LAQUASIA MCCRAY
NEW ZION
Summary
Competent Eligibility Specialist with background in evaluating, determining, and documenting program eligibility. Strengths include comprehensive knowledge of local, state, and federal program regulations coupled with strong decision-making abilities. Previous roles have seen significant improvement in process efficiency due to expertise in electronic case management systems.
Overview
14
14
years of professional experience
Work History
ELIGIBILITY SPECIALIST
TEKSystems
Columbia
09.2023 - Current
- Process eligibility applications with meticulous attention to detail, ensuring compliance with regulations while maintaining data accuracy and confidentiality.
- Guide applicants through documentation requirements, resolve complex eligibility issues, and provide clear explanations of program benefits.
- Streamline application review processes, reduce processing time, and maintain high accuracy rates while managing substantial caseload volumes.
Processing Specialist
ManpowerGroup
Florence
11.2022 - 09.2023
- Reviewing/updating per documents received to ensure insurance coverage is up to date.
- Process documents in an accurate and timely manner to ensure proper insurance coverage for homeowners and client satisfaction goals.
- Called out as needed. Review various types of insurance documents and update the hazard insurance lines on the clients servicing system according to established procedures.
- Verify that the policy contains acceptable coverage and disburse premium payments from the escrow account if required; make necessary outbound phone calls to insurance agents and companies to update insurance policies.
Quality Control Inspector
Stratosphere Quality
Timmonsville
03.2021 - 11.2022
- Used specialized tools to take precise measurements of various aspects of samples.
- Conducted routine visual inspections of work to uncover issues with compliance and tolerances.
- Reviewed and inspected products for conformance to established standards, specifications and customer requirements.
- Completed evaluations by properly using various gauges, tools and equipment.
- Documented inspection information and compiled data into reports for dissemination to management.
Prior Authorization Representative
Cigna
01.2019 - 12.2020
- Processed prior authorization requests efficiently and accurately for healthcare services.
- Reviewed medical documentation to determine eligibility for requested procedures.
- Communicated with healthcare providers to gather necessary information and clarifications.
- Maintained detailed records of authorization requests and outcomes using electronic systems.
- Followed all Medicare, Medicaid, HIPAA and private insurance regulations and requirements.
CUSTOMER SERVICE SPECIALIST
Assurant Specialty and Property Insurance
Florence
03.2017 - 01.2019
- Review and update insurance documents to ensure current coverage and client satisfaction.
- Process documents accurately and timely, ensuring proper homeowner insurance coverage.
- Verify policy coverage, disburse premiums, and communicate with insurance agents.
- Analyze insurance documents, updating hazard insurance lines per procedures.
- Execute outbound calls to update insurance policies, maintaining compliance.
QUALITY INSPECTOR
Olsten Staffing
Timmonsville
03.2016 - 03.2017
- Conducted thorough inspections of assembled products, ensuring high-quality standards.
- Labeled and marked containers accurately, enhancing workflow efficiency.
- Utilized gauges and tools for precise evaluations, improving product quality.
- Removed defective items promptly, maintaining smooth operational flow.
- Identified and addressed quality issues, escalating major concerns to supervisors.
TELEPHONE OPERATOR
Lowes
Sumter
09.2014 - 01.2016
- Managed switchboard, efficiently directing calls and resolving inquiries.
- Handled customer transactions, ensuring accurate billing and refunds.
- Processed call requests, improving response times and customer satisfaction.
CUSTOMER SERVICE REPRESENTATIVE
Sykes Enterprise
Kingstree
01.2012 - 09.2014
- Resolved billing inquiries, boosting customer satisfaction and retention.
- Provided accurate product details, enhancing customer trust and loyalty.
- Processed payments promptly, ensuring seamless transactions.
- Arranged payment plans, fostering long-term customer relationships.
Education
DIPLOMA -
Crestwood High School
Sumter, SCSkills
- Problem Solving
- Time Management
- Team collaboration
- Conflict resolution
- Adaptability
- Documentation review
- Customer service
- Information verification
- Problem solving
Languages
English, Native
Timeline
ELIGIBILITY SPECIALIST
TEKSystems
09.2023 - Current
Processing Specialist
ManpowerGroup
11.2022 - 09.2023
Quality Control Inspector
Stratosphere Quality
03.2021 - 11.2022
Prior Authorization Representative
Cigna
01.2019 - 12.2020
CUSTOMER SERVICE SPECIALIST
Assurant Specialty and Property Insurance
03.2017 - 01.2019
QUALITY INSPECTOR
Olsten Staffing
03.2016 - 03.2017
TELEPHONE OPERATOR
Lowes
09.2014 - 01.2016
CUSTOMER SERVICE REPRESENTATIVE
Sykes Enterprise
01.2012 - 09.2014
DIPLOMA -
Crestwood High School