DeLisa Atterberry

• Helped large volume of customers every day with positive attitude and focus on customer satisfaction.
• Provided exceptional service through active listening, understanding member needs, and offering appropriate solutions.
• Responded to customer calls and emails to answer questions about products and services.
• Enhanced customer satisfaction by efficiently addressing and resolving inquiries and concerns
• Proficient skill in different software platforms including sales force and HSP
• Assess and monitor inpatient census and screen for eligibility and benefits.

• Screen for eligibility and benefits. Identify members without a PCP and refer to Member Services.

• Data enter assessments and authorizations into the system.

• Conducted thorough investigations for complex cases, ensuring fair and accurate outcomes within CMS guidelines
• Optimized workflows within the department by identifying inefficiencies and making recommendations for improvement based on data-driven analysis.
• Promoted a culture of continuous learning and development within the Grievance Appeals team, encouraging skill growth and knowledge sharing.
• Established strong relationships with internal and external stakeholders to facilitate smooth information exchange during case investigations.
• Implemented quality control measures that ensured accuracy and CMS guidelines in case documentation and reduced instances of rework or errors in processing claims.
• Collaborated with cross-functional teams to address systemic issues identified during the grievance appeals process.

• Handle provider call inquiries related to benefits, eligibility and claim related questions, which may include resolving issues, providing education, and problem solving
• Developed strong relationships with clients, resulting in repeat business and positive feedback.
• Maintained customer satisfaction with forward-thinking strategies focused on addressing customer needs and resolving concerns.
• Delivered exceptional customer service experiences by maintaining a positive attitude, active listening skills, and empathetic responses to customer concerns.
• Managed a high volume of inbound calls while maintaining excellent call quality standards and adhering to established procedures.
• Reviewed statistic enrollment data and prepared reports.
• Updated benefit cost summaries for employees.
• Responded to customer requests for products, services and company information.
• Offered advice and assistance to customers, paying attention to special needs or wants.
• Provided primary customer support to internal and external customers.
• Responded to customer concerns and questions on daily basis via email

• Exceeded client objectives of utilization, brand recognition and customer loyalty
• Leveraged John Paul networks and offered expertise to the benefit of the customer
• Constantly exceeded expectations of client by creating and building experiences that leverage direct and personal knowledge of the client’s personality and desire
• Researched and recommended travel on the client’s behalf
• Propositioned and process redemption and statement credit
• Developed personal and diverse relationships within the travel industry
• Managed complex international travel arrangements, ensuring smooth and seamless experiences for business travelers.

• Handle and serviced phone calls to book cruises and promote carnival Cruise Line products
• Provide the highest level of service to all related travel partners
• Direct all escalated matter to the appropriate resource
• Leverage direct and personal knowledge of the client’s personality and desire
• Researched and recommended travel on the client’s behalf
• Communicate with specific organizational support as necessary maximizing revenue opportunities by offering to confirm space, offering stateroom category upgrades, offer air and land components, along with ancillary products.

• Respond to youth and adolescent substance abuse or adolescents at risk for abuse; including intake, long term counseling, group work, crisis intervention, and family therapy
• Developed strong relationships with youth, fostering a supportive and inclusive environment.
• Maintained accurate records of attendance, participation rates, and program outcomes for reporting purposes.
• Create a well-functioning team environment
• Provided direct individual supervision of coordinators, develop effective departmental systems of communication and accountability, motivating staff and building a shared vision method of working together.

• Received all patient referral and relays information to the clinical manager for appropriate assignment
• Reviewed schedules on a daily basis
• Consulted with the clinical manager prior to make assignment changes
• Received lab reports and submitted to case manager for review
• Faxed copy of lab to the physician and assessed clients for appropriateness for referral to other programs within the agency and outside the agency
• Followed-up on missing data and account problems
• Documented and complete accurate data relating to all necessary eligibility, benefits and pre certifications