SHERMYRA MCKINNIE
Summary
Motivated and passionate professional with 10 years of experience in all aspects of customer service and support in healthcare. Strong background of excellent communication and organizational skills seeking a position in customer success management (CSM). Experience includes policy analysis, claims management, customer service and compliance with state insurance regulations. Strengths include strong analytical skills, adept at multitasking and effective communication capabilities. Demonstrated impact through improved operational efficiency in previous roles.
Overview
11
11
years of professional experience
Work History
Insurance Specialist
Texas Department of Insurance
2019.03 - 2022.05
- Research and resolve client concerns in a proficient manner
- Assist agent and adjusters with general questions, complaints, and inquiries on regulations/statutes from TIC and TAC
- Provide licensing requirements, license renewals, and application status
- Update client demographic information
- Coordinate with cross functional teams to ensure adequate resolutions on escalations.
Provider Relations Coordinator
Cenpatico
2016.02 - 2018.01
- Act as a liaison between the organization and provider to ensure contract disputes, reimbursement issues, and credentialing questions are addressed and resolved timely
- Assist providers with joining the network process
- Resolve provider escalated issues and manage work items through department queues
- Submit updates for key provider demographics, contracting amendments, & roster updates
- Assist with prior auth for behavioral health services.
Customer Service Rep
Logisticare
2015.08 - 2016.02
- Assist Medicaid beneficiaries with transportation services
- Verify benefits and eligibility to utilize services
- Responsible for scheduling meals and lodging for recipients.
Client Operation Team Lead
Teleperformance
2011.10 - 2015.06
- Monitor quality reports to ensure agents’ performance meets KPIs established by client
- Assist with onboarding, training, and defining performance objective of new agents
- Review grievance and appeals to ensure required criteria were met
- Educate Medicare members on prior auth requirements, benefits eligibility, claims status, and grievance & appeals process.
Education
Master's Degree - Health Administration And Management
Colorado State University—Global Campus
06.2017
Bachelor of Arts - Psychology
La Roche College
2010-05
Skills
- Self-Motivated
- Time Management
- Organized
- Empathetic
- Problem Solving
- Microsoft Office
Timeline
Insurance Specialist
Texas Department of Insurance
2019.03 - 2022.05
Provider Relations Coordinator
Cenpatico
2016.02 - 2018.01
Customer Service Rep
Logisticare
2015.08 - 2016.02
Client Operation Team Lead
Teleperformance
2011.10 - 2015.06
Master's Degree - Health Administration And Management
Colorado State University—Global Campus
Bachelor of Arts - Psychology
La Roche College
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