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Healthcare operations professional with 6+ years of experience supporting Medicare Advantage, Medicaid, member enrollment, appeals processing, billing, and customer service within highly regulated healthcare environments. Skilled in researching and resolving complex member issues, processing appeals in accordance with regulatory standards, maintaining detailed documentation, and collaborating across departments to support operational efficiency and member satisfaction.

Results-driven healthcare and sales professional with experience in Medicare escalations, prior authorization processing, and outbound sales. Skilled at resolving complex member and provider issues, ensuring regulatory compliance, and delivering exceptional customer service. Demonstrated expertise in Medicare Advantage and Part D guidelines, pharmacy benefit management, and clinical case review, as well as sales strategy, lead generation, and closing new accounts. Proficient in CRM and PBM systems including Salesforce, RxCLAIM, MedAccess, QNXT, and Microsoft Office Suite. Known for strong problem-solving, communication, and process improvement skills, consistently achieving quality, productivity, and performance targets.

Dynamic and motivated medical billing and coding professional with over 17 years of extensive experience in health operations, revenue cycle management, and clinical. Expertise in ICD-9 and ICD-10, CPT, and HCPCS coding, with a proven ability to analyze and validate patient information, diagnoses, and billing data. Highly skilled in medical billing and coding, Medicare, Medicaid, and Commercial Insurance, and handling medical insurance appeals, authorizations, denials, and rejections. I seek a position to leverage my skills and experience in a dynamic organization.
Seasoned Medical Billing, Insurance, and Coding Instructor known for high productivity and efficient task completion. Possess specialized skills in medical billing software, compliance regulations, and coding standards which ensure accurate and effective teaching. Excel in communication, problem-solving, and adaptability, contributing to successful training outcomes.
Highly knowledgeable in medical billing, insurance and coding with background as an instructor. Have facilitated student understanding of complex concepts through innovative teaching methods. Strengths lie in strong communication skills, patience, and ability to simplify complex topics for better comprehension. Previous work has led to improved student performance and increased interest in the field.
Highly-motivated employee with desire to take on new challenges. Strong work ethic, adaptability, and exceptional interpersonal skills. Adept at working effectively unsupervised and quickly mastering new skills.
Results-driven individual with a solid track record in delivering quality work. Known for excellent communication and teamwork abilities, with a commitment to achieving company goals and delivering exceptional service. Passionate about continuous learning and professional development.
Experienced professional with a strong background in technology-related roles. Proficient in software development, system administration, and technical support. Skilled in problem-solving and optimizing performance. Capable of managing projects and collaborating effectively with teams. Committed to continuous learning and staying current with industry trends to contribute to organizational success.
Proactive and versatile professional with a dedication to quickly adapting to new challenges. Strong problem-solving abilities and a proven track record of fostering strong relationships with clients and team members. Focused on supporting team success and achieving positive results.
Results-oriented individual with a passion for continuous learning and innovation. Known for leveraging analytical thinking and creativity to solve problems and deliver high-impact solutions in fast-paced environments.

Dedicated Customer Service Specialist providing skills to prioritize and multi-task in fast-paced working environment. Successfully works as part of team to reach personal and business goals. Known for successfully handling escalated customer support issues.
Communicative customer service professional motivated to maintain customer satisfaction and contribute to company success. History managing large amounts of inbound calls and sustaining satisfactory relationships with customers. Offers skill with CRM systems paired with outstanding active listening and multitasking abilities.
Diligent professional brings top skills in customer service, data entry and conflict resolution. Recognized for resolving customer complaints with integrity and professionalism to maintain customer satisfaction and retention. Motivated team player committed to contributing to company success goals.
Empathetic Customer Service Specialist known for high productivity and efficient task completion. Skilled in problem-solving, conflict resolution, and time management which enable success in fast-paced environments. Excel at communication, active listening, and empathy to understand customer needs and provide exceptional service.
Empathetic professional in customer service known for high productivity and efficiency in task completion. Possess specialized skills in conflict resolution, data entry, and customer relationship management. Excel in communication, problem-solving, and adaptability, ensuring positive experiences and outcomes for customers.

JALLAHOU SB SANDY

Summary

Overview

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Regulatory Consumer Specialist

Grant Writing & Data Intern

Medical Claims Supervisor

Education

Master of Public Health -

Master of Health Administration - undefined

Doctor of Behavioral Health - Management

Skills

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Grant Writing & Data Intern

Regulatory Consumer Specialist

Medical Claims Supervisor

Master of Health Administration - undefined

Doctor of Behavioral Health - Management

Master of Public Health -

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