Jo'Quana Brookshire

Work History

Molina Healthcare

04.2024 - Current

Review complaint from members and providers.
Review policies related to claims.
Communicating resolutions to members, authorize representatives or providers.
Ensuring adherence to grievances redressal policies and processes.
Ensuring timeliness and appropriateness of appeals according to guidelines.
Input data, maintain records in various computer programs and database.
Prepare and report documentation supporting verbal and written provider claims and pre-authorization appeals.

OneShare Health

01.2022 - 12.2023

Resolved member inquiries by conducting comprehensive research and determining necessary actions for effective resolution.
Acted as a liaison to the Training Department, offering constructive feedback on case handling to enhance the one-call resolution process.
Documented all interactions with providers and members, ensuring timely and precise record-keeping in line with company protocols.
Maintained adherence to service level agreements, internal standards, and procedures, consistently meeting or surpassing Quality Assurance audit benchmarks.

OneShare Health

01.2020 - 12.2021

Provide comprehensive support for member accounts through both inbound and outbound calls, ensuring meticulous entry and updating of member and billing information.
Maintain strict adherence to HIPAA regulations, safeguarding member confidentiality while conducting thorough research to identify and rectify account discrepancies.
Collaborate with the billing department to address and resolve member concerns, enhancing customer satisfaction and trust.
Deliver empathetic and professional customer service, assisting members with website navigation and issue resolution, while consistently meeting departmental performance benchmarks.

Kohl's Corporate Office

01.2016 - 01.2018

Managed a high volume of inbound and outbound calls, ensuring prompt customer service and accurate payment processing.
Facilitated customer inquiries by offering multiple payment solutions and maintaining detailed records of interactions.
Upheld strict confidentiality protocols while handling sensitive customer information and executing financial transactions.

Department of Health and Human Services

01.2009 - 01.2011

Assessed and processed eligibility for public assistance programs, ensuring accurate provision of Food Share, medical coverage, and childcare support.
Facilitated access to resources for individuals ineligible for state benefits, addressing the needs of homeless populations.
Managed client communications, handling inquiries, scheduling appointments, and maintaining meticulous records through data entry and verification procedures.

Kohl's Corporate Office

01.2005 - 01.2009

Managed a high volume of inbound and outbound communications, effectively offering tailored payment solutions to meet customer needs while ensuring meticulous record-keeping of interactions.
Upheld stringent data privacy standards and efficiently processed financial transactions, including check and credit card payments, to facilitate customer satisfaction and trust.