Jessica Briner
Georgetown,SC
Summary
Hardworking and passionate job seeker with strong organizational skills eager to secure an Appeals position. Ready to help team achieve company goals and develop a career. Detail-oriented team player with strong organizational skills. Ability to handle multiple projects simultaneously with a high degree of accuracy.
Overview
16
16
years of professional experience
Work History
Senior Appeals Coordinator
CVS
02.2018 - Current
- Resolved issues through active listening and open-ended questioning, escalating major problems to manager.
- Hired, managed, developed and trained staff, established and monitored goals, conducted performance reviews and administered salaries for staff.
- Coordinated individual duties after careful evaluation of each employee's skill level and knowledge.
- Delegated tasks to administrative support staff to organize and improve office efficiency.
- Create job aid documents
- Preform MHK testing
Appeals Coordinator
CVS
02.2016 - 02.2018
- Created, composed and maintained appeal response templates.
- Developed appeals functions, policies and procedures and documentation.
- Coordinated with senior specialist to compose appeal responses.
Customer Service Representative
Aetna
03.2014 - 01.2016
- Handled customer inquiries and suggestions courteously and professionally.
- Actively listened to customers, handled concerns quickly and escalated major issues to supervisor.
- Answered constant flow of customer calls with minimal wait times.
- Answered customer telephone calls promptly to avoid on-hold wait times.
Server/Lead Bartender
Lykens Valley Golf Resort
06.2007 - 06.2015
- Performed opening and closing duties, printing sales reports, setting up for incoming shift, preparing cash drawers, and taking inventory.
- Closed out cash register and prepared cashier report at close of business.
- Kept alcoholic beverages well-stocked and organized to meet expected demands.
- Maintained secure cash drawers, promptly resolving discrepancies in daily totals.
- Kept detailed inventories and notified management of ordering needs for liquor, beer, wine, and bar supplies.
- Handled simultaneous customer, team, and business needs while avoiding unnecessary delays or errors.
Credentialing
Aetna
08.2008 - 03.2014
- Conducted primary source verifications such as background checks and board certifications.
- Prepared records for site visits and file audits.
- Received and evaluated applications to look for missing and inaccurate information.
- Enrolled providers and Medicaid, Medicare and private insurance plans.
Education
Millersburg Area Senior High School
Millersburg, PA06.2007
Skills
- Benefits Coordination
- Filing Appeals
- Benefits Guidelines
- CMS Guidelines
- Medicare Regulation
- MHK Testing
- Investigative Reporting
- Write Reports
- Coordinate Schedules
- Enforce Policies
- Research and Analysis
- Case Management
- Prioritizing Workflows
Timeline
Senior Appeals Coordinator
CVS
02.2018 - Current
Appeals Coordinator
CVS
02.2016 - 02.2018
Customer Service Representative
Aetna
03.2014 - 01.2016
Credentialing
Aetna
08.2008 - 03.2014
Server/Lead Bartender
Lykens Valley Golf Resort
06.2007 - 06.2015
Millersburg Area Senior High School
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