Rosemond Churchill
Greensboro,NC
Summary
Highly motivated and detail-oriented Information Technology student seeking an internship position to gain practical experience and contribute to the success of an organization. Reliable business professional with experience in project management, process improvement and financial analysis. Proven track record of successfully streamlining business operations and reducing costs. Adept at analyzing data to identify trends and developing strategies to improve efficiency.
Overview
8
8
years of professional experience
Work History
Digital Engagement Specialist
Blue Cross, NC
12.2019 - Current
- Provide user support for ad hoc questions, inquiries, and service requests
- Data Collection for initial campaign processes
- Perform user support and monitor system performance as needed
- Act as point of contact or subject matter expert for internal and external audits and projects
- Collaborating with team to plan, coordinate, and implement Diabetes Management Pilot Program for select State Health Plan Members
- Create and Manage campaign data for departmental reporting, tracking, and data analysis
- Leading and developing training plans
- Develop system support processes with IT
- Test Care Radius system update before launch date
- Provide timely and accurate reporting/data on inventory and productivity
- Coordinate daily to resolve production support issues, including application failures and user errors
- Document, track, and report all system support activities
- Subject Matter Expert for Wellframe application with State Health Plan.
Intake Specialist
Blue Cross, NC
04.2018 - 11.2019
- Provided high-quality, member/provider-focused servicing using knowledge of plans, products, systems, and procedures to meet or exceed member/provider experience
- Scheduled Peer-to-Peer Reviews with Medical Director
- Assisted in locating specialists and nurses
- Worked as team member to assist nurses in researching providers
- Concisely and accurately enter documentation into Care Radius
- Effectively engaged over phone via both inbound and outbound members
- Screened inquiries to determine if authorization was required
- Verified member benefits and eligibility and provider setup
- Processed provider requests as needed
- Planned, coordinated, and scheduled department events
- Provided clinical review outcome notification to members and providers (verbal and written)
- Assisted with training new specialists on phones in timely and professional manner.
Inter-Plan Program: Customer Service Professional
Blue Cross, NC
07.2016 - 04.2018
- Communicated daily with providers in high volume call center regarding claims or coding issues by assuring issue resolution and exceeded department requirements
- Recognized patterns of inconsistent and inaccurate claims filing practices among providers
- Identified and obtained information and records from customers, provided correct/updated information and claims
- Completed and updated inventory
- Educated and encouraged customers on alternative delivery channels, including self-service, web, etc
- Evaluated account and service histories to identify trends, using data to mitigate future issues
- Helped large volume of customers every day with positive attitude and focus on customer satisfaction
- Maintained and managed customer files and databases
- Developed customer service policies and procedures to meet and exceed industry service standards
- Surpassed performance goals by approaching interactions with resourcefulness, organization, and customer-centric solutions
Education
M.D. - Information Technology
North Carolina Agricultural And Technical State University
Greensboro, NC05.2024
Skills
- Project Planning
- Leadership
- Program Management
- Process Planning
- Production Support
- Problem Solving
- Detailed Oriented
- Communication
- Data Collection
- Process Improvement
- Training
- Testing
- Customer Relations
- Emergency Response
- Root Cause Analysis
- Quality Assurance
Timeline
Digital Engagement Specialist
Blue Cross, NC
12.2019 - Current
Intake Specialist
Blue Cross, NC
04.2018 - 11.2019
Inter-Plan Program: Customer Service Professional
Blue Cross, NC
07.2016 - 04.2018
M.D. - Information Technology
North Carolina Agricultural And Technical State University
Similar Profiles
Nicholas MihaloNicholas Mihalo
Actuarial Analyst - Government Pricing at Blue Cross NCActuarial Analyst - Government Pricing at Blue Cross NC
Theresa LyonTheresa Lyon
Sr Transplant Coordinator at Blue Cross NCSr Transplant Coordinator at Blue Cross NC
Desiree HancockDesiree Hancock
Pharmacy Services Specialist at Blue Cross NCPharmacy Services Specialist at Blue Cross NC
Kirstie DixonKirstie Dixon
Teacher at Winston-Salem Forsyth County SchoolsTeacher at Winston-Salem Forsyth County Schools
Robert Lunsford IIIRobert Lunsford III
Manufacturing Associate at GKN AutomotiveManufacturing Associate at GKN Automotive