Santosha Brown
Ellenwood,GA
Summary
Experienced Eligibility Specialist with a strong track record of accurately and efficiently evaluating and processing eligibility applications. Proficient in assessing eligibility for a range of programs, including Medicaid and SNAP. Committed to delivering exceptional customer service and ensuring strict compliance with program guidelines. Highly organized and detail-oriented professional excelling in managing complex application processes while maintaining a focus on accuracy and efficiency.
Overview
9
9
years of professional experience
Work History
Eligibility Specialist 1
Department of Human Services
Atlanta, GA
10.2024 - Current
Senior Resolution Coordinator
Walmart
Remote, GA
09.2022 - 02.2025
- Reviewed transactions and receipts to identify any suspicious activity.
- Advised parties on dispute resolution processes, policies and procedures, helping disputants make informed choices.
- Consistently met or exceeded performance metrics including average handle time, first-call resolution rate, and adherence to schedule requirements.
- Handled customer inquiries and suggestions courteously and professionally.
- Resolved customer complaints with empathy, resulting in increased loyalty and repeat business.
- Actively listened to customers, handled concerns quickly and escalated major issues to supervisor.
Secretary
WCH CONSTRUCTION LLC
Atlanta, GA
01.2019 - 02.2024
- Maintained organized filing system of paper and electronic documents
- Coordinated communications, taking calls, responding to emails and interfacing with clients
- Created agendas, meeting notes and other documents to enhance collaborative process
- Prepared packages for shipment by generating packing slips and setting up courier deliveries
- Scheduled conferences and made hotel, airfare and ground transportation arrangements and reservations
- Assisted with answering phones, filing paperwork, entering data and to support operations department.
- Handled scheduling for executive's calendar and prepared meeting agenda and materials.
- Maintained daily report documents, memos and invoices.
- Handled sensitive information discreetly, maintaining confidentiality when managing personnel files or financial data.
Insurance Verification Specialist
Quantum 3 Media
Remote
01.2022 - 09.2022
- Ensure positive consumer experience by educating consumers on the features and benefits of the product, responding to questions, and overcoming objections
- Ability to motivate and persuade prospective buyers and attention to detail
- Verified that patients had proper insurance coverage prior to procedures or appointment scheduling
- Updated patient and insurance data and input changes into company computer system
- Entered data in EMR database to record payer, authorization requirements and coverage limitations
- Navigated through multiple online systems to obtain documentation.
Customer Service Representative
Maximus Call Center
Remote
08.2021 - 04.2022
- Advised customers on required information for claim submissions to progress applications.
- Responded to customer requests for products, services, and company information.
- Processed insurance policy cancellations and renewals quickly to meet call time targets.
- Liaised with insurance carriers to resolve billing errors and discrepancies.
- Handled sensitive customer information with discretion, adhering to strict data privacy regulations at all times.
Scanner
Inmar
Atlanta, GA
02.2018 - 02.2019
- Kept inventory areas clean, organized and free of safety hazards for maximum efficiency
- Operated equipment such as box cutters, hand jacks, tape guns and scanners in alignment with company guidelines
- Completed diary logs to maintain accurate inventory levels
- Received deliveries, scanned packages and updated orders in internal database
- Examined packages and goods for damage and notified vendors of replacement needs
- Managed warehouse system updates to increase productivity and reduce errors.
Administrative Assistant
We Care Pediatrics And Adolescent group
Atlanta, GA
03.2016 - 08.2016
- Organized and maintained filing and document management systems by coordinating, archiving and purging files
- Handled management of communication to executives by taking and making telephone calls, reviewing and prioritizing mail and composing and typing correspondence
- Entered insurance, demographics and health history into patient database
- Called patients to confirm scheduled appointments and obtain additional details
- Protected patients by observing strict HIPAA guidelines
- Took messages from patients and promptly relayed to appropriate staff.
Education
High School Diploma -
George Washington Carver High School
Atlanta, GA05.2014
Skills
- Assertiveness
- De-Escalation Techniques
- Teamwork and Collaboration
- Problem-Solving
- Active Listening
- Data Entry
- Problem-solving abilities
- Computer Proficiency
- Interviewing techniques
- Schedule management
Timeline
Eligibility Specialist 1
Department of Human Services
10.2024 - Current
Senior Resolution Coordinator
Walmart
09.2022 - 02.2025
Insurance Verification Specialist
Quantum 3 Media
01.2022 - 09.2022
Customer Service Representative
Maximus Call Center
08.2021 - 04.2022
Secretary
WCH CONSTRUCTION LLC
01.2019 - 02.2024
Scanner
Inmar
02.2018 - 02.2019
Administrative Assistant
We Care Pediatrics And Adolescent group
03.2016 - 08.2016
High School Diploma -
George Washington Carver High School