PAMELA GRILL
FESTUS,MO
Summary
A seasoned professional with a proven track record at Centene Corporation, I excel in quality auditing and team building. Demonstrated expertise in enhancing data accuracy and efficiency, coupled with exceptional communication skills, ensures operational excellence. Achieved significant improvements in process adherence, showcasing a unique blend of analytical prowess and interpersonal effectiveness.
Overview
15
15
years of professional experience
Work History
Coordinator I
Centene Corporation
01.2021 - 10.2024
- Quality Auditor evaluate data to ensure its accuracy, consistency, and reliability.
- Enter pertinent claims information from source documents
- Correct entries where indicated
- Maintain appropriate records, files, documentation, etc.
- Print Prior Authorization and deliver to the appropriate department
Operations Office Clerk
Six Flags , Inc
03.2020 - 01.2021
- Data entry of Operations daily reports
- Compute park gate counts accurately and timely every hour
- Review guest service recovery issues
- Assist team members at counter with questions/concerns
- Maintain a supply of forms used in the office and the park
- Prepare, copy, organize, and file department reports, documents, and correspondences
- Answer telephone and direct to appropriate personnel
Senior Eligibility Specialist
Express Scripts / United BioSource
02.2018 - 03.2019
- Label inbound faxes that physician office would fax for their patients.
- Assign labeled faxes to my queue.
- Enter new and updated existing patient information into the database.
- Direct misroute and no name documents to the the lead.
- Ran Re Authorization report.
- Assist lead with coworker HIPPA audits.
Data Entry Specialist
Kelly Services
10.2017 - 02.2018
- Quality check hard copy to insure accuracy.
- Maintained strict confidentiality of sensitive information, adhering to established guidelines and protocols.
- Completed data entry tasks with accuracy and efficiency.
- Compiled data and reviewed information for accuracy prior to input.
- Contributed to team success by consistently meeting or exceeding performance targets in speed, accuracy, and output volume.
- Process eligibility requests according to department procedures.
- Accurately and productively input requests from start forms or prescriptions.
Customer Service Representative
American Home Patient
05.2013 - 04.2016
- Managed high-stress situations effectively, maintaining professionalism under pressure while resolving disputes or conflicts.
- Resolved customer complaints with empathy, resulting in increased loyalty and repeat business.
- Handled escalated calls efficiently, finding satisfactory resolutions for both customers and the company alike.
- Responded to customer requests for products, services, and company information.
- Entered orders for durable medical equipment (i.e. oxygen, cpap, wheelchairs, hospital beds, etc...) into data base.
Data Entry Clerk
Help At Home, Inc
04.2010 - 04.2013
- Entered payroll into data base.
- Facilitated criminal background check process for new hires.
- Ran Medicaid eligibility for services.
- Tracked and obtained Prior Authorizations.
- Assisted Registered Nurse Case Managers with 485/Plan of Care.
Education
GED - General Education
Windsor High School
Imperial, MOSkills
- Typing
- Quality Auditing
- Detailed
- Deadline Adherence
- Train employees
- Evaluate performance
- Problem-solving abilities
- Team building
Timeline
Coordinator I
Centene Corporation
01.2021 - 10.2024
Operations Office Clerk
Six Flags , Inc
03.2020 - 01.2021
Senior Eligibility Specialist
Express Scripts / United BioSource
02.2018 - 03.2019
Data Entry Specialist
Kelly Services
10.2017 - 02.2018
Customer Service Representative
American Home Patient
05.2013 - 04.2016
Data Entry Clerk
Help At Home, Inc
04.2010 - 04.2013
GED - General Education
Windsor High School
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