Summary

Overview

Work History

Education

Skills

Timeline

Akierra Sherrice Smith

Burlington,NC

Summary

Healthcare professional with specialized expertise in handling appeals and grievances. Proven track record of resolving complex cases efficiently and positively impacting client satisfaction. Known for collaborative approach, adaptability, and strong problem-solving abilities, key to driving successful outcomes.

Overview

years of professional experience

Work History

Intake Specialist / Appeals and Grievances Coordinator

Centene Corporation (WellCare of NC / Carolina Complete Health)

Raleigh, NC

08.2021 - Current

- Analyze medical appeal cases to ensure strict compliance with regulatory, contractual, and organizational requirements.
- Investigate complex case data to identify and resolve discrepancies.
- Collaborate with clinical, operations, and compliance departments to resolve high-priority issues.
- Implemented work guides and standardized processes adopted by other appeal departments within the health plan.
- Track case status and performance metrics to ensure timely processing and adherence to regulatory timelines.
- Contribute to the engagement committee, presenting operational updates during Town Hall meetings.

Customer Service Representative / Lab Technician

Essilor of America (Southern Optical)

Morrisville, NC

01.2018 - 08.2021

- Maintained high customer satisfaction levels through effective verbal and written communication regarding orders and services.
- Performed lab technician duties, including frame tracing and entering prescription data into the database.
- Managed data entry for warranty and remake discounts while maintaining accurate distribution records.
- Negotiated and processed loan payments effectively.

Contract Consultant

Kelly Services Staffing Agency

Morrisville

06.2015 - 01.2018

- Supported data gathering and reporting for non-authorizations, appeals, and provider disputes.
- Acted as a liaison between individuals and management to resolve problem cases and obtain necessary data.
- Identified risk areas and reported findings to unit managers to ensure operational integrity.

Team Lead

Chick-Fil-A

Durham, NC

08.2007 - 04.2015

- Managed daily operations, including opening/closing procedures, inventory management, and financial reconciliation of safe and registers.
- Trained incoming employees and ensured high standards of customer care and food safety.
- Maintained ServSafe certification and resolved customer complaints with professionalism.