Tenisha Snipes

Works as an eligibility worker for two years before pursuing a healthcare management career, primarily in the state.

Benefit program settings.

• Determines the eligibility of applicants and recipients for public assistance programs.

Interactive interviewing and fact-gathering.

• Maintain current knowledge of program regulations and procedures necessary for multiprogram caseload administration.

• Initiates and processes casework through automated systems.

• Identify needs and make appropriate referrals for health, social, and/or employment services.

And perform related work as required.

Creates, develops, and implements training programs for employees and patients.

• Gathering and analyzing data.
• Creating detailed reports.
• Identifying process improvements.
• Collaborating with departments.
• Maintaining accurate documentation.

I worked as a patient services representative for 3 years. Assisting members with private state and

government insurance services.

• Answer inbound calls remotely regarding patients and members-managed medical care plans.

• Assist providers and members with verifying insurance eligibility dates and coverage.

• Analyze medical claims status and adjustments. Navigate various medical and healthcare

systems used daily to assist members.

• Verify and confirm if medical services need prior authorization according to CPT or diagnosis

codes.

Document and notate all calls using a call tracking system.

• Confirm if medical records and forms are received for prior authorizations to arrange the.

Patient's medical care.

Assist members with scheduling visits according to their care plan.

• Escalate member appeals and grievances to the proper department for review. Update

Members coordinate benefits and verify other insurance. Make outbound calls to providers and.

Doctors' offices to confirm the status of claims, or any changes.

Update members' demographic information, and process Medicaid ID cards to be mailed to.

Members, and confirm benefits according to members' coverage and fee schedule.

Train and prepare new hires and employees for policy and system procedures.

I worked in Insurance Services as a Client Support Specialist for five years.

• Answer inbound calls remotely to assist clients with life insurance inquiries about billing.

Regarding term life, whole life, and universal life policies.

• Process payments, and assist policy owners and beneficiaries with initiating, filing, and.

Processing death claims.

• Performs accounting duties by setting up and calculating payment arrangements.

Daily administrative office duties include faxing, scanning, mailing, and emailing clients' forms.

documents.

• Perform data entry to submit policy owners' loan requests, withdrawals, and billing.

Review changes, initiate and file insurance claims, and assist with the claims process and paperwork.

• Researched and analyzed policies to correct errors.

• Offer and recommend insurance products and services that will benefit the customer and the.

The company aims to promote sales.

Assist and train new and current team members with complex issues and system knowledge.