Summary
Overview
Work History
Education
Skills
Timeline
Generic

Reshae Ellzey

Sumrall,MS

Summary

Friendly Insurance Verification Specialist promoting a background in keeping sensitive patient data confidential while maintaining knowledge of Medicaid and private policy benefits. Possessing great relationship-building and communication skills. Looking to tackle new challenges with a company that values dynamic skills and a strong work ethic.

Overview

12
12
years of professional experience

Work History

Grievance and Appeals Specialist

SaviLinx LLC
, United States
11.2019 - 06.2023
  • Managed a caseload of complex grievances and appeals from initiation to resolution
  • Conducted in-depth reviews of medical records, policy documents, and claim files to assess the validity of appeals
  • Collaborated with internal departments and external parties to gather necessary information for resolution
  • Developed and maintained strong relationships with healthcare providers, ensuring smooth communication during the appeals process
  • Prepared and presented comprehensive reports to senior management and regulatory authorities
  • Continuously monitored changes in healthcare regulations and updated internal procedures accordingly.

Case Manager

Simply Well
, United States
01.2017 - 11.2020
  • Collaborated with a multidisciplinary team to assess patient needs and develop individualized care plans
  • Conducted regular assessments to monitor progress, address barriers, and ensure quality care delivery
  • Advocated for patients' rights and coordinated with community resources to provide holistic support
  • Implemented discharge planning to facilitate smooth transitions from hospital to home care
  • Maintained accurate documentation and records, adhering to privacy and confidentiality protocols
  • Assisted case managers in managing caseloads and coordinating patient care services
  • Scheduled appointments, arranged transportation, and followed up on medical appointments
  • Conducted home visits to evaluate patient living conditions and assess additional support needs
  • Collaborated with insurance companies to obtain prior authorizations for medical procedures and services
  • Provided emotional support to patients and families during challenging times.

Oncology Data Coordinator

Sedgwick
Remote
03.2011 - 01.2017
  • Collaborated with medical professionals to accurately abstract and code cancer diagnoses, treatments, and follow-up data
  • Ensure compliance with cancer reporting guidelines and standards to support research and quality improvement initiatives
  • Maintain and update cancer registry databases, ensuring data integrity and completeness
  • Assist in generating comprehensive cancer reports for medical staff, administration, and regulatory agencies
  • Provide educational support to clinical staff regarding proper documentation and coding practices.

Education

Associate's - Office Management

Hinds Community College
12.2006

High school diploma -

Salem High School

Skills

  • Customer service
  • Recruiting
  • Medicare
  • Data entry
  • Human resources
  • Customer support
  • Negotiation
  • Leadership
  • Data Entry and Maintenance
  • Employee Relations Oversight
  • Employee orientation
  • Mentoring
  • Human resources management
  • Office management
  • Patient Rapport
  • Dispute Resolution
  • Policy Knowledge
  • Policy Development
  • Complaint Handling
  • Queue management

Timeline

Grievance and Appeals Specialist

SaviLinx LLC
11.2019 - 06.2023

Case Manager

Simply Well
01.2017 - 11.2020

Oncology Data Coordinator

Sedgwick
03.2011 - 01.2017

Associate's - Office Management

Hinds Community College

High school diploma -

Salem High School

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Reshae Ellzey