Torika Rogers
Sugar Land,TX
Summary
Knowledgeable Desired Position with solid background in analyzing and resolving appeals efficiently. Proven track record of accurately reviewing cases and contributing to policy improvements. Demonstrated expertise in critical thinking and effective communication.
Overview
11
11
years of professional experience
1
1
Certification
Work History
Grievance & Appeals Analyst (Medicaid)
Anthem/Elevance Health
03.2022 - Current
- Analyze and evaluate inquiries, complaints, reports, and/or filings
- Prepare and organize case research, notes, and documents
- Conduct research and analysis and recommend appropriate course of action and next steps for management review
- Performs fact checking, gather documents, research and respond to inquiries and records requests and assists with investigative and discovery activities and processes
- Corresponds with both internal and external associates for grievance regulatory cases
- Utilize guidelines and review tools to conduct extensive research
- Render determinations on assigned non-complex grievance and appeal issues
- Complete respective written communication documents to convey the case determination
Customer Service Representative
Kelly Services
11.2021 - 03.2022
- Analyze problems and provide information/solutions
- Document information, activities and changes in the database
- Thoroughly document inquiry outcomes for accurate tracking and analysis
- Develop and maintains positive customer relations and coordinate with various functions within the company to ensure customer requests and questions are handled appropriately and in a timely manner
- Research and analyze data to address operational challenges and customer service issues
- Provide customers with requested information
- Receive and place follow-up telephone calls / e-mails to answer customer questions
- Understand and respond to the needs and expectations of internal and external customers
Certified Nursing Assistant
Tomball Regional Hospital
04.2016 - 08.2017
- Provided compassionate patient care under RN supervision
- Monitored vital signs and reported abnormalities promptly
- Documented patient observations and responses accurately
- Assisted with activities of daily living and promoted patient dignity and respect
Certified Nursing Assistant
North Cypress Medical Center
01.2014 - 06.2016
- Delivered bedside care according to established care plans
- Administered treatments and conducted vital sign assessments
- Documented patient information accurately using EMR systems
- Performed medical procedures with proficiency and maintained patient safety
Education
GED -
Lonestar Community College
Cypress, TXSkills
- Excellent communication skills
- Strong critical thinking and analytical abilities
- Leadership qualities
- Problem-solving skills
- Effective multitasking capabilities
- Strong decision-making skills
- Proficient in Microsoft Excel
Certification
Certified Nursing Assistant, 12/08/10, Active
Timeline
Grievance & Appeals Analyst (Medicaid)
Anthem/Elevance Health
03.2022 - Current
Customer Service Representative
Kelly Services
11.2021 - 03.2022
Certified Nursing Assistant
Tomball Regional Hospital
04.2016 - 08.2017
Certified Nursing Assistant
North Cypress Medical Center
01.2014 - 06.2016
Certified Nursing Assistant, 12/08/10, Active
GED -
Lonestar Community College
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