Shia Sheppard

Collaborate with carrier partners to clarify and fulfill file requirements, ensuring timely delivery and alignment with project needs.

Provide continuous assistance in SBM reconciliation to maintain synchronization of MHBE carrier and CMS records.

Facilitate resolution of 1095-A consumer issues through MHBE escalation process.

Handle escalated tickets via Salesforce CRM, updating records to reflect resolution status and improve overall operational clarity.

Format 834 files from collected data, improving accuracy of consumer enrollment records within internal database.

Research into Member Level Record (MLR) data from the Carriers, obtain additional information from the consumers, analyze and resolve 834 escalated cases.

Research 834 escalated cases using CRM records, and update CRM records upon resolution.

Provided incident management and technical support to Maryland Health Benefit Exchange (MHBE) consumers and workers, ensuring prompt resolution of inquiries.

Maintain direct communication with MDH to assist with Medicaid Override processes.

Collaborated in biweekly carrier calls to address and resolve complex consumer issues, enhancing communication and problem-solving efforts.

Administered technical support and incident management, improving service delivery for Maryland Health Benefit Exchange users.

Engaged in biweekly carrier calls to effectively troubleshoot and resolve multifaceted consumer concerns.

Coordinated with MDH to clarify and streamline Medicaid override process management.

Conducted comprehensive data analysis to identify trends and inform strategic decision-making.

Facilitated comprehensive user acceptance testing, focusing on identifying and resolving issues within Maryland Health

Benefit Exchange new consumer enrollment system.

Recommended process improvements to enhance efficiency and effectiveness.

Prepared weekly status reports detailing completed activities and upcoming plans for Project Manager review.

Led cross-functional teams to develop and implement training programs for staff efficiency.

Developed comprehensive reporting framework with daily, weekly, monthly, and quarterly reports to meet CMS and ISO quality standards for MHBE Call Center.

Facilitated knowledge transfer sessions, enhancing team capabilities and service delivery standards.

Analyzed and assessed representative calls, offering actionable feedback to optimize agent performance within a high-volume call center environment.

Identified and managed staff performance issues, addressing attendance, call avoidance, call quality, and workplace behavior to improve overall team effectiveness.

Supervised daily operations to ensure adherence to quality standards and customer service excellence.

Trained and mentored team members, fostering skill development and enhancing performance.