Summary
Overview
Work History
Education
Skills
Languages
Certification
Affiliations
Timeline
Generic
Donelle Siudut

Donelle Siudut

Monroeville

Summary

Organized and motivated professional with strong time management and organizational skills. Proven ability to solve problems and build strong relationships with team members. Committed to supporting team success and driving positive outcomes. Seeking opportunities to leverage skills in diverse environments.

Overview

35
35
years of professional experience
1
1
Certification

Work History

Complaints and Appeals Associate

Horizon BCBSNJ
Hopewell
10.1998 - Current
  • Analyzed and responded to high-level complaints submitted through Enterprise platforms including Legislative Offices, CEO, Social Media, DOBI, and New Jersey Division of Pensions & Benefits.
  • Investigated and addressed Second Level Administrative Appeals including creating educational opportunities.
  • Analyze legal cases to identify key issues
  • Supported New Jersey Division of Pensions and Benefits through onsite assistance for Open Enrollment applications over several years.
  • Conducted engaging PowerPoint presentation about HorizonCares Volunteer Program at SHBP Town Hall
  • Contributed to Ambassador Program aimed at enhancing operations and implemented a personal suggestion.
  • Participated in Buddy Program developing competencies for onboarding new staff.
  • Acknowledged by numerous external customers for exceptional performance
  • Commended for outstanding writing expertise
  • Completed Rutgers Professional Development Accreditation
  • Achieved accreditation from Professional Academy of Healthcare Management

Enrollment Specialist

First Option Health Plan
Red Bank
07.1995 - 10.1998
  • Oversaw member inquiries concerning eligibility and enrollment status.
  • Managed new enrollments by inputting customer data and conducting detailed information assessments for multiple contracts.
  • Oversaw all newborn enrollment applications for large and small groups.
  • Validated Full Time Student verifications
  • Collaborated with multiple Brokers on Enrollment and Eligibility requirements.

Service Clerk

Prudential Healthcare
Toms River
07.1990 - 07.1995
  • Extracted microfiche copies of documents for SHBP claims assessors.
  • Operated Kodak data processing machines for document scanning and retrieval of scanned copies via tapes
  • Executed mail sorting and distribution processes within mailroom

Education

Some College (No Degree) - Business

Ocean County College
Toms River, NJ

Skills

  • Conflict resolution
  • Legal analysis
  • Root Cause analysis
  • Time management
  • Strong Business writing skills
  • Customer Service
  • Critical thinking
  • Team collaboration
  • Presentation skills
  • Onboarding support
  • Complex Problem-solving
  • Multitasking and organization
  • Courteous and professional
  • Attention to detail
  • Verbal and written communication
  • Cross-functional teamwork
  • Research
  • Decision-making

Languages

American Sign Language
Limited

Certification

  • Professional Academy of Healthcare Management (PAHM)
  • Rutgers Certificate of Professional Development in Customer Service

Affiliations

  • I enjoy volunteering for community events.

Timeline

Complaints and Appeals Associate

Horizon BCBSNJ
10.1998 - Current

Enrollment Specialist

First Option Health Plan
07.1995 - 10.1998

Service Clerk

Prudential Healthcare
07.1990 - 07.1995

Some College (No Degree) - Business

Ocean County College

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