Laila Khalaf
Reseda,CA
Summary
Accomplished professional with a proven track record at Centene, adept in dispute resolution and analytical thinking. Excelled in processing appeals and grievances, enhancing customer satisfaction through effective problem-solving and time management. Demonstrated flexibility and adaptability across various roles, significantly improving operational efficiency.
Overview
8
8
years of professional experience
Work History
Appeals and Grievances Coordinator
Centene
Woodland Hills, CA
10.2021 - 11.2023
- Processed and finalized appeals and grievances within the agreed-upon turnaround time.
- Submitted verbal and written notifications to members and providers.
- Provided outreach for additional information for appeals and grievances.
Broker Sales and Support Representative
Elevance
Woodland Hills, CA
08.2019 - 10.2021
- Assisted agents and brokers via telephone or written communication.
- Responded to inquiries involving commissions, legislation, product information, and policies and procedures for Individual, Small Group, Dental, and Life.
- Researched and analyzed claims issues, responds to inquiries, and may involve customer/client contact.
Customer Service Representative
Joerns Healthcare LLC.
Chatsworth, CA
08.2017 - 07.2019
- Collected, screened, and evaluated information to identify and pursue opportunities that improve all aspects of patient care and services, thereby increasing client satisfaction.
- Processed orders, schedule delivery, and/or pick up via phone or web portal orders, specifically with Kaiser patients.
- Updated system with order specifics and customer details, preferences, and billing information.
Caregiver
IHSS
Lake Balboa , CA
06.2016 - 08.2017
- Helped the client with laundry, and performed light housekeeping tasks.
- Transported clients to and from appointments and social gatherings, and prepared and maintained documentation about the clients' conditions and care provided.
- Prepared and maintained documentation about the client's condition and care provided.
Site & Data Analysis Lead
Paragon Solutions
Valencia , CA
10.2015 - 06.2016
- Interpreted data, analyzed and organized reports, implemented the collection of data, and confirmed efficiency.
- Reviewed reports and properly coded pertinent information. Performed quality assurance on all document findings and uploaded them to company software.
- Performed quality assurance on all document findings and uploaded them to the company software.
Education
Public Health
University of Phoenix
Tempe, AZHigh School Diploma -
Buxton School
Williamstown, MASkills
- Dispute resolution
- Problem solving
- Analytical thinking
- Business correspondence writing
- Time management
- Flexible and adaptable
Timeline
Appeals and Grievances Coordinator
Centene
10.2021 - 11.2023
Broker Sales and Support Representative
Elevance
08.2019 - 10.2021
Customer Service Representative
Joerns Healthcare LLC.
08.2017 - 07.2019
Caregiver
IHSS
06.2016 - 08.2017
Site & Data Analysis Lead
Paragon Solutions
10.2015 - 06.2016
Public Health
University of Phoenix
High School Diploma -
Buxton School
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