MICHOL WILLIAMS
Cincinnati,OH
Summary
Organized and dependable candidate successful at managing multiple priorities with a positive attitude. Willingness to take on added responsibilities to meet team goals.
Overview
9
9
years of professional experience
1
1
Certification
Work History
Grievance and Appeals Analyst
Anthem
09.2022 - Current
- Processed over 300 grievances and appeals with a 15% efficiency increase, maintaining compliance with standards
- Achieved a 98% accuracy rate in case analysis and decision-making through meticulous research
- Enhanced inter-departmental communication and coordination, improving operational efficiency by 20%.
Behavioral Health Utilization Management Representative
Anthem
12.2021 - 09.2022
- Managed 200+ monthly inpatient and outpatient requests, expediting complex case turnaround by 25%
- Collaborated with Nurse Reviewers, enhancing clinical review efficiency and member satisfaction
- Improved benefit check processes for facility-based treatments, leading to a 30% increase in member satisfaction.
Customer Care and Claims Representative (Federal Employee Program)
Anthem
07.2015 - 12.2021
- Handled 50+ daily customer inquiries, maintaining a 95% satisfaction rate in issue resolution
- Processed and documented over 1,000 claims, enhancing claims processing efficiency by 10%
- Fostered strong customer relations, resulting in a 40% increase in positive member and provider feedback.
Education
A.S. - Healthcare Information Management
Penn Foster
Some College - Psychology
University of Akron
Skills
- Healthcare Systems
- Medical Terminology
- Data Management
- ICD-10
- Data Entry
- Team Leadership
- Claims Investigation
- Critical Thinking
- Computer Skills
- Customer service and support
Certification
CURES | The Enterprise Problem Solving Framework (White Belt)
Timeline
Grievance and Appeals Analyst
Anthem
09.2022 - Current
Behavioral Health Utilization Management Representative
Anthem
12.2021 - 09.2022
Customer Care and Claims Representative (Federal Employee Program)
Anthem
07.2015 - 12.2021
A.S. - Healthcare Information Management
Penn Foster
Some College - Psychology
University of Akron