Symone Moultrie
Roseville,MI
Summary
With a proven track record at Blue Care Network of Michigan, I excel in streamlining enrollment processes and enhancing user experiences, showcasing credentialing knowledge and strong communication skills. My approach has consistently surpassed performance targets, demonstrating leadership and a keen attention to detail, vital for advancing provider services operations.
Overview
15
15
years of professional experience
Work History
Provider Enrollment Specialist
Blue Care Network of Michigan
03.2023 - Current
- Streamlined provider enrollment processes by implementing efficient data management systems.
- Assisted providers with navigating online portal systems and enhancing user experience .
- Consistently met or exceeded departmental performance targets through diligent management of individual workload and effective collaboration with team members.
- Reduced errors in processing provider applications with meticulous attention to detail and thorough review procedures.
- Maintained up-to-date knowledge on Provider processing departmental changes.
- Reviewed applications for eligible BCN/BCBSM networks and determined which qualification criteria was met for individual Practitioners, Groups and Facilities.
- Used online systems such as LARA, Medicare Opt Out List and Sanction List to verify potential Practitioners and Facilities information.
- Processed Contracting Task for BCN/BCSBM PCPs, Specialist and Groups.
- Experienced with using Facets and Macess Programs.
Customer Service Representative II
Blue Care Network of Michigan
12.2019 - 03.2023
- Managed high-stress situations effectively, maintaining professionalism under pressure while resolving disputes or conflicts.
- Resolved customer complaints with empathy, resulting in increased loyalty and repeat business.
- Handled escalated calls efficiently, finding satisfactory resolutions for both customers and the company alike.
- Discussed in detail member healthcare benefits.
- Assisted members with premium billing and payments.
- Processed members material request.
- Assisted members and providers with claim inquires.
At Your Service Agent
Detroit Marriott at the Renaissance Center
04.2016 - 12.2019
- Make and confirm guest reservations.
- Confer with guest by telephone via inbound call center to provide information regarding reservations and complaints.
- Verify guest Credit Cards and establish how guest will pay for their stay.
- Contact housekeeping or maintenance staff when guest report problems within their stay.
- Investigated and resolved customer inquiries and complaints quickly.
- Followed up with customers about resolved issues to maintain high standards of customer service.
Customer Service Representative
Netflix
05.2013 - 02.2016
- 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.
- Confer with customers by telephone via inbound call center to provide technical support and payment processing.
- Assisted customers with recommendations for streaming services.
- Collaborated with team members to develop best practices for consistent customer service delivery.
Crew Trainer
McDonald's
06.2009 - 05.2013
- Trained other employees in customer service, food safety, and performance requirements.
- Taught new team members correct procedures for all areas of operations.
- Studied crew members during work shift to provide feedback and guidance in improving performance.
- Set positive example for team members by providing high-quality, efficient service.
- Fostered positive work environment, leading to increase in crew morale and productivity.
- Boosted customer satisfaction ratings by implementing effective communication techniques within crew.
Education
High School Diploma -
Henry Ford High Scool
Detroit, MIPsychology
Wayne State University
Detroit, MISkills
- Credentialing knowledge
- Strong Communication Skills
- HIPAA compliance awareness
- Medicare and Medicaid knowledge
- Effective written and verbal communication
- Leadership Qualities
- Continuous Learning Attitude
- Goal Setting Abilities
Timeline
Provider Enrollment Specialist
Blue Care Network of Michigan
03.2023 - Current
Customer Service Representative II
Blue Care Network of Michigan
12.2019 - 03.2023
At Your Service Agent
Detroit Marriott at the Renaissance Center
04.2016 - 12.2019
Customer Service Representative
Netflix
05.2013 - 02.2016
Crew Trainer
McDonald's
06.2009 - 05.2013
High School Diploma -
Henry Ford High Scool
Psychology
Wayne State University
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