Serena Robertson
Birmingham,AL
Summary
Highly-motivated employee with over 20 years experience in the Healthcare industry with a desire to take on new challenges. Strong work ethic, adaptability, and exceptional interpersonal skills. Adept at working effectively unsupervised and quickly mastering new skills.
Overview
21
21
years of professional experience
Work History
Member Advocate Trainer and Retention Coordinator
VIVA Medicare Member Services
2022.09 - Current
- Provided training to new hires
- Developed a range of educational resources including training manuals, job aids, refresher training classes and reference materials
- Updating training materials for ongoing relevance in both hard-copy and electronic formats
- Facilitated employee training programs aimed at enhancing compliance with departmental policies and procedures.
- Coached and provided feedback on calls in alignment with department policies and procedures.
Medicare Products Representative
VIVA Medicare Sales and Marketing
2019.01 - 2022.08
- Contacted and engaged Medicare-eligible individuals over the phone, highlighting the benefits of the plan while determining their eligibility
- Collaborated with multiple departments at VIVA including sales and marketing, provider services, quality improvement, medicare enrollment, and medicare member services to drive successful sales, retention and quality campaigns.
- Complied with Company and Center for Medicare and Medicaid Services policies regarding sales, ensuring adherence to all relevant regulations.
- Trained new representatives on product knowledge, sales strategies, and company policies.
- Established positive relationships with customers through effective communication techniques.
Medicare Member Services Advocate
VIVA Medicare
2018.06 - 2019.08
- Provided timely and friendly assistance to VIVA Medicare members
- Attended training sessions on updates to VIVA Medicare products and services.
- Maintained a high level of professionalism when dealing with difficult customers.
- Promoted high customer satisfaction by resolving problems with knowledgeable and friendly service.
Provider Outreach and Education Consultant
Cahaba Government Benefit Administrators
2015.01 - 2018.01
- Utilized various platforms such as WebEx, Telspan, and GoToMeeting to personally present engaging training sessions on important Medicare policies, new initiatives, and key national program modifications for the provider community.
- Organized information effectively for meetings and presentations using various software tools such as Microsoft PowerPoint, Word, Excel SharePoint, and Adobe Life Cycle
- Wrote and shared educational resources including meeting recordings, articles, and presentations on the Cahaba website with the help of WordPress.
- Facilitated training sessions to providers regarding billing procedures, coding standards, and other administrative topics.
- Maintained professional relationships with healthcare providers.
- Collaborated with other departments within the organization to resolve complex issues related to provider relations activities.
ISO Coordinator
Cahaba Safeguard Administrators LLC
2014.01 - 2015.01
- Maintained the ISO Quality Management System for all sites
- Informed leadership about audit findings, recommendations, and areas of enhancement through regular management review meetings
- Maintained communication channels with internal associates and external business partners through oral and written correspondence
- Took proactive approach in identifying areas that require quality improvement and effectively implemented necessary corrective and preventive measures.
- Monitored performance metrics related to quality assurance processes.
- Ensured timely creation and distribution of required deliverables per CMS guidelines.
- Implemented efficient document management processes and protocols in Microsoft SharePoint for seamless record-keeping.
- Analyzed current trends in quality management systems to identify potential opportunities for improvement.
Benefit Configuration Analyst
DST Health Solutions
2011.01 - 2014.01
- Developed workflow procedures for claim processors to streamline operations.
- Tested the validity of benefit plans entered into the system for accuracy
- Retrieved and compared data from large databases using SQL queries
- Provided technical assistance, training, support, consulting and other duties as needed by clients and co-workers
- Assisted Marketing Department with software presentations to prospective clients.
- Conducted simulations with multiple scenarios to test system configurations.
- Acted as a liaison between users and IT staff when resolving complex problems related to system configurations.
- Monitored changes in system configurations to ensure compliance with organizational policies and procedures.
- Provided training on proper use of configured systems as well as guidance on troubleshooting common issues.
- Implemented new configurations based on customer requirements or industry standards.
Resource Coordinator
Cahaba Safeguard Administrators LLC
2004.01 - 2011.01
- Produced statistical reports showcasing trends through effective utilization of techniques like graphs, charts, and flowcharts
- Evaluated workflows to define metrics and goals for improving work procedures
- Applied analytical skills to monitor, analyze, research, track and control diverse projects aimed at enhancing quality, productivity and service.
- Performed all operational and ISO 9001:2008 internal audits at each company site for all departments
- Tracked progress in development of training program for Subject Matter Experts
- Assisted with the development and oversight of an internal database for investigating Medicare fraud
- Implemented an organized system to store and update relevant documentation in SharePoint
- Facilitated Operational Workgroup meetings with Affiliated Contractors and associates.
- Partnered with programmers to implement automation solutions for generating Quality Assurance reports across different functional domains within the company.
Education
Bachelor of Science Degree in Business Management -
Miles College
Fairfield, AL05.2003
Skills
- Claims Processing
- Quality Assurance
- Benefit Configuration
- Statistical Analysis
- Project Management
- Microsoft Office, Excel
- Policy Interpretation
- Effective Communication
- Training development
- Documentation and reporting
- Facilitation
Timeline
Member Advocate Trainer and Retention Coordinator
VIVA Medicare Member Services
2022.09 - Current
Medicare Products Representative
VIVA Medicare Sales and Marketing
2019.01 - 2022.08
Medicare Member Services Advocate
VIVA Medicare
2018.06 - 2019.08
Provider Outreach and Education Consultant
Cahaba Government Benefit Administrators
2015.01 - 2018.01
ISO Coordinator
Cahaba Safeguard Administrators LLC
2014.01 - 2015.01
Benefit Configuration Analyst
DST Health Solutions
2011.01 - 2014.01
Resource Coordinator
Cahaba Safeguard Administrators LLC
2004.01 - 2011.01
Bachelor of Science Degree in Business Management -
Miles College
Similar Profiles
Stacey O'NealStacey O'Neal
Customer Service Representative at Humana Medicare Member ServicesCustomer Service Representative at Humana Medicare Member Services
Tabitha TatumTabitha Tatum
Management Analyst at Centers For Medicare & Medicaid ServicesManagement Analyst at Centers For Medicare & Medicaid Services
William HollandWilliam Holland
IT Security Specialist at Centers for Medicare & Medicaid ServicesIT Security Specialist at Centers for Medicare & Medicaid Services