MARTANIA WHITE
Lancaster,TX
Summary
- Grievances and appeals professional well versed in ensuring that day to day goals are met and ensure that issues are resolved timely. looking to continue to develop my skills and experience.
- Ability to prioritize work to meet expected and routine deadlines in a fast-paced business environment without oversight
- Makes decisions on moderately complex to complex issues regarding technical approach for project components, and work is performed without direction
- Experience resolving Medicare Grievances and appeals with Resolution Team
- Advance experience utilizing Microsoft Excel, WordPerfect, and Microsoft Word to accomplish tasks. Ability to train, motivate, and supervise customer service employees.
- Case management- ability to prioritize and manage inventory and workflow- strong attention to detail, organizational and time management skills
- Superior communication, organizational, and detail-oriented traits
- Self-motivated, self-starting, with a positive attitude open to flexibility and learning
Overview
15
15
years of professional experience
Work History
Healthcare Project Manager
Humana Insurance
09.2015 - Current
- I manage client denials and concerns by conducting a comprehensive analytic review of clinical documentation to determine if an a grievance, appeal or further request is warranted and then delivers final determination based on trained skillsets and/or partnerships with clinical and other Humana parties
- Investigates and resolves member and practitioner issues
- Decisions are typically focused on methods, tactics and processes for completing administrative tasks/projects
- Regularly exercises discretion and judgment in prioritizing requests and interpreting and adapting procedures, processes and techniques, and works under limited guidance due to previous experience/breadth and depth of knowledge of administrative processes and organizational knowledge
- Administrative/operational/customer support duties that require independent initiative and judgment
- Developed strong communication and organizational skills through working on group projects.
- Managed time efficiently in order to complete all tasks within deadlines.
Team Lead HR Representative
ADT Security Services
Irving, TX
01.2009 - 01.2015
- Administers employee benefit programs including insurance plans and employee savings plans
- Handle high volumes of heavy customer contact in a professional and efficient manner
- Quickly and effectively solve customer challenges on a daily basis
- Conducted employee on-boarding and helped organizing training and development initiatives
- Schedules training activities and recruiting events
- Worked with team members 1-on-1 and in small groups to enhance performance and employee satisfaction
Education
A Maceo Smith High School
2008
Masters - Human Resources
Keller University
Bachelors - Business Administration, Commerce
Texas A&M University
Work Availability
monday
tuesday
wednesday
thursday
friday
saturday
sunday
morning
afternoon
evening
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Skills
- Project manager supervision
- Multiple project coordination
- Project timeline compliance
- Complex project delivery
- Healthcare experience
Timeline
Healthcare Project Manager
Humana Insurance
09.2015 - Current
Team Lead HR Representative
ADT Security Services
01.2009 - 01.2015
A Maceo Smith High School
Masters - Human Resources
Keller University
Bachelors - Business Administration, Commerce
Texas A&M University
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