Lisa White

• Assisted clients in understanding their long-term care benefits and policy language.
• Reviewed initial assessments completed by applicants.
• Reviewed Medical Records to determine eligibility for long term care benefits
• Adjudicated complex long term care claims
• Communicated with internal and external departments to ensure timely submission of documentation needed for claim adjudication purposes.
• Maintained up-to-date knowledge of applicable state regulations and industry standards regarding claims adjudication.
• Conducted research into past payment histories and other pertinent information needed for accurate adjudication of claims.
• Maintained up-to-date knowledge of changes in legislation affecting adjudication process.
• Ensured accurate completion of case files prior to submission for adjudication by higher authorities.
• Collaborated with team members from various departments within the organization on projects related to adjudication processes.
• Interpreted statutes, rules, regulations, policies and procedures related to adjudication processes.
• Resolved complex problems relating to claim adjudication processes.
• Ensured compliance with applicable federal and state regulations governing the adjudication process.
• Researched policy language, relevant laws, and regulations to ensure accurate adjudication of claims.
• Attended formal training sessions to stay up-to-date on current laws and regulations pertaining to adjudication processes.
• Corresponded with providers regarding any missing or incomplete documentation needed for successful adjudication of claims.
• Ensured that all required paperwork is completed accurately and submitted timely.
• Protected patient data in alignment with HIPAA privacy protocols.
• Performed audits of objectives and case progression for case management team.
• Updated customer records with accurate information, including contact details and notes about inquiries.
• Provided timely responses to all incoming calls and emails from customers seeking assistance or advice.
• Participated in weekly team meetings to discuss progress towards goals and share best practices for success.
• Resolved customer issues quickly and efficiently while maintaining a professional attitude at all times.
• Adhered strictly to company policies when handling sensitive personal data or other confidential information.
• Recorded detailed notes about every interaction with customers for future reference or follow-up purposes.
• Communicated effectively with clientele to maintain customer satisfaction and loyalty.
• Provided timely, courteous, and knowledgeable responses to information requests.
• Developed templates for standard document types, ensuring consistent formatting throughout the organization.
• Transcribed handwritten notes into electronic format.
• Performed data entry tasks to update databases or spreadsheets with new information.
• Prepared summaries of long documents by extracting key points from original text.
• Knowledge of Word, Excel, PowerPoint, Outlook, Skype, Teams, PEGA, Genius systems

• Greeted customers and answered any questions they had about the store's products and services.
• Operated cash register efficiently and accurately, processed payments by cash, check, credit card, gift card or automatic debit.
• Counted money in cash drawer at the beginning of shift to ensure that amounts were correct and have sufficient change.
• Issued receipts, refunds, credits or change due to customers.
• Stocked shelves with merchandise when needed.
• Assisted customers over the phone regarding store operations, product information and order placement.
• Maintained cleanliness of checkout area including countertops, registers, windowsills and floors.
• Ensured compliance with all safety regulations within the store environment.
• Provided excellent customer service while promoting loyalty programs to increase sales potential.
• Kept records of purchases; maintained orderly appearance of checkout area; restocked supplies as needed.
• Adhered to loss prevention policies such as monitoring suspicious activity in order to prevent shoplifting.
• Followed company security procedures for handling large sums of money.
• Performed other duties as assigned by management.
• Delivered high level of customer service to patrons using active listening and engagement skills.
• Trained new team members in cash register operation, stock procedures, and customer services.
• Directed trash removal and sanitation procedures to keep aisles and register area organized.
• Checked back with customers throughout meal service to ensure satisfaction.
• Replenished beverages when necessary.
• Answered questions about menu items, ingredients, and pricing,

Communicated daily specials to customers.

• Bussed tables as needed during peak hours.
• Adhered to food safety standards when storing and preparing foods.
• Cleaned kitchen equipment, surfaces, utensils and dishes.
• Ensured that all food was cooked at the correct temperature and stored correctly.
• Maintained a clean working environment by sweeping, mopping floors, washing surfaces and emptying trash cans.