Summary
Overview
Work History
Education
Skills
Additional Information
Certification
Volunteer
Timeline
Hi, I’m

Selima Ahialaka

Rock Hill,SC

Summary

Cordial Case Manager dedicated to providing superior support for patients in need of reliable information regarding insurance coverage, finance options and documentation requirements. Excels at identifying client needs and concerns to improve engagement strategies and overall service. Maintains highest standards of ethics, professionalism and regulatory compliance to ease common stressors and de-escalate potential conflicts. Dedicated Liaison assisted Contingent Associate during Annual Reverification for smooth and simple process of new hire. Offering more than 4 years of documenting and reporting changes in relation to benefits. Composed, talented and considered effective team player. Collaborative individual with expertise in providing exemplary service regarding benefits support. Multitasking Benefits Specialist knowledgeable in HIPPA and federal regulations and maintaining customer confidentiality. Strategic manager consult to leverage knowledge in tax laws. Skilled in using data and analytics to evaluate job duties and requirements. Qualified to implement compensation and benefits strategies. Reliable and committed to professional development and growth.

Overview

18
years of professional experience
1
Certification

Work History

Verfication/ AR SAL, AmerisourceBergen Lash Group
Fort Mill, SC

Benefit
11.2019 - Current

Job overview

  • Verified patient-specific benefits, and precisely documented specific, for various payer plans like Medicare, Medicaid, and Private Commercial. This includes patient coverage, cost share, and access/provider
  • Review patient insurance information that's needed to process benefit verification, and finalize product quality review.
  • Supported AR Season as SAL (Support Associate Liaison) for 2 years. Trained new team members in policies and procedures. Offered insight into best ways to manage job tasks and duties of Benefit Verification Specialist.
  • Observed strict procedures to maintain data and plan participant confidentiality.
  • Checked customer benefits enrollment for accuracy and ensured data entry in SalesForce is inputted correctly.

Taxes Services
Rock Hill, SC

Manager
01.2009 - Current

Job overview

  • Accomplished multiple tasks within established Federal and State tax deadlines and oversee 15 clients.
  • Answered customer questions about products and services, helped locate merchandise, and promoted key items.

HealthGram
Charlotte, NC

Customer Service Representative
10.2018 - 09.2019

Job overview

  • Established up-to-date knowledge of product and service changes which oversees 500 insurance policies.
  • Performed 65-90 calls, emails, and faxes per day, addressing customer inquiries, solving problems, and providing product information.

PRI Nurse
Rock Hill, SC

Senior Caregiver
05.2018 - 10.2018

Job overview

  • Established nutritious meal plans and prepared daily offerings to meet patients' dietary needs.
  • Monitored 25 clients' vital signs, and administered medications.
  • Recorded patients' pulse, blood pressure, and respirations (TPRs) to assess and document important health information.

Bank of America
Charlotte, NC

Fraud Investigator
08.2005 - 05.2013

Job overview

  • Testified in court for both federal, civil, and criminal cases, answering questions honestly and respectfully.
  • Gathered evidence, which included recorded and written statements, financial documentation, and audio materials for examination.
  • Summarized all key information regarding detailed investigation report for delivery to law enforcement, overseeing 53 states.

Education

ITT TECHNICAL INSTITUTE
Charlotte, NC

Associate of Science from Criminal Justice
06.2012

University Overview

  • Honoree of Science
  • 4.0 GPA
  • Ranked in Top 25% of class
  • Relevant Coursework: Mathew Police Department, Fraud Investigation.

Ultimate Medical Academy Online Operations
Florida City, FL

Some College (No Degree) from Health And Human Services

Skills

  • Service Quality
  • Special Projects
  • Customer Care
  • Electronic Filing System
  • Workflow Processes
  • Compensation and Benefits
  • Data Integrity
  • Team Goals
  • Complex Problem-Solving
  • Excel Spreadsheet Functions
  • Job and Task Observation
  • Documentation

Additional Information

  • Awards , Global Recognition Award for being a team player Recognized for being a consistent top performer among Video Retrieval Specialist throughout the USA (United States of America) Achievement Awards/ Certificate of Recognition Global Recognition Bronze Award Global Recognition Award for shift training The Presidents National & Community Service Award Achievement Award/ Certificate of Volunteer Service. Outstanding Job Award for competing BV Case correctly point system.

Certification

  • Global Recognition Award for being a team player Recognized for being a consistent top performer among Video Retrieval Specialist throughout the USA (United States of America)
  • Achievement Awards/ Certificate of Recognition Global Recognition Bronze Award Global Recognition Award for shift training
  • The Presidents National & Community Service Award Achievement Award/ Certificate of Volunteer Service.
  • Outstanding Job Award for competing BV Case correctly point system.

Volunteer

 Habitat for Humanity/ Bank of America 2012- Volunteer building Home/Build roof 

Timeline

Benefit

Verfication/ AR SAL, AmerisourceBergen Lash Group
11.2019 - Current

Customer Service Representative

HealthGram
10.2018 - 09.2019

Senior Caregiver

PRI Nurse
05.2018 - 10.2018

Manager

Taxes Services
01.2009 - Current

Fraud Investigator

Bank of America
08.2005 - 05.2013

ITT TECHNICAL INSTITUTE

Associate of Science from Criminal Justice

Ultimate Medical Academy Online Operations

Some College (No Degree) from Health And Human Services

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Selima Ahialaka