Johnny Ferrell III
Tampa,Florida
Summary
Customer Service Representative bringing top-notch skills in oral and written communication, active listening and analytical problem-solving skills. Enhances customer experiences by employing service-oriented behaviors, understanding customer desires and providing customized solutions to build loyalty. Committed to providing high-quality service by listening to customers and responding quickly to satisfy their needs. Strong interpersonal skills and understands best practices for dealing with difficult and challenging situations.
To seek and maintain full-time position that offers professional challenges utilizing interpersonal skills, excellent time management and problem-solving skills.
Organized and dependable candidate successful at managing multiple priorities with a positive attitude. Willingness to take on added responsibilities to meet team goals.
Overview
11
11
years of professional experience
Work History
Appeals and Grievances Coordinator
Evolent Health
12.2024 - Current
- Processed and finalized appeals and grievances within agreed-upon turnaround time.
- Remained knowledgeable regarding company policies and procedures and current developments within operational departments.
- Demonstrated high-level attention to detail when reviewing medical records, provider contracts, and other relevant documents during case assessments.
Grievance & Appeals Coordinator I
Centene
03.2020 - 01.2024
- Maintained strong knowledge of basic medical terminology to better understand services and procedures.
- Demonstrated respect, friendliness and willingness to help wherever needed.
- Investigate member complaints against providers and specialists and pursue resolution of formal grievances from members.
- Gather, analyze and report verbal and written member and provider complaints, grievances and appeals.
- Prepare response letters for member and provider complaints, grievances and appeals.
- Maintain files on individual appeals and grievances.
- Support the pay-for-performance programs, including data entry, tracking, organizing, and researching information.
- Assist with HEDIS production functions including data entry, calls to provider’s offices, and claims research
Admin Appeals
Integrated Resources, Inc, IRI
02.2024 - 10.2024
- Collaborated with cross-functional teams to gather necessary documentation and evidence to support the appeals process.
- Managed high-stress situations with professionalism, ensuring that appeals were handled promptly and accurately even under tight deadlines or heavy caseloads.
- Consistently met or exceeded performance metrics, demonstrating a strong understanding of the claims review process and an unwavering commitment to achieving positive results for clients.
- Achieved successful appeal outcomes by meticulously reviewing and analyzing claim denials, identifying errors, and presenting persuasive arguments.
- Maintained strict confidentiality of patient information in accordance with HIPAA regulations.
- Checked documentation for accuracy and validity on updated systems.
- Verified client information by analyzing existing evidence on file.
- Made contact with insurance carriers to discuss policies and individual patient benefits.
- Maintained confidentiality of patient finances, records, and health statuses.
Store Associate
JC Penney Co Inc.
05.2019 - 03.2020
- Balanced and organized cash register by handling cash, counting change and storing coupons.
- Offered each customer top-notch, personal service and polite support to boost sales and customer satisfaction.
- Greeted customers, helped locate merchandise and suggested suitable options.
- Refunded payments for returned items, processed exchanges and offered store credit to achieve customer satisfaction.
- Answered questions about store policies and concerns to support positive customer experiences.
- Approached browsing customers to initiate conversations to determine buying preferences.
- Employed strategic tactics such as cross-selling and upselling to drive sales.
Store Associate
Aldis Inc.
06.2018 - 03.2019
- Kept on top of changes to store products and promotions to maintain strong sales.
- Refunded payments for returned items, processed exchanges and offered store credit to achieve customer satisfaction.
- Improved operational efficiencies while managing customers requests, store inventory, transactions, new purchase orders and pricing needs.
- Organized store merchandise racks and displays to promote and maintain visually appealing environments.
- Offered each customer top-notch, personal service and polite support to boost sales and customer satisfaction.
Forklift Operator
Quad/Graphics
03.2017 - 06.2018
- Closely inspected parts to ensure cleanliness and free of contaminants
- Recognized and reported defective material and equipment to shift supervisor
- Prevented waste when transferring materials between transport containers and processing equipment
- Used strapping and bracing techniques combined with proper balancing to prevent load shifting
- Updated daily logs with production data such as weights, destinations and delivery times to keep management current on team activities
- Troubleshoot and diagnosed mechanical issues, completed basic repairs and conducted preventive maintenance actions to keep equipment functional
- Coordinated team member movements based on current needs, avoiding safety concerns or delays
- Unloaded materials and goods at designated locations for best project availability
Merchandise Team Manager
Cirque Du Soleil
01.2017 - 03.2017
- Maintained well-stocked cashier lanes and store shelves to promote strong sales
- Counted cash in register drawer to balance register at beginning and end of shift
- Consistently met up-sell goals by highlighting target merchandise with strategic promotional approaches
- Assisted customers with obtaining discounts by checking coupon validity and applying credits to orders
- Monitored and replenished display inventory and restructured according to available stock
- Prepared interesting and innovative visual displays to grab customer interest and promote sales
Warehouseman
Quad/Graphics
09.2016 - 01.2017
- Prepared orders for shipment by inserting associated paperwork, tagging boxes and scanning barcodes to upload package data to tracking system
- Inspected ingoing and outgoing shipments to verify accuracy and prevent errors
- Sorted and weighed products after packaging to assess quality, identify defects and grade resulting items
- Reported malfunctions and errors to supervising staff, addressed concerns and supported other machine operators completing challenging workloads under tight schedules
- Observed machine operations to verify quality and conformity of packaged products, stepping in to resolve issues promptly and avoid costly production errors
- Picked products for specific routes according to pick sheets
- Picked up incoming stock and delivered materials to designated locations
- Supervised material flow, storage and global order fulfillment
Loss Prevention Specialist
Ross Stores Inc
01.2015 - 09.2016
- Provided loss control reporting for prospects and clients
- Built strong partnerships by gaining customer trust for the implementation of viable loss control strategies
- Trained loss prevention staff, retail managers and store employees on loss control and prevention measures
- Monitored paperwork procedures to prevent error-related losses
Education
High School Diploma -
Howard W. Blake High School of The Performing Arts
Tampa, FL07.2014
Skills
- Customer service
- Written Communication
- Grievance Resolution
- HIPAA Guidelines
- Microsoft Excel
- Microsoft Access
- Inbound Calls
- Reviewing Documentation
- Data Entry Software
- Coverage Determination
- Appeals Process Proficiency
- Insurance Policies Understanding
- Claims Investigation
- Microsoft Office
Timeline
Appeals and Grievances Coordinator
Evolent Health
12.2024 - Current
Admin Appeals
Integrated Resources, Inc, IRI
02.2024 - 10.2024
Grievance & Appeals Coordinator I
Centene
03.2020 - 01.2024
Store Associate
JC Penney Co Inc.
05.2019 - 03.2020
Store Associate
Aldis Inc.
06.2018 - 03.2019
Forklift Operator
Quad/Graphics
03.2017 - 06.2018
Merchandise Team Manager
Cirque Du Soleil
01.2017 - 03.2017
Warehouseman
Quad/Graphics
09.2016 - 01.2017
Loss Prevention Specialist
Ross Stores Inc
01.2015 - 09.2016
High School Diploma -
Howard W. Blake High School of The Performing Arts
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