MARISA VOGUS
Fort Lauderdale
Summary
Enthusiastic Appeals & Grievance Coordinator with more than four years experience in a Health Insurance Company environment. Primarily focusing on Clear Spring Health Care and Medicare member appeals and grievances. Skilled in receiving, routing, filing and delivering a wide range of medical documentation.
Overview
8
8
years of professional experience
Work History
Appeals & Grievance Coordinator
Clear Spring Health Care
07.2020 - 01.2025
- Investigate and resolve complex patient and insurance provider complaints related to enrollment and claims, provider payment disputes, medical appeals, and reversals within the healthcare industry
- Conducting outreaches to find out appeal statuses, determinations, and explanations, along with ensuring accuracy while communicating with members, providers, and customers
- Analyze and resolve verbal and written complaints and pursue resolution of formal grievances from members
Shift Leader
Planet Fitness
10.2019 - 07.2020
- Monitored employee performance and safety, conducting retraining to correct problems and optimize productivity
- Assisted with performance reviews to identify areas of improvement and devise proactive approaches
- Complied with all company safety procedures, policies and regulations to promote a safe working environment
- Verified employee compliance with housekeeping, safety and sanitary requirements to protect team members and customers
- Trained and supervised team members to maximize performance and meet daily objectives
Customer Service Associate
Winn Dixie
10.2016 - 11.2018
- Maintained revenue streams by exhausting every option before offering refunds
- Delivered fast, friendly and knowledgeable service for routine questions and service complaints
- Met and exceeded productivity targets by handling every interaction with top-notch customer service
- Evaluated customer account information to assess current issues and determine potential solutions
- Achieved high customer satisfaction scores by de-escalating complaints quickly
Education
High school or equivalent -
William T. McFatter Technical College
Davie, FL06.2019
High school or equivalent -
Stranahan High School
Fort Lauderdale, FL06.2018
Skills
- Dispute resolution
- Teamwork
- Time management
- Attention to detail
- Problem-solving abilities
- Multitasking
Timeline
Appeals & Grievance Coordinator
Clear Spring Health Care
07.2020 - 01.2025
Shift Leader
Planet Fitness
10.2019 - 07.2020
Customer Service Associate
Winn Dixie
10.2016 - 11.2018
High school or equivalent -
William T. McFatter Technical College
High school or equivalent -
Stranahan High School
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