Charmore Neely
Grievance Coordinator
Chicago,IL
Summary
Self-motivated Quality Assurance Analyst with outstanding oral and written communication skills. Extensive knowledge in call flow and benefit details. Coaching customer service representatives on compliance and time management. Willing to go above and beyond for the client to maintain superior service.
Overview
5
5
years of professional experience
Work History
Financial Coordinator
Northwestern Medicine
09.2022 - 10.2024
- Completed journal entries, reconciliations, and account analysis to prepare quarterly financial documents and general account management.
- Researched insurance benefits, for managed care and commercial health plans.
- Coordinated with utilization management department to get authorization approvals.
- Resolve patients' billing inquiries to ensure financial clearance.
- Communicated regulatory and facility accreditation as per insurance contracts.
Customer Service Representative
Evolent Health
09.2021 - 09.2022
- Recorded member grievances and appeals in detail including appropriate documentation.
- Provided top notch customer service while maintaining quality scores.
- Researched products while maintaining call flow.
- Utilize multiple internal and external systems and technology to resolve inquiries.
- Assisted members with Medicaid policy and regulations.
- Responded to 60-100 calls per day.
Quality Assurance Analyst
Evolent Health
06.2019 - 09.2022
- Mentored and coached team members on QA topics and strategies.
- Examined and evaluated member service calls against for quality company guidelines.
- Audit calls for compliance and accuracy based on health plan terms and conditions.
- Identify trends and training opportunities based on call evaluations.
Education
MBA - Business Management
Keller Graduate School of Management
03-2024
Skills
Quality assurance metrics
Collaboration and communication
Data Analysis
Audit processes
Critical thinking abilities
Quality Assurance
Research
Decision making
Timeline
Financial Coordinator
Northwestern Medicine
09.2022 - 10.2024
Customer Service Representative
Evolent Health
09.2021 - 09.2022
Quality Assurance Analyst
Evolent Health
06.2019 - 09.2022
MBA - Business Management
Keller Graduate School of Management
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