KATIE SIKES
Madison
Summary
Proactive and goal-oriented professional with excellent time management and problem-solving skills. Known for reliability and adaptability, with swift capacity to learn and apply new skills. Committed to leveraging these qualities to drive team success and contribute to organizational growth.
Overview
11
11
years of professional experience
Work History
Appeals Coordinator
Centene
01.2023 - Current
- Tracked and monitored appeals inventory to ensure timely processing within regulatory guidelines
- Managed multiple priorities simultaneously while maintaining attention to detail and meeting deadlines under pressure
- Identified areas for improvement in claim processing procedures and recommended changes to internal processes as needed
- Participated in regular audits of completed appeal files to ensure accuracy and adherence to company standards
- Utilized various software applications proficiently for data entry, report retrieval, tracking purposes, etc., ensuring efficient workflow throughout the appeals process
- Prioritized case load with sound judgement and with minimal supervision
Complaints and Appeals Specialist II
DentaQuest
08.2021 - 01.2023
- Resolved high level, complex issues and provided solutions to clients and customers
- Conducted regular audits of complaint handling processes for compliance purposes
- Trained new employees on complaints and appeals processes
- Participated in cross-functional projects aimed at reducing errors and enhancing client experience
- Prepared written correspondence and reports regarding complaint and appeal decisions
- Handled escalated cases for high-level clients that required additional expertise
- Researched and resolved discrepancies in claim payment information
Team Lead - Office of the President
DentaQuest
08.2018 - 08.2021
- Contributed to successful quality control initiatives and implemented new strategies to improve overall quality
- Collaborated with other team leaders to achieve company metrics and goals
- Onboarded new hires and mentored each side-by-side to build a higher performing team
- Developed strategies for improving customer satisfaction and loyalty through various initiatives
- Solved high-level problems proactively, implementing new solutions which resulted in contract renewals and customer satisfaction
- Managed team members and delegated tasks effectively
Customer Service Representative III
DentaQuest
07.2016 - 08.2021
- Exceeded personal, team and company goals in a customer service environment
- Documented, researched, and resolved customer service issues
- Anticipated needs and resolved problems to keep customers happy
- Collaborated with colleagues to deliver a quality customer experience
- Managed customer, client and provider calls in a fast-paced call center environment
- Enhanced customer satisfaction with fast, knowledgeable service
Merchandising Associate Manager
Gap
05.2014 - 07.2016
- Managed merchandising staff and delegated tasks efficiently to achieve sales and performance goals
- Used strategic product placement to drive sales
- Maintained inventory by checking in deliveries, pricing items and stocking merchandise
- Implemented plan-o-grams in-line with store presentation guidelines
- Stocked and rotated products on store floor in bins, racks, and shelves
- Prioritized task load with sound judgement and with minimal supervision
Education
Associate of Applied Science - Design Drafting - Architectural
Calhoun Community College
Huntsville, AL 05-2026
Professional Certificate - Data Science
Duke University
Online01.2020
Skills
- Analytical skills
- Medical terminology
- Case management
- Adaptability
- Problem solving
- Data entry proficiency
- Office 360
- Salesforce
- Conflict resolution
Timeline
Appeals Coordinator
Centene
01.2023 - Current
Complaints and Appeals Specialist II
DentaQuest
08.2021 - 01.2023
Team Lead - Office of the President
DentaQuest
08.2018 - 08.2021
Customer Service Representative III
DentaQuest
07.2016 - 08.2021
Merchandising Associate Manager
Gap
05.2014 - 07.2016
Associate of Applied Science - Design Drafting - Architectural
Calhoun Community College
Professional Certificate - Data Science
Duke University
Similar Profiles
Ruzica PaunicRuzica Paunic
Utilization Management Supervisor at CenteneUtilization Management Supervisor at Centene
John RowedderJohn Rowedder
Medicare Inside Sales Representative at CenteneMedicare Inside Sales Representative at Centene
April M. Barron RN, BSN, BBAApril M. Barron RN, BSN, BBA
Business Analyst IV, Digital Transformation at CenteneBusiness Analyst IV, Digital Transformation at Centene