Sasha Doucette
Combined Locks,WI
Summary
Executive Assistant/Assistant Court Clerk
Overview
31
31
years of professional experience
Work History
Appeals and Grievances Coordinator
Navitus Health Solutions
09.2023 - Current
- Processed and finalized appeals and grievances within agreed-upon turnaround time.
- Remained knowledgeable regarding company policies and procedures and current developments within operational departments.
- Submitted verbal and written notification to members and providers.
- Upheld organization's reputation as a compliant plan sponsor by staying current on all relevant regulations and guidelines governing the appeals and grievances process.
Member Service Specialist II / Special Teams
Navitus Health Solutions
03.2010 - 09.2023
- Answer and correctly log all calls
- Meet required goals including random call and documentation monitoring
- Offer benefits explanation and troubleshoot claims on every applicable call
- Assist in answering questions that arrive via the mentor queue
- Assisted developing new training materials for Special Teams Queues, Finesse, and the Callback Feature
- Assisted updating failed faxes
- Trained call center reps for the new Callback feature and Discount Lines of Business
- Acting lead for the Callback team
- Answer questions that arrive via the Client Service, Ask Customer Care, Member Portal, and Electronic Request queues
- Enter PHI, Guardianship, and Power of Attorney information into NCRx
- Send email requests to agents for additional information and follow up
- Compile the monthly Provider Updates and forward to Provider Credentialing
- Update and review Special Teams Work Instructions
- Assisted with the implementation of Finesse 12.6
Pharmacy Technician
Walgreens
11.2017 - 03.2018
- Answer calls
- Gather prescription and ring them through the register when patient picks up
- Fill prescriptions by manually counting medications and/or obtaining medications from the automatic dispensing machine
Accreditation Coordinator
Navitus Health Solutions
05.2016 - 11.2016
- Take notes and document meeting minutes
- Assist in upkeep of policies and procedures
- Gather materials for meetings
- Send out meeting reminders
- Assist in gathering proof for accreditations
- Assist in providing client services with requested materials for clients
PA Specialist
Navitus Health Solutions
01.2014 - 05.2016
- Answer and correctly log all calls
- Meet required goals including random monitoring, TAT, maintain a 90% monthly audit score, and handle times
- Offer benefits explanation and troubleshoot claims on every applicable call
- Answer, name, process, assist, and correspond through phone and/or email prior authorization requests
- Assisted as a CCS III for member services
- Assist Client Services with member questions and building MPA's for overrides
Customer Care Consultant
QTI Group
11.2009 - 03.2010
- Answered and correctly logged all calls
- Meet required goals including random monitoring and handle times
- Offer benefits explanation and troubleshoot claims on every applicable call
Customer Care Consultant
Convergys
09.2009 - 11.2009
- Answered and correctly logged all calls
- Meet required goals including random monitoring and handle times
- Offer products on every applicable call
- Troubleshoot equipment over the phone with member
Customer Care Consultant
AT&T
03.2008 - 08.2009
- Answered and correctly logged all calls
- Meet required goals including random monitoring and handle times
- Offer products on every applicable call
- Explained billing and adjustments
- Received 25 customer commendations for outstanding customer service
Customer Service Representative
West Business Services
03.2005 - 03.2008
- Answered and correctly logged all calls
- Meet required client goals including random call monitoring and handle times
- Enter contacts with little to no corrections
- Answer consumer questions and troubleshoot products and services
- Troubleshoot consumer products, while logging and recording the resolution
Customer Service Manager
Burlington Coat Factory
10.2000 - 03.2005
- Compiled daily financials, quarterly, and annual reports and paperwork
- Researched and solved financial discrepancies and report reason for discrepancies
- Counted safe money and made daily deposits
- Conducted layaway audits, office, and equipment inventory
- Solved customer problems, complaints and communicated customer requests to corporate office
- Solved register problems
- Interviewed, trained, and scheduled cashiers
Sales Representative
Cadre
09.2000 - 10.2000
- Went through RJ Reynolds telemarketing training
- Called businesses to sell promotional items
- Completed call lists and entered business data into call system
Crew Chief & Swing Manager
McDonald's
10.1993 - 09.2000
- Trained new employees
- Scheduled crew placement and shifts
- Compiled daily deposits
- Conducted food and equipment inventory and placed required orders
- Made sure health requirements were compliant
- Handled customer complaints
Education
High School Diploma -
Washburn High School
Washburn, WICPhT Certification -
Pharmacy Technician Training
Appleton, WISkills
- Training Development
- Documentation
- Coordination
- Scheduling
- Data Validation
- Queue Testing
- Troubleshooting
- Monitoring
- Outreach
- UAT Testing
- Reporting
- Contact Center Administration
- Performance Management
- Email Management
- Quick Learning
- Technical Support
- Policy Review
- Microsoft Office
References
- Krystal Aldridge , (812) 719-8158, kaldridge8158@gmail.com
- Jennifer Haak, (608) 516-0680
- Maria Abegglen, (920) 268-9920
Timeline
Appeals and Grievances Coordinator
Navitus Health Solutions
09.2023 - Current
Pharmacy Technician
Walgreens
11.2017 - 03.2018
Accreditation Coordinator
Navitus Health Solutions
05.2016 - 11.2016
PA Specialist
Navitus Health Solutions
01.2014 - 05.2016
Member Service Specialist II / Special Teams
Navitus Health Solutions
03.2010 - 09.2023
Customer Care Consultant
QTI Group
11.2009 - 03.2010
Customer Care Consultant
Convergys
09.2009 - 11.2009
Customer Care Consultant
AT&T
03.2008 - 08.2009
Customer Service Representative
West Business Services
03.2005 - 03.2008
Customer Service Manager
Burlington Coat Factory
10.2000 - 03.2005
Sales Representative
Cadre
09.2000 - 10.2000
Crew Chief & Swing Manager
McDonald's
10.1993 - 09.2000
CPhT Certification -
Pharmacy Technician Training
High School Diploma -
Washburn High School
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