Crystal Brady
Statham,GA
Summary
Results-oriented enrollment professional with a track record of processing health insurance enrollments in compliance with CMS guidelines. Skilled in managing complex data operations and resolving discrepancies, leading to improved accuracy and reduced processing delays.
Overview
15
15
years of professional experience
Work History
Compliance & Triage Enrollment Rep 3
Humana
Remote, GA
04.2026 - Current
- Process high-volume health insurance enrollments, changes, cancellations, and terminations in accordance with CMS and company guidelines
- Managed PID merge inventory and danger dials daily, ensuring compliance and promoting team awareness of regulatory standards.
- Resolved complex TRR CPU reply codes, improving accuracy in processing and reducing delays.
- Utilized CI Marx, CRM, MACESS, CAS, EMME, and letter database to streamline data handling and enhance support for enrollment processes.
- Operated independently to prioritize tasks while adhering to CMS compliance and company policies.
Seasonal Enrollment Representative
Humana
Remote, Georgia
09.2023 - 04.2026
- Processed high-volume health insurance enrollments, changes, cancellations, and terminations, ensuring compliance with CMS and company guidelines while maintaining high accuracy.
- Reviewed applications for completeness, accuracy, and eligibility, enhancing regulatory compliance and reducing error rates.
- Supported departmental operations through cross-training and executing special projects, strengthening team capabilities and operational flexibility.
Case Manager, CPhT
Pharmaceutical Specialties Inc
Bogart, GA
06.2013 - 12.2016
- Maintained accurate case records and documentation, ensuring compliance with agency guidelines and facilitating effective patient care.
- Processed prescription orders accurately and efficiently for diverse patient needs.
- Assisted pharmacists in medication preparation and dispensing, contributing to accurate and timely patient care.
- Collaborated with cross-functional teams to optimize pharmaceutical service delivery, resulting in improved patient satisfaction.
- Monitored inventory levels and ordered medications proactively to ensure continuous availability of essential pharmaceuticals.
Office Coordinator
Athens Sleep And Wellness Center
Athens , GA
06.2011 - 06.2013
- Coordinated prior authorization submissions for diagnostic sleep studies to streamline scheduling.
- Collaborated with healthcare providers to ensure seamless patient care delivery.
- Communicated with healthcare providers to obtain necessary documentation.
- Facilitated patient intake procedures and ensured accuracy of medical records.
- Developed and organized filing systems for efficient access to paper and electronic documents.
Education
Associate of Arts - Early Childhood Care and Education
Athens Technical College
Athens, GASkills
- Regulatory compliance
- Prior authorization management
- Case documentation
- Data integrity
- Medical terminology
- Effective communication
Timeline
Compliance & Triage Enrollment Rep 3
Humana
04.2026 - Current
Seasonal Enrollment Representative
Humana
09.2023 - 04.2026
Case Manager, CPhT
Pharmaceutical Specialties Inc
06.2013 - 12.2016
Office Coordinator
Athens Sleep And Wellness Center
06.2011 - 06.2013
Associate of Arts - Early Childhood Care and Education
Athens Technical College