Youlonda Moody Giles
Arkdelphia,AR
Summary
To obtain a position with a corporation or in an office setting will allow continued opportunities for growth and advancement.
Overview
25
25
years of professional experience
Work History
Direct Service Professional
Group Living Inc.
05.2025 - Current
- Managed medication administration for multiple clients following strict protocols to ensure proper dosage and adherence.
- Facilitated successful transitions for clients moving between different levels of care or living arrangements by providing consistent support and guidance.
- Documented client progress through detailed case notes, contributing to their ongoing evaluation and treatment plan adjustments.
- Facilitated group activities that promoted social interaction and skill-building among clients with diverse backgrounds.
- Provided transportation for clients to appointments, recreational activities, and community events, fostering social engagement.
Substitute Teacher
Kelly Educational Staffing
03.2025 - Current
- Followed classroom plans left by class teacher to continue student education and reinforce core concepts.
- Upheld classroom routines to support student environments and maintain consistent schedules.
- Developed strong rapport with students through consistent encouragement and support, fostering a positive learning atmosphere conducive to academic growth.
- Repeatedly requested as substitute teacher by teachers based on excellent past referrals and trusted performance.
Admissions Support Specialist
Baptist Health Medical Center
06.2024 - Current
- Reviewed patient insurance coverage within the Epic system for out patient services.
- CallIed insurance companies to inquire if CPT codes required authorization.
- Clarified patients primary and secondary coverages.
- Verified if patients coverage was active or termed.
Customer Service Representative / Team Lead
Centene Corporation Inc.
07.2019 - Current
- Distribute daily Productivity, Adherence, and Quality Reports
- Supervise team agents, review and respond to agent Quality rebuttals, review Hippa fails, and conduct follow up coaching
- Travelled to Virginia to assist with the satellite location for new hire nesting
- Submit service tickets for system issues, oversee daily support chats, assist with escalated calls and emails, my health pays, IEX updates, monitor real time adherence, and communicate trends or issues to Mgt
- Assist with virtual nesting during work from home status, conduct interviews
- Conduct weekly Huddle Team Meetings, process return mail
- Assisted with training of new incoming agents in the absence of the Lead Trainer
- Answered inquiries from Ambetter and Medicaid members regarding claims, finding a provider, status of prior authorizations, member rewards, premium payments, transportation, benefits, and eligibility, and submitted grievances
Supervisor / Customer Service
Centene Corporation Inc.
01.2021 - 08.2023
- Ensure the team meets its goals and objectives through effective hiring, performance management, coaching and career development
- Act as the Complaints Coordinator; ensuring all complaints are resolved and responded to appropriate parties
- Develop, implement and maintain materials and programs ensuring production and quality standards are met
- Hire, motivate, coach, counsel, and supervise the daily functions of the provider services staff
- Educate members regarding plan benefits as appropriate and refer members to Connections Representatives
- Evaluate and audit performance and identify and implement improvement opportunities to increase overall productivity and effectiveness
- Ensure plan pends are completed
- Review and respond to complex issues and questions
- Ensure processes are compliant with contractual agreements and State and Federal regulations
- Analyze and advise management of personnel, work-flow issues and trends and recommend resolutions
- Audit daily phone log reports and access the need for changes
Customer Service Representative / Provider Agent
Centene Corporation Inc.
11.2015 - 07.2019
- Answered inquiries from Ambetter and Medicaid members regarding claims, finding a provider, status of prior authorizations, member rewards, premium payments, transportation, benefits, and eligibility, and submitted grievances
- Assisted provider offices with benefit and coverage information
- Answered inquiries regarding medical claims and payment
Team Lead / Transport Driver
Allcare Pharmacy Inc.
11.2009 - 12.2015
- Supervise Employees to ensure company policies are followed
- Making sure drivers are assigned correct routes throughout the state
- Ensure delivery of Medicine, Medical Supplies, and Office Equipment
- Deliver to Retirement Nursing Facilities and County Jails
- Scan bar codes to record delivery time and signatures
Teller One
Simmons First National Bank
03.2008 - 09.2008
- Consumer Banking
- Assist customers in Consumer Banking
- Paying and receiving teller procedures
- Promoting bank products and services
Medical Payroll/ Purchasing Clerk/ Intake Clerk
Pulaski County Sheriff Dept.
07.2000 - 11.2007
- Processed Medical Payroll
- Performed overtime and shift differential tasks using Microsoft Excel Spreadsheets
- Reviewed medical claims from various agencies for services provided to inmates
- Submitted invoices with written vouchers for payment on medical treatment, supplies, Contract labor, etc
- Assisted in maintaining a 2.5-million-dollar budget
- Also was an Intake Clerk where I entered incoming inmate charges within the system, checked NCIC and ACIC for outstanding warrants, assisted with the Court Liaison's office to release inmates from jail, processed payment of fines, bonds, released clothing and personal property
Education
High School -
Arkadelphia High School
General Studies - Communications
Henderson State University
01.1988
Skills
- Customer service
- Data entry
- Recordkeeping and file management
- Office administration
- MS office
- Team building and leadership
- Decision-making
- Personable and approachable
- Team collaboration
- Employee supervision
Timeline
Direct Service Professional
Group Living Inc.
05.2025 - Current
Substitute Teacher
Kelly Educational Staffing
03.2025 - Current
Admissions Support Specialist
Baptist Health Medical Center
06.2024 - Current
Supervisor / Customer Service
Centene Corporation Inc.
01.2021 - 08.2023
Customer Service Representative / Team Lead
Centene Corporation Inc.
07.2019 - Current
Customer Service Representative / Provider Agent
Centene Corporation Inc.
11.2015 - 07.2019
Team Lead / Transport Driver
Allcare Pharmacy Inc.
11.2009 - 12.2015
Teller One
Simmons First National Bank
03.2008 - 09.2008
Medical Payroll/ Purchasing Clerk/ Intake Clerk
Pulaski County Sheriff Dept.
07.2000 - 11.2007
High School -
Arkadelphia High School
General Studies - Communications
Henderson State University
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