Emmi Christensen
Denver,CO
Summary
Detail-oriented healthcare professional with 5+ years of Medicare operations and claims support experience. SME in eligibility reconciliation, discrepancy resolution, CRM data validation, and Excel reporting.
Overview
7
7
years of professional experience
Work History
Senior Medicare Broker / Operations SME
Gallagher
Denver, Colorado
08.2025 - Current
- Provide ongoing client portfolio management for Medicare Advantage and PDP plans
- Act as senior-level SME for escalated issues involving claims status, premiums, formularies, and pharmacy networks
- Identify and reconcile eligibility and benefit discrepancies using CRM and Excel reports
- Coordinate corrective actions with carrier operations to ensure accurate downstream claims outcomes
- Support AEP quality assurance efforts and CMS-compliant documentation
Senior Medicare Broker
Gohealth LLC
Denver, Colorado
03.2024 - 07.2025
- Managed high-volume enrollments and servicing for Medicare Advantage and Part D products
- Conducted pharmacy network and formulary verification for accurate benefit explanations
- Investigated and escalated discrepancies affecting coverage and claims
- Utilized CRM systems and Excel to validate member data and implement corrections
- Achieved 95%+ resolution of complex eligibility issues within required timelines
Medicare Insurance Agent / Account Coordinator
Health Insurance Associates
Centennial, Colorado
07.2023 - 01.2024
- Managed Medicare enrollments and post-sale servicing through carrier portals
- Processed eligibility and benefit change requests
- Identified and escalated coverage discrepancies for resolution
- Maintained CMS-compliant documentation
Senior Medicare Broker
GoHealth LLC
Minneapolis, Minnesota
05.2021 - 10.2022
- Supported operational pilots analyzing client portfolios and retention
- Investigated enrollment and pharmacy-access concerns requiring carrier coordination
- Validated eligibility documentation prior to AEP
- Achieved 80%+ client retention through compliant execution
Insurance Specialist
State Farm Insurance Inc
Minneapolis, Minnesota
10.2020 - 03.2021
- Managed policy updates, claims inquiries, and coverage corrections
- Used structured Excel data to verify pricing and documentation accuracy
- Collaborated with underwriting and claims teams to streamline operations
Clinic & Pharmacy Operations Intern
Martin Engineering
Neponset, Illinois
06.2019 - 08.2019
- Facilitated implementation and workflow processes for employer-sponsored on-site clinic pharmacy.
- Collaborated with licensed pharmacist to establish intake and inventory procedures.
- Supported medication access aligned with employer benefit structures.
- Resolved employee eligibility and access discrepancies effectively.
- Engaged clinical and administrative stakeholders to enhance operational efficiency.
- Acquired knowledge of self-funded employer healthcare and pharmacy economics.
Education
BBA - Marketing
University of Iowa
Iowa City, IA08-2019
Colorado Life & Health Insurance Licensed
Skills
- PBM & Pharmacy Benefit Administration Fundamentals
- Account Servicing Benefit Changes & Configuration
- Support Eligibility Updates & Reconciliation
- Claims Resolution
- Escalation Management
- Process Quality Assurance
- Cross-Functional Collaboration
- HIPAA/CMS-Compliant Documentation
- Microsoft Office Suite (Excel, Outlook, Word
Timeline
Senior Medicare Broker / Operations SME
Gallagher
08.2025 - Current
Senior Medicare Broker
Gohealth LLC
03.2024 - 07.2025
Medicare Insurance Agent / Account Coordinator
Health Insurance Associates
07.2023 - 01.2024
Senior Medicare Broker
GoHealth LLC
05.2021 - 10.2022
Insurance Specialist
State Farm Insurance Inc
10.2020 - 03.2021
Clinic & Pharmacy Operations Intern
Martin Engineering
06.2019 - 08.2019
BBA - Marketing
University of Iowa
Colorado Life & Health Insurance Licensed