Felicity Rhodes
Charlotte,NC
Summary
I am a highly-motivated employee with the desire to take on new challenges. Strong work ethic, adaptability, and exceptional interpersonal skills. Adept at working effectively unsupervised and quickly mastering new skills. I am accustomed to managing sensitive, confidential records. Demonstrated history of producing accurate and sound results in a fast-paced work environment. I am flexible and poised under pressure, competent, and versatile with the ability to embrace diversity to effectively communicate and thrive in deadline-driven environment.
Overview
10
10
years of professional experience
Work History
Front Desk Manager
Hyatt
Charlotte, NC
06.2023 - Current
- Trained new staff members on front desk procedures and policies.
- Provided excellent customer service by addressing guest inquiries promptly and professionally.
- Provided administrative support to coworkers, taking on additional tasks during high-volume periods.
- Maintained important files, running reports and delivering updates on occupancy and revenue.
- Promoted loyalty programs to encourage repeat business from customers.
- Collaborated with staff to meet incoming guest needs, smooth check-in processes and maximize satisfaction.
- Coordinated check-out processes including verifying room charges, collecting payment and issuing receipts.
Performance Quality Analyst II
Elevance
Norfolk, VA
08.2021 - 06.2023
- Analyzed issues and recommended corrective actions to improve results.
- Participated in technical training and workshops to improve skills set and boost overall knowledge.
- Performed quality control inspections at customer sites to determine alignment with safety regulations.
- Developed quality control procedures for inclusion in technical staff manuals.
- Evaluated audits against quality requirements to maximize efficiency.
- Gathered and input data in WGS mainframe to develop models and assess trends.
- Worked successfully with a diverse group of coworkers to accomplish goals and address issues
Medical Management Specialist II
Elevance
Norfolk, VA
03.2020 - 08.2021
- Maintains and updates tracking databases.
- Knowledge of health plans, including familiarity with prior authorization.
- Determines contract and benefit eligibility: provides authorization for inpatient admission, outpatient precertification, prior authorization, and post service requests.
- Serves as a liaison between users of the software and technical staff, assist with complex cases.
- Participates in quality improvement programs to assure the members receive timely, appropriate, and accessible health care.
- Systems policies, programs, procedures, and workflows.
- Ensure appropriate implementation of policies and procedures to maintain compliance with accreditation of regulatory agencies.
Health Program Representative III
Elevance
Norfolk, VA
06.2018 - 03.2020
- Resolves complex situations and ensures assigned staff are directed to the appropriate resources.
- Resolves escalated calls from team members.
- Provides training and mentoring of staff, develop training manuals.
- Consistently met deadlines while demonstrating strong analytical and critical thinking skills to achieve the department objectives.
- Gathers information from hospitals, health plans, physicians, patients, vendors, and other referral sources.
Utilization Management Representative
Elevance
Norfolk, VA
05.2017 - 06.2018
- Responsible for the identification and data entry of referral requests into the UM system in accordance with the plan certificate.
- Responds to telephone and written inquiries from members, providers, and in-house departments.
- Conducts clinical screening process.
- Determines contract and benefit eligibility; provides authorization for inpatient admission, outpatient pre-certification, prior authorization and post service requests.
HEDIS Service Associate
Elevance
Norfolk, VA
01.2014 - 05.2017
- Conducted provider medical record reviews, analyze, and abstract information as part of the data collection process in addition to providing support for the over read process related to auditor requirements.
- Served and an analyst and consultant in the use of HEDIS and quality date and the quality improvement process.
- Reported critical incidents and information regarding quality-of-care issues, ensured the documentation was produced and / or process complied with state regulations accrediting body requirements.
- Ensured assigned contract / regulatory report content were accurate and the submissions adhered to the deadline.
- Team lead
- Trained and evaluated temporary staff, created training resources.
Education
Associate of Applied Science - Human Services
Tidewater Community College
Norfolk, VA05-2014
Skills
- Reception Management
- Operations Management
- Documentation and Reporting
- Information Gathering
- Analytical Thinking
- Data Processing
Timeline
Front Desk Manager
Hyatt
06.2023 - Current
Performance Quality Analyst II
Elevance
08.2021 - 06.2023
Medical Management Specialist II
Elevance
03.2020 - 08.2021
Health Program Representative III
Elevance
06.2018 - 03.2020
Utilization Management Representative
Elevance
05.2017 - 06.2018
HEDIS Service Associate
Elevance
01.2014 - 05.2017
Associate of Applied Science - Human Services
Tidewater Community College
Similar Profiles
Felix Enrique Zarate GuaidaFelix Enrique Zarate Guaida
Senior Manager Product at HyattSenior Manager Product at Hyatt
ERIK AGUIRREERIK AGUIRRE
Director of Stewarding at HyattDirector of Stewarding at Hyatt
Shubham PokharnaShubham Pokharna
Assistant Manager at HyattAssistant Manager at Hyatt
Henry CorderoHenry Cordero
Houseman/Guest Runner at HyattHouseman/Guest Runner at Hyatt
Samantha CottonSamantha Cotton
Manager at Mellow MushroomManager at Mellow Mushroom