Marealle Summerbell
Riverview,FL
Summary
Polished individual boasting background writing grant proposals and conducting extensive research. Bilingual Social Services Director considered multitasking leader with terrific interpersonal and communication skills. Hardworking employee with customer service, multitasking, and time management abilities. Devoted to giving every customer a positive and memorable experience.
Overview
12
12
years of professional experience
Work History
Short Term Disability Case Manager
Metlife
Tampa, FL
10.2020 - Current
- Managed overall STD block of claims and possible companion claims to include statutory plans,
- Federal, company, state and other leave types as required by group, customers or other Federal state local laws,
- Followed up with customers on unresolved issues,
- Reviewed new files to determine current status of injury claim to develop plan of action,
- Adhered to company requirements for patient interactions and care standard
Senior Appeal Representative
Centene
Tampa, FL
02.2016 - 10.2020
- Created IRA packets for second level appeal,
- Reviewed submitted Medical Records and plan documentation for appeals for pre and post services for Medicare beneficiaries,
- Submitted verbal and written notification to members and providers,
- Remained Knowledgeable regarding CMS and company policies and procedures and current development within operational departments
Service Advocate
Florida Blue
Tampa, FL
02.2012 - 02.2016
- Used meetings to help clients prioritize actions and establish short- and long-term goals related to leave
- Completed reports, paperwork and documentation accurately and on time.
- Recruited, trained and supervised volunteer advocates to support mission.
- Assisted customers in resolving service issues by troubleshooting technical problems.
- Provided customer-minded services by using online surveys and face-to-face interviews to determine customer preferences and needs.
- Built customer loyalty and strength by finding solutions to customers needs.
- Identified and implemented process improvement opportunities to achieve objectives.
- Attended hearings with victims to provide emotional support.
- Answered calls and interacted with community members to provide information on advocacy services.
Education
GED -
Leary Technical Center
5410 N 20th St Tampa FL 3361005-2009
Skills
- Incident Reports
- Individual Support Plans
- Personal Care
- Progress Documentation
- Risk Assessments
- Documentation Skills
- Long-Term Care
- Computer Skills
- CMS guidelines
- Written Communication
- Social Perceptiveness
- Multitasking
- Customer Relations
- Microsoft Word
- Customer Service
- Problem Resolution
- Organizational Skills
Languages
English
Professional
Timeline
Short Term Disability Case Manager
Metlife
10.2020 - Current
Senior Appeal Representative
Centene
02.2016 - 10.2020
Service Advocate
Florida Blue
02.2012 - 02.2016
GED -
Leary Technical Center
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