Committed job seeker with a history of meeting company needs with consistent and organized practices. Skilled in working under pressure and adapting to new situations and challenges to best enhance the organizational brand. I have a strong work ethic and hold myself to a very high standard.
Overview
15
15
years of professional experience
Work History
Appeals Representative
First Coast Service Options
01.2024 - Current
Expedited the appeals process for faster resolutions by streamlining procedures and workflows.
Enhanced the accuracy of appeal decisions through thorough research and factchecking.
Obtained additional documentation required for case review.
Examined case to initiate clinical review.
Developed training materials for new hires, ensuring consistent quality standards across the team.
Collaborated with cross-functional teams to ensure proper handling of complex cases, resulting in more accurate outcomes.
Supported fellow Appeals Representatives through peer coaching and knowledge sharing, fostering a collaborative work environment.
Managed sensitive client information with confidentiality and discretion, maintaining trust between customers and the company.
Completed documentation of final appeals or grievance determination using appropriate templates.
Maintained up-to-date knowledge on industry regulations and guidelines to ensure compliance during the appeals process.
Assisted management in identifying areas for improvement, contributing to overall department efficiency gains.
VIP Tour Guide/Safety Trainer/Helping Hand
Dollywood Theme Park
08.2022 - Current
Led guided tours and informational talks for large groups to showcase attractions and highlights
Created tour programs with focus on providing positive guest experiences
Assisted in developing tour programming to enhance guest experience
Developed well-versed tour guides by mentoring and training peers
Used strong verbal and written communication skills to convey messages to others
Completed semi-skilled and skilled work under supervision of fully qualified professionals
Displayed strong public speaking and communication skills to facilitate high quality guest tours
Developed guest relationships to achieve high level of satisfaction
Customer Sales Representative
AeroCare
08.2020 - 08.2022
Consulted with customers regarding needs and addressed concerns
Gave customers quotes based on potential sales
Advised customers on promotions, sales procedures and strategies for maximizing results from company products
Performed needs analysis and presented options based on findings to help customers make decisions
Delivered fast, friendly and knowledgeable service for routine questions and service complaints
Maintained comprehensive understanding of company offerings to drive consistent sales during routine service touches
Rendered ongoing support and account management to customers to maintain loyalty and continue revenue streams
Used excellent verbal skills to engage customers in conversation and effectively determine needs and requirements
Resource Coordinator
OmniVisions
06.2018 - 08.2020
Maintained thorough case history records and wrote detailed reports
Implemented social service interventions to achieve treatment goals and address client needs
Maintained lists of resources helpful to clients
Engaged in community outreach and program development to support patient and caregiver needs
Interviewed clients individually and in family groups to determine services to best address specific needs
Developed workable solutions for recurring problems for individuals and families
Collaborated with multidisciplinary team of mental health case managers and disability workers
Educated patients and caregivers on community resources and post-acute level of care criteria, benefits and coverage
Completed intake assessments with patients and drafted community reentry plans following treatment
Coordinated mental health assessments for children, adolescents and adults receiving child welfare and prevention services
Restorative Interventionist
Knox County Schools
08.2017 - 05.2018
Selected interventions most appropriate to individual [Student or patient] and laid out treatment plan
Documented evaluation results, treatment plans and other actions according to requirements
Determined capabilities and function of [Type] individuals through personal interviews, home visits and assessments
Implemented behavioral plans designed by IEP teams for students with behavior disorders or other special conditions to help meet special education students needs
Modeled social, peer facilitation and peer training to achieve academic, social, emotional and behavioral goals
Adapted classroom activities, assignments and materials to provide educational opportunity for special education students to participate in classroom activities
Built relationships with students and guardians through active communication and positive feedback
Offered counseling to students and parents to increase personal growth, self-understanding and behavioral management
Collaborated with other educational personnel to provide inclusive activities or programs for children with disabilities
Demonstrated appropriate behaviors using behavior modeling and positive reinforcement techniques
Intensive Case Manager
Helen Ross McNabb
04.2015 - 08.2017
Assisted individuals with eligibility for available benefits
Provided case management services including intake, assessment, crisis intervention, advocacy, referral and monitoring of families
Maintained up-to-date case records with case activity status
Developed trusting relationships with social services, health care providers and governmental agencies
Linked clients with social services, health care providers and governmental agencies to help claim or reclaim individual autonomy
Advocated for clients by obtaining information regarding treatment options and clinical status
Coordinated support services and optimized communication between healthcare workers and patients
Encouraged and motivated clients to develop new coping mechanisms and techniques to drive behavior modification
Acted as role model for clients by exhibiting positive behaviors
Maintained and developed community relationships to support various client referrals
Case Management Specialist
Region IV Mental Health Services
08.2010 - 03.2015
Facilitated ongoing case management services to support successful outcomes and meet stabilization goals
Conducted assessments to obtain information for participant-centered plan of care
Protected patient data in alignment with HIPAA privacy protocols
Advocated for members and families to coordinate care and navigate resources within [Type] system
Developed comprehensive client-driven case plan with short and longterm goals
Cooperated with local service providers, outreach workers, case managers and collaborative agencies to facilitate services for members
Constructed case notes and comprehensive reports for data entry into [Software] portal
Identified strengths and opportunities for staff improvement based on audit results
Provided hands-on and proactive leadership to community services staff