Danielle Cota
Menifee,CA
Summary
Dynamic Sr Appeals Rep with a proven track record at UnitedHealth Group, mastering policy interpretation and dispute resolution. Excelled in enhancing appeal accuracy and customer trust through meticulous attention to detail and empathetic communication. Fostered team collaboration, sharing expertise to elevate team performance. Demonstrated adaptability and critical thinking in fast-paced environments.
Overview
13
13
years of professional experience
Work History
Child Caregiver
Maxim Healthcare
05.2023 - Current
- Sanitized dishes, tabletops, toys, and frequently touched surfaces to prevent spreading of germs.
- Ensured child safety through diligent supervision and adherence to established protocols.
- Administered first aid when necessary, maintaining a calm demeanor during emergencies and handling situations effectively.
- Applied positive behavior management techniques to enhance social interactions and emotional development.
- Created a safe environment through routine inspections of play areas, toys, and equipment for potential hazards.
- Prepared healthy foods and beverages for children based on optimal dietary guidelines and individual restrictions.
- Taught children to organize toys, wash hands, and share by leading by example.
- Prepared healthy meals following dietary guidelines or specific parent instructions while considering individual food preferences or allergies.
- Collaborated with parents to develop individualized care plans addressing specific needs of their children.
- Established daily routines to provide structure and predictability for children under care.
- Provided transportation to extracurricular activities, ensuring punctuality and fulfilling parental requests.
- Fostered emotional development by providing support, guidance, and encouragement during challenging situations.
- Liaised with parents and guardians to discuss child progress.
Sr Appeals Rep
UnitedHealth Group
02.2012 - 03.2023
- Conducted comprehensive reviews of claim denials, identifying errors or discrepancies that led to successful reversals on appeal.
- Provided excellent customer service by actively listening to customer concerns and empathetically addressing their needs throughout the appeals process.
- Supported fellow Appeals Representatives through peer coaching and knowledge sharing, fostering a collaborative work environment.
- Implemented best practices for documenting case notes, improving record-keeping accuracy, and aiding team members in tracking progress on ongoing cases.
- Enhanced the accuracy of appeal decisions through thorough research and factchecking.
- Managed sensitive client information with confidentiality and discretion, maintaining trust between customers and the company.
Education
Early Childhood Development
Rio Hondo College
Whittier, CADiploma -
Pioneer High School
Whittier, CA06.2005
Skills
- Microsoft office
- Policy interpretation
- Dispute resolution
- Teamwork
- Teamwork and collaboration
- Problem-solving
- Time management
- Multitasking skills
- Attention to detail
- Listening skills
- Problem-solving abilities
- Excellent communication
- Critical thinking
- Reliability
- Organizational skills
- Team collaboration
- Active listening
- Decision-making
- Relationship building
- Adaptability and flexibility
Timeline
Child Caregiver
Maxim Healthcare
05.2023 - Current
Sr Appeals Rep
UnitedHealth Group
02.2012 - 03.2023
Early Childhood Development
Rio Hondo College
Diploma -
Pioneer High School
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