Sianna Sinclair-Philpott
Cleveland,OH
Summary
Professional with strong background in Medicaid eligibility determination and case management. Proven ability to navigate complex regulations and ensure compliance. Strong focus on team collaboration and achieving results. Known for reliability and adaptability in dynamic environments. Expertise in data analysis, client communication, and process improvement.
Overview
3
3
years of professional experience
Work History
Medicaid Eligibility Specialist
The Revenue Group
12.2024 - Current
- Managed high caseloads efficiently, prioritizing tasks effectively and utilizing time-management skills to meet deadlines consistently.
- Collaborated with other specialists to ensure consistent interpretation of Medicaid regulations and policies.
- Resolved eligibility discrepancies by carefully reviewing regulations and collaborating with relevant parties to reach accurate determinations.
- Participated in ongoing professional development opportunities to stay informed about industry trends and maintain proficiency in job-related skills.
- Streamlined application processing for increased efficiency by implementing a well-organized case management system.
Prescription Benefit Specialist
CVScaremark
11.2023 - 12.2024
- Helped clients optimize their medication regimens by conducting thorough assessments of individual needs and available resources.
- Played an active role in promoting health and wellness initiatives within the community, educating patients on prescription benefits and available resources.
- Promoted a positive work environment through collaborative teamwork and clear communication among colleagues.
- Developed strong relationships with pharmaceutical representatives to stay informed about new products and industry updates.
Customer Service Representative
The Solution Center
02.2022 - 11.2023
- Resolved customer complaints with empathy, resulting in increased loyalty and repeat business.
- Managed high-stress situations effectively, maintaining professionalism under pressure while resolving disputes or conflicts.
- Handled escalated calls efficiently, finding satisfactory resolutions for both customers and the company alike.
- Enhanced customer satisfaction by promptly addressing concerns and providing accurate information.
Education
High School Diploma -
Treca Digital Academy
Marion, OH05-2023
Skills
- Application processing
- Eligibility determination
- Policy interpretation
- Interviewing techniques
- Medicaid
- Teamwork
- Multitasking ability
- Teamwork and collaboration
- Customer service
- Effective communication skills
- Time management
- Problem-solving
- Attention to detail
Timeline
Medicaid Eligibility Specialist
The Revenue Group
12.2024 - Current
Prescription Benefit Specialist
CVScaremark
11.2023 - 12.2024
Customer Service Representative
The Solution Center
02.2022 - 11.2023
High School Diploma -
Treca Digital Academy
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