Miracle M. Email & Phone Number

- PRO SME-In this current Pro- Subject Matter Expert Position performing daily managing & developing of advisors skills by implementing plan of actions using targeted coaching’s for improvement conducting Knowledge, Skills & Attitude focused roundtables and 1:1’s , collaborating with Quality Evaluators and Team Leads to initiate S.M.A.R.T Goals with Performance Improvement plans utilizing the S.W.O.T analyst & G.R.O.W. style coaching methods. Providing effective feedback using the “sandwich” model. Knowledge of C.O.P.C (client operation performance center).

In this current position took inbound/ outbound calls to clients, duties include responding to questions and concerns about products or services.

-Position called for Statewide Medicaid Managed Care (SMMC) claims submission and explanation of benefits or statement casework including yet not limited to: denials, P.A.'s, time sensitive cases, claims adjudications etc., knowledge of HCPCS, CPT, billing codes, other healthcare terminology gained. Acting Call Center Manager for member services -managed MSR’s , provided coaching and development per service rep, monitored scheduling along with attendance, AHT, area aligned focus on attrition paying close attention to shrinkage areas , KPI’s for State issued Medicaid, Chip, and other government plans.

In this position handled different L.O.B' s while managing & improving client call center procedures, evaluated team performance levels on key metrics (AHT, Attendance, etc.), prepared business reports for different departments and upper management for state issued healthcare plans, budgets & other government funded programs, focusing on details of issues used effective and timely communication serving as a liaison between assigned client cases and state Medicaid administration personnel while able to maintain top performing site in state.