Shakebra Ghee
Norfolk,VA
Summary
Organized professional knowledgeable in regulatory standards and compliance requirements. Confident Prior Authorization Specialist with a background spent working in medical offices, communicating effectively orally and through writing and developing prior authorization workflows.
Overview
21
21
years of professional experience
1
1
Certification
Work History
Benefit Specialist
ElevenceHealth
09.2023 - 01.2024
- Established strong relationships with insurance carriers, negotiating favorable pricing and service terms for the organization.
- Conducted benefits orientation sessions for new hires, ensuring smooth onboarding and integration into company culture.
- Enhanced customer satisfaction by efficiently addressing and resolving Medicare-related inquiries.
- Provided exceptional support to Medicare beneficiaries, guiding them through coverage options and plan details.
- Assisted in enrollment processes for new beneficiaries, providing clear guidance through each step for seamless transitions into coverage plans.
- Managed a high volume of inbound calls, adeptly navigating multiple systems while maintaining focus on customer needs.
- Maintained strong working knowledge of Medicare regulations, ensuring accurate information dissemination to clients.
Pharmacy Representative
Anthem Healthcare
10.2022 - 01.2023
- Medicare B & D
- Handling Prior Authorization’s provider contracts, eligibility, and claim
- Handling Faxes
- Responding to customer questions via telephone and written correspondence regarding insurance benefits, provider contracts, eligibility and claims
- .ePA
- Sorting, Taking phone
- COS, PA Hub, Facets, Concord
- Pharmacy & Medical Benefits
- Worked closely with other members of the pharmacy team, demonstrating strong communication skills for effective collaboration.
- Developed expertise in managing pharmaceutical supply chains through strategic ordering practices.
- Provided exceptional customer service by addressing inquiries and concerns in a timely manner, resulting in increased loyalty and trust from clients.
- Educated patients on proper medication usage and potential side effects, promoting adherence to treatment plans.
- Resolved insurance claim issues promptly, facilitating seamless coverage for patients'' medications.
- Handled sensitive patient information confidentially, ensuring compliance with HIPAA guidelines.
Administrative Specialist
Care4u
03.2012 - 05.2022
- Handling All Internal Affairs
- Evaluated account and service histories to identify trends, using data to mitigate future issues.
- Met customer call guidelines for service levels, handle time and productivity.
- Collaborated with staff members to enhance customer service experience and exceed team goals through effective client satisfaction rates.
- Optimized customer support by establishing collaborative service environment.
- Followed-through on all critical inter-departmental escalations to increase customer retention rates.
- Delivered top-notch administrative support to office staff, promoting excellence in office operations.
- Scheduled meetings booked meeting rooms and prepared meeting agendas.
- Handled mail, packages, emails, document transmissions and other types of data with both manual and automated tracking strategies.
Community Outreach Worker/Voluntary Worker
Dominion Psychiatric Associates
03.2012 - 07.2016
- Acted as main point of contact between management, clinical staffs and external community.
- Connected individuals with available and relevant resources.
- Networked with local organizations, leaders and consumers, resulting in establishment of new and lasting partnerships and relationships.
- Developed presentations for public events, community groups and school assemblies.
- Documented and analyzed performance of different programs in order to make proactive decisions about services.
- Built partnerships with related organizations to develop support and gain greater attention for important issues.
- Educated young people about strategies for driving discussions and promoting social changes.
- Gathered opinions and support from grass-roots supporters to solidify group position.
Technical Support Specialist
MCI Telecommunications
12.2007 - 05.2012
- Assisted customers in identifying issues and explained solutions to restore service and functionality.
- Explained technical information in clear terms to non-technical individuals to promote better understanding.
- Resolved diverse range of technical issues across multiple systems and applications for customers and end-users across various time zones.
- Used ticketing systems to manage and process support actions and requests.
- Monitored systems in operation and input commands to troubleshoot areas.
- Activated accounts for clients interested in new services.
- Loaded software, granted permissions and configured hardware for new employees as part of onboarding process.
Clerical Worker
Delphinus Engineering Inc.
04.2003 - 10.2007
- Completed clerical tasks such as filing, copying and distributing mail.
- Delivered clerical support by handling range of routine and special requirements.
- Interacted with customers by phone, email or in-person to provide information.
- Welcomed office visitors and alerted staff to arrivals of scheduled appointments.
- Developed correspondence letters, memos and emails.
- Verified accuracy of business records by consistently updating customer information.
Education
Bachelor of Science - Theology
Grand Canyon University
Phoenix, AZ02.2015
Bachelor of Arts - Psychology
University of Phoenix
Tempe, AZ12.2014
GED -
Tidewater Community College
Norfolk, VA03.2000
Skills
- Medicare B & D
- Medicaid
- Pharmacy Representative
- Prior Authorizations
- Customer Service
- Facets
- Concord
- Medical Report Preparation
- EPA
- Fax
- Payment Processing
- Client Relations
Certification
Medicare B
Medicare D
Customer Service
Timeline
Benefit Specialist
ElevenceHealth
09.2023 - 01.2024
Pharmacy Representative
Anthem Healthcare
10.2022 - 01.2023
Administrative Specialist
Care4u
03.2012 - 05.2022
Community Outreach Worker/Voluntary Worker
Dominion Psychiatric Associates
03.2012 - 07.2016
Technical Support Specialist
MCI Telecommunications
12.2007 - 05.2012
Clerical Worker
Delphinus Engineering Inc.
04.2003 - 10.2007
Bachelor of Science - Theology
Grand Canyon University
Bachelor of Arts - Psychology
University of Phoenix
GED -
Tidewater Community College
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