Cash Store-Idaho Falls, ID
12.2017 - 10.2019
Direct Caregiver
Idaho Falls Group Homes
06.2015 - 07.2017
CSR/Manager
Pizza Hut
04.2014 - 03.2015
Associate of Applied Science - Surgical Technology
Eastern Idaho Technical College
GED -
Eastern Idaho Technical College - Idaho Falls, ID
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