Keirah McCall
Durham,NC
Summary
OBJECTIVES-
Pragmatic Insurance and Clinical Care Specialist touting 9 years of expertise in benefits explanation and behavioral health service navigation . Gifted in working with stressed, confused and upset individuals in need of supportive guidance. A team player with a vast knowledge of medical terms and working with all types of personalities effectively. Offering dynamic organizational skills and attention to detail. Dedicated to integrity and providing an exceptional customer service experience with every interaction.
Overview
17
17
years of professional experience
Work History
Clinical Care and Claims Representative
Beacon Health Options
09.2013 - Current
- Managing Crisis Calls/ Escalating when appropriate
- Assessing Member needs to align them with the appropriate Mental Health and Substance Abuse services.
- Follow-up/Aftercare referrals
- Educating members/providers about benefits, claim submission process and all other nuances of managed plans
- Managing various queues for claims researching, reprocessing and appeals
Member Specialist/ Solutions Specialist
SEFCU
Albany, NY
10.2008 - 06.2012
- Performing multiple daily financial transactions
- Training new hires
- Providing member service though the call center and branches
- Needs based selling and financial advisement
Group Coordinator/Revenue Manager
Crowne Plaza Hotel
Albany, NY
06.2004 - 08.2008
- Collecting and inputting all room blocks
- Forecasting and managing daily hotel capacity
- Communicating all group room needs with each department daily
- Managing room revenue and pricing
- Assisting with marketing strategies based on weekly reports
Education
BBA -
East Carolina University
E 5th St Greenville, NC06.2024
Associate Degree for - Business Administration
Bryant And Stratton College
1259 Central Ave Albany, NY 1220504.2009
Skills
- Life and Health Insurance Management
- Insurance Claims Processing
- Clinical Assessment of Mental Health Service Needs and Resources
- Data Entry/General Computer Programs
- Financial Advisement
- Call Center Operation
- Cash Handling
- Management
- Sales and Marketing
Additional Information
- AWARDS , Certificate of Professional Excellence,
- Transworld entertainment “Rising Star” Award for professional excellence in hospitality
Timeline
Clinical Care and Claims Representative
Beacon Health Options
09.2013 - Current
Member Specialist/ Solutions Specialist
SEFCU
10.2008 - 06.2012
Group Coordinator/Revenue Manager
Crowne Plaza Hotel
06.2004 - 08.2008
BBA -
East Carolina University
Associate Degree for - Business Administration
Bryant And Stratton College
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