Sabrina MacEachern

• Process appeals in compliance with internal policies, and both Medicare and Medicaid regulations.
• Collaborate with both internal departments and external vendors to conduct appeal research.
• Manage Part B, Part C and Part D appeals cases.
• Conducted ongoing training sessions for staff on regulatory updates and new procedures, ensuring compliance with changing industry and internal standards.
• Use Excel spreadsheets and business analytics tools to track analyst workloads, document appeal trends, and create agendas for weekly appeal review meetings.

• Analyze information from both members and providers to determine level and type of appeal or grievance while following strict regulatory requirements and timeframes.
• Work cross functionally with Customer Relations, Claims, Case Managers, Supervisors, Analysts, and external vendors to create cases and process Fast Track Appeals from Acentra.
• Streamlined training materials for the coordinator team to ensure consistency and accuracy in job achievement.
• Earned a Gold Hall of Fame award in April 2021.
• Contributed to workflow tracing, restructuring processes, and implementing automated integration to enhance efficiency and accuracy of the intake process.

• Efficiently opened or closed the bar according to established procedures, ensuring preparedness for each shift.
• Trained new employees in all aspects of the job including the proper steps of service, drink menu knowledge, and allergy protocol.
• Developed loyal clientele by consistently delivering outstanding service and engaging in friendly conversation.
• Selected as Employee of the Year (2014) for excellent customer service and teamwork.

Brand Ambassador: Formed brand awareness and brand loyalty through field work and social media channels among both future and existing patrons.