MarQuetta McKentry
Muskegon,United States
Summary
Diplomatic customer service professional experienced in defining and analyzing customer requests to resolve issues. Accurate in documenting customer concerns and dedicated to maintaining deep knowledge of products and promotions. Confident communicator recognized for consistently receiving excellent customer feedback.
Overview
14
14
years of professional experience
Work History
Prior Authorization Representative
Corewell health
Grand Rapids, MI
06.2024 - Current
- Researched medical policies to ensure appropriate coverage of services.
- Submitted prior authorization requests electronically or by phone to payers.
- Advised healthcare professionals on proper coding practices that meet requirements of payers.
- Assessed insurance benefits and determined eligibility criteria.
- Reviewed prior authorization requests for completeness and accuracy.
- Maintained high level of professionalism when speaking to doctors and insurance companies.
- Contacted insurance carriers to obtain authorizations, notifications and pre-certifications for patients.
- Scheduled peer to peer reviews for physicians to discuss medical necessity with insurance providers.
- Performed detailed medical reviews of prior authorization request, following established criteria and protocols.
- Verified patient's insurance eligibility prior to appointment date for payment purposes.
- Applied knowledge of Medicare, Medicaid and third-party payer requirements utilizing on-line eligibility systems to verify patient coverage and policy limitations.
- Coordinated resolutions for issues and appealed denied authorizations.
Customer Service Representative (Senior)
Priority Health
Grand Rapids, MI
07.2021 - 06.2024
- Remained calm and professional in stressful circumstances and effectively diffused tense situations.
- Demonstrated excellent communication skills in resolving product and consumer complaints.
- Maintained knowledge of current promotions, exchange guidelines, payment policies and security practices.
- Fielded customer complaints and queries, fast-tracking for problem resolution.
- Escalated customer concerns, issues and requirements to supervisors for immediate rectification.
- Promoted high customer satisfaction by resolving problems with knowledgeable and friendly service.
- De-escalated problematic customer concerns, maintaining calm, friendly demeanor.
- Upheld quality control policies and procedures to increase customer satisfaction.
Surface Mount Technician
GHSP
Grand Haven, MI
04.2018 - 07.2021
- Documented robotics test procedures and results.
- Used AI software to train robots to perform different tasks.
- Removed and replaced malfunctioning circuit boards and sensors.
- Fabricated housings, jigs, fittings and fixtures, utilizing metalworking machines.
- Maintained effective supply levels by acquiring material quotes and placed orders from vendors.
- Promoted high customer satisfaction by resolving problems with knowledgeable and friendly service.
- Approached customers and engaged in conversation through use of effective interpersonal and people skills.
Manager
Burger King
Norton Shores, MI
02.2011 - 07.2020
- Trained employees on additional job positions to maintain coverage of roles.
- Completed thorough opening, closing and shift change functions to maintain operational standards each day.
- Enforced customer service standards and resolved customer problems to uphold quality service.
- Leveraged leadership skills to identify deficiencies and opportunities to improve policies, procedures and controls.
- Monitored staff performance and addressed issues.
Education
Associate of Science -
Muskegon Community College
Muskegon, MISkills
- Customer relations
- Call Center Operations
- Adaptive team player
- Business development understanding
- Problem-solving abilities
- High-energy attitude
Timeline
Prior Authorization Representative
Corewell health
06.2024 - Current
Customer Service Representative (Senior)
Priority Health
07.2021 - 06.2024
Surface Mount Technician
GHSP
04.2018 - 07.2021
Manager
Burger King
02.2011 - 07.2020
Associate of Science -
Muskegon Community College
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