Summary
Overview
Work History
Education
Skills
Certification
Timeline
Generic

CHANEL GOGGINS

Jacksonville,FL

Summary

I am ambitious and experienced in the healthcare field working as a healthcare analyst, registration associate, correspondence lead, expertise in verification of health insurance, referrals, obtaining authorizations, and following state and company compliance. I am seeking to secure a position where I can utilize my knowledge and experience to increase operation efficiency, as well as expanding my comprehension in the healthcare industry, and develop my competency and commitment to service customers healthcare medical coverage needs.

Overview

14
14
years of professional experience
1
1
Certification

Work History

Janitorial Supervisor

Velociti Services
03.2023 - Current
  • Conduct performance evaluations and provide feedback to employees
  • Maintained required records of work hours, budgets and payrolls.
  • Inspect and evaluate cleanliness of various areas, such as offices, restrooms, and shared areas
  • Ensure that cleaning procedures are followed, including the use of appropriate cleaning agents and equipment
  • Address and resolve any cleaning issues or concerns promptly.
  • Monitored staff performance and provided feedback to drive productivity.
  • Distributed supplies and goods to staff at beginning of shift to manage inventory and maintain proper supplies while controlling expenses.

Wealth Management, Operations Associate

Bank of America
04.2022 - 03.2023
  • Review that legal requirements are met to complete the transfer request
  • Review and process requests for account maintenance when contacted by an investor
  • Answering phone calls where we will assist investors with a wide range of questions about the transfer and account maintenance process
  • Cross training to help with other functions within the group
  • Update and or write procedures
  • Communicate effectively with other members of both verbally and through e-mail
  • Perform daily repetitive work accurately and with minimal supervision
  • Implemented control measures to reduce costs and align with budget.
  • Applies all internal and external policies/guidelines and requirements of the regulators and to agreed SLAs, KRIs and/or KPIs and quality measures.

Claims Examiner II

AmeriHealth Caritas
08.2010 - 04.2022
  • Investigate coverage, including evaluate insurance coverage problems and/or disputes
  • · Ensure and maintained compliance with all applicable federal state and/or county laws and regulations related to our documented guidelines and processes.
  • Review, research, analyze, and process complex healthcare claims by navigating multiple computer systems and platforms and accurately capturing the data/information for processing
  • Creates and supports a professional environment which fosters teamwork, cooperation, respect and diversity
  • Meet department quality and production requirements
  • Process claims for multiple Lines of Business as requested by management.
  • Examined claims forms and other records to determine insurance coverage. Make claim payment decisions and processed claims that meet production and quality standards.
  • Responsible for reviewing and adjudicating claims based on provider and health plan contractual agreements and claims processing guidelines.


Education

High School Diploma -

William M. Raines High School
Jacksonville, FL
05.2003

Skills

  • Platforms: Microsoft Office 365,Outlook,Excel,OneNote
  • Mobile Platforms: Apple iOS, Google Android
  • Healthcare Systems: IDX, Mincron, Jacada, Onbase, AthenaHealth, RightFax, EMR, ICD-9, ICD-10
  • Products:Encompass (Mortgage Software), Oracle EnterpriseOne (JDE),LexisNexis

Certification

0620- ADJUSTER ALL LINES, W922810

Timeline

Janitorial Supervisor

Velociti Services
03.2023 - Current

Wealth Management, Operations Associate

Bank of America
04.2022 - 03.2023

Claims Examiner II

AmeriHealth Caritas
08.2010 - 04.2022

High School Diploma -

William M. Raines High School

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CHANEL GOGGINS