Janniessea Stewart

Resolved high volumes of member inquiries and complex insurance claims while maintaining confidentiality and meeting strict processing timeframes. Assisted members with policy changes, claims processing, and benefits enrollment to improve first-call resolution and satisfaction.

Processed eligibility, benefits verifications, and authorizations while resolving participant inquiries via phone and email. Ensured accurate documentation and acted as a subject matter expert to reduce errors and speed claims filing.

Conducted in-depth investigations for appeals and grievances, coordinated with clinical and operations teams, and recommended resolutions to facilitate appropriate client placement. Managed intake, case histories, and insurance data to ensure compliant appeals processing.

Handled complex and escalated customer calls, performed routine and advanced account maintenance, and investigated posting defects to meet service level agreements. Collaborated across teams and systems to achieve timely resolutions and maintain account accuracy.

Addressed complex banking inquiries, reviewed account activity for discrepancies, and delivered proactive resolutions that increased customer satisfaction. Monitored accounts for creditworthiness and provided timely support to prioritize customer needs.

Prepared and processed provider enrollments for Medicare and Medicaid across multiple states and served as liaison between providers, members, and internal teams to resolve issues. Identified enrollment opportunities and supported partnership meetings to streamline provider relations.

High School Diploma from Stepping Stones High School in Tampa, FL.