. Dedicated and customer-focused professional with management experience in the fast-food industry and current experience as a Member Engagement Specialist. Skilled in leadership, customer service, conflict resolution, team development, and problem-solving in fast-paced environments. Proven ability to build strong relationships with customers, handle sensitive information professionally, and meet performance goals while maintaining a positive attitude. Adaptable, dependable, and committed to delivering exceptional service and supporting both team and organizational success.
Work History
Member Engagement Specialist
8 Months
Senture | 12.2025 - Current
Verify patient eligibility and benefit coverage for Medicaid and other insurance programs using internal systems and payer portals.
Review benefit details including covered services, limitations, authorization requirements, and effective dates.
Communicate benefit information clearly to members, providers, and internal departments to ensure accurate service delivery.
Identify coverage discrepancies, missing information, or eligibility issues and initiate resolution following established procedures.
Document verification results, case notes, and updates accurately in compliance with HIPAA and agency standards.
Coordinate with providers, eligibility teams, and insurance representatives to confirm benefits and resolve billing or coverage concerns.
Maintain current knowledge of Medicaid policies, benefit structures, and regulatory updates to ensure accurate verification.
Ensure timely processing of benefit verifications to support claims, authorizations, and patient access to care.
Handle sensitive information with discretion while delivering professional and empathetic customer service.
Remote
Assistant General Manager
10 Months
KPOT | 02.2025 - 12.2025
Trained and mentored staff in product knowledge and customer service best practices.
Coordinated daily store operations to enhance customer experience and optimize sales.
Implemented inventory management procedures to reduce stock discrepancies and improve accuracy.
Oversaw scheduling and staffing needs, ensuring optimal coverage during peak hours.