Open to opportunities

Keila Nicole

@keilanicole

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Enrollment Specialist optimizing healthcare processes through data management.

United States

Message

What I'm looking for

I am looking for a role that values analytical skills and offers growth opportunities in healthcare operations.

As an Enrollment Specialist, I have a strong track record in optimizing healthcare enrollment processes through meticulous data management and documentation review. My proficiency in conflict management and customer service has allowed me to enhance operational efficiency while delivering unparalleled support. I am committed to applying my analytical skills and innovative solutions to future challenges.

In my recent role at Humana, I streamlined enrollment processes by managing customer data and validating plan documentation, ensuring accurate effective dates for healthcare coverage. My experience at Aetna further honed my customer service skills, where I resolved inquiries professionally and improved customer satisfaction through tailored advice and proactive service strategies. I thrive in environments where I can leverage my skills to enhance client experiences and operational workflows.

Experience

Work history, roles, and key accomplishments

Benefit Verification

Caremetx

Dec 2024 - Present (7 months)

Verified benefits and resolved over 100 queries monthly, enhancing client satisfaction and ensuring compliance. Collaborated with healthcare providers to streamline benefit verification workflows, reducing processing time and enhancing patient care coordination.

Benefit Verification Query Resolution Compliance

Processor

NTT Data

May 2024 - Present (1 year 2 months)

Streamlined payment processing workflows by coordinating suspense account reconciliations and implementing efficient fund distribution procedures. Optimized banking information updates and payment system maintenance while maintaining data accuracy and reducing processing delays.

Payment Processing Workflow Optimization Communication

Enrollment Specialist

Humana

Sep 2023 - Present (1 year 10 months)

Streamlined enrollment processes by managing customer data, validating plan documentation, and ensuring accurate effective dates for healthcare coverage. Optimized member enrollment workflow through meticulous data entry, application review, and systematic plan termination procedures.

Enrollment management Data Entry Documentation Review Customer Service Healthcare Regulations

Customer Service Representative

Aetna, a CVS Health Company

Jul 2021 - Present (4 years)

Resolved customer inquiries with professionalism, enhancing satisfaction and loyalty. Streamlined customer communication channels and implemented proactive service strategies to enhance client satisfaction and resolve complex inquiries efficiently.

Customer Service Conflict Resolution Data Integrity Communication Problem Solving

Ops Admin

Towers Watson

Aug 2015 - Present (9 years 11 months)

Assisted customers in setting appointments for Healthcare/Medicare and made outbound calls to customers. Established positive and effective communication among unit staff and organization leadership, reducing miscommunications and missed deadlines.

Outbound Calling Communication Conflict Resolution Data Management