Summary
Overview
Work History
Education
Skills
Certification
Awards
Assessments
Timeline
Generic

Ranita Shade

Columbus,OH

Summary

Experienced professional seeking a career change, eager to join a company and utilize existing skills to exceed employer expectations. Motivated to acquire new knowledge and skills for personal growth within the organization. Authorized to work in the US, open to opportunities with any employer.

Overview

18
18
years of professional experience
1
1
Certification

Work History

Grievance and Appeals Coordinator

Buckeye Health Ins
08.2024 - Current
  • In this role I triage Grievances and Appeals to our coordinators for processing. I retrieve incoming mail and outgoing mail for our dept. I open each letter , scan and email to the proper dept. I print outgoing mail received from our wfh staff to package and mail. I also assist with any tasks as assigned by management.

Patient Care Coordinator

Quantum Health
10.2023 - 07.2024
  • Help members navigate their Healthcare journey. Assist member with claim issues and also provide information in reference to their Healthcare plan. Help member with bridging any gaps in provider care and help with finding doctors and specialists that fit their needs.

Grievance and Appeals Specialist

CareSource
06.2021 - 09.2023
  • Work directly with the clinical nursing staff to set up clinical cases for review. Review incoming documents to determine if it will be clinical or for sent to our claims team.

Grievance & Appeals

Buckeye Health Plan
10.2018 - 06.2021
  • Assist with mail intake assuring mail is scanned in and loaded to the proper system for G&A or Claims. I check our claims system for the EX codes, that determines where its uploaded. Also triaging work to coordinators and send invalid letters to providers advising of incorrect or missing information. I have also assisted with triaging member grievances and close cases I was assigned. I'm responsible for sending a daily report for work done during that work day.

Customer Service Representative

PNC Financial Services Group
04.2018 - 10.2018
  • Assist customer with questions related to their bank acct or online issues.

CSR - Customer Service Representative

Fiserv
07.2017 - 03.2018
  • Answer inbound calls in ref to debit card fraud. Assist customer with determining if particular transactions are fraudulent or auth by the customer

CSR - Customer Service Representative

Affinion Group
04.2017 - 06.2017
  • Assist callers with booking travel using their Chase credit card reward points.

CSR - Customer Service Representative

Aetna
12.2014 - 03.2017
  • Inbound call center assisting members with questions in ref to their health plan. Also help members and providers with billing issues to assure a properly billed claim, mail information when requested by member. I also assist with team projects when needed.

COTS Specialist

Chase
10.2011 - 12.2014
  • Assist customer with any questions or concerns with their account in reference to Balances, Deposits, and any other concerns they may have with the checking or savings. Also assist with questions regarding Credit Cards, Mortgage and Loans. With the Consumer Online Technical Support team I also assist with any online questions like Bill Pay, Quick Pay and setting up online accounts. I also assist with troubleshooting as needed.

Supervisor

Scioto Services
11.2010 - 10.2011
  • Oversee a crew of 7, inspect areas that have been cleaned, coach, train and report back to management. Also answer any questions or concerns the customer may have with the company.

Account Manager

ABM
04.2007 - 08.2010
  • Oversee a crew of 14 and inspect 4 buildings. I was responsible for payroll, scheduling, area assignment, supply ordering, building budgets, crew disciplinary actions and reporting to management. Also regular meetings with the customers to answer any questions or concerns they may have with the company.

Education

Certification in Underwriter/ Loan Processor - undefined

National Association for Mortgage Underwriting
Columbus, OH
04.2025

Skills

  • Customer service (10 years)
  • Help desk (3 years)
  • Banking (5 years)
  • Microsoft Office (10 years)
  • Driving
  • Triage (3 years)
  • Supervising (4 years)
  • Management (5 years)
  • Help Desk
  • English
  • Supervising experience
  • Industrial cleaning
  • Banking
  • Payroll (3 years)
  • Quality Assurance (6 years)
  • Cleaning
  • Ordering (3 years)
  • Custodial experience
  • Floor care

Certification

Driver's License

Awards

Banker of the Month Held Banker of the Month while with Chase several times for having met company metrics.

Assessments

  • Time management skills — Proficient April 2024 Managing one's own time to complete tasks quickly and efficiently Full results: Proficient
  • Cleaner fit — Proficient June 2023 Measures the traits that are important for successful cleaners Full results: Proficient
  • Work style: Reliability — Proficient June 2023 Tendency to be reliable, dependable, and act with integrity at work Full results: Proficient
  • Indeed Assessments provides skills tests that are not indicative of a license or certification, or continued development in any professional field.

Timeline

Grievance and Appeals Coordinator

Buckeye Health Ins
08.2024 - Current

Patient Care Coordinator

Quantum Health
10.2023 - 07.2024

Grievance and Appeals Specialist

CareSource
06.2021 - 09.2023

Grievance & Appeals

Buckeye Health Plan
10.2018 - 06.2021

Customer Service Representative

PNC Financial Services Group
04.2018 - 10.2018

CSR - Customer Service Representative

Fiserv
07.2017 - 03.2018

CSR - Customer Service Representative

Affinion Group
04.2017 - 06.2017

CSR - Customer Service Representative

Aetna
12.2014 - 03.2017

COTS Specialist

Chase
10.2011 - 12.2014

Supervisor

Scioto Services
11.2010 - 10.2011

Account Manager

ABM
04.2007 - 08.2010

Certification in Underwriter/ Loan Processor - undefined

National Association for Mortgage Underwriting

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