Robert Cieslewicz
Green Bay,WI
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
23
23
years of professional experience
Work History
Grievance Appeals Specialist
Humana Inc
03.2020 - 04.2024
- Analyzed and processed member and non-contracted provider appeals regarding dental and medical issues.
- Evaluated and worked each case according to process and compliance guidelines.
- Work high volume case loads to meet compliance deadlines.
- Created, composed and maintained appeal response templates.
Customer Care Specialist
Humana Inc
09.2014 - 03.2020
- Helped large volume of customers every day with positive attitude and focus on customer satisfaction.
- Achieved high satisfaction rating through proactive one-call resolutions of customer issues.
- Responded to customer needs through competent customer service and prompt problem-solving.
- Resolved member inquiries regarding claim, benefit, eligibility, and enrollment issues.
Teacher Substitute
Green Bay Public Schools
02.2013 - 06.2014
- Planned and implemented integrated lessons to meet national standards.
- Kept students on-task with proactive behavior modification and positive reinforcement strategies.
- Supported student physical, mental, and social development using classroom games and activities.
Teacher
Cave Creek Unified School District
11.2000 - 05.2012
- Worked cooperatively with other teachers, administrators, and parents to help students reach learning objectives.
- Incorporated multiple types of teaching strategies into classroom.
- Communicated frequently with parents, students, and faculty to provide feedback and discuss instructional strategies.
- Graded and evaluated student assignments, papers, and course work.
Education
Post Baccalaureate Certification in Education - Elementary Education
Ottawa University
Phoenix, AZ12.2000
Bachelor of Arts - Business Administration
University of Wisconsin - Eau Claire
Eau Claire, WI12.1989
Skills
- Case analysis
- Workflow Management
- Customer service excellence
- Classroom Instruction
- Student Engagement
- Curriculum Implementation
Timeline
Grievance Appeals Specialist
Humana Inc
03.2020 - 04.2024
Customer Care Specialist
Humana Inc
09.2014 - 03.2020
Teacher Substitute
Green Bay Public Schools
02.2013 - 06.2014
Teacher
Cave Creek Unified School District
11.2000 - 05.2012
Post Baccalaureate Certification in Education - Elementary Education
Ottawa University
Bachelor of Arts - Business Administration
University of Wisconsin - Eau Claire
Similar Profiles
Daron ShealyDaron Shealy
Risk Adjustment Representative2 at Humana IncRisk Adjustment Representative2 at Humana Inc
Andrew HendersonAndrew Henderson
Claims Representative at HUMANA INCClaims Representative at HUMANA INC
Maya KernMaya Kern
Market Point Field Sales Agent at Humana IncMarket Point Field Sales Agent at Humana Inc