Raven Francis
@ravenfrancis
I’m an Expedited Appeals Expert focused on Medicare/Medicaid resolution and customer advocacy.
United StatesWhat I'm looking for
I’m a dedicated customer service and operations professional with more than 10 years of experience across healthcare, financial services, telecommunications, manufacturing, and retail environments. I’m skilled in appeals resolution, escalation resolution, customer advocacy, account management, and delivering exceptional service while meeting performance goals.
Currently, I serve as an Expedited Appeals Expert / Tier 2 Expert at UnitedHealthcare (Remote), reviewing and processing Medicare and Dual Eligible (Medicare/Medicaid) member appeals. I communicate with members, providers, and internal departments, maintain accurate case documentation, support Tier 1 advocates with guidance and escalation support, and coordinate follow-ups to support member care.
Experience
Work history, roles, and key accomplishments
Reviewed and processed Medicare and Dual Eligible (Medicare/Medicaid) member appeals, coordinating with members, providers, and internal teams to obtain required documentation. Maintained detailed case records, supported Tier 1 advocates with escalations, and met performance goals through coaching and feedback.
Weaver (Loom Operator)
BGF Industries
Aug 2021 - Oct 2023 (2 years 2 months)
Operated and monitored 20+ weaving looms while completing quality inspections and maintaining production standards. Followed workplace safety procedures to ensure efficient operations.
Bank Teller
BB&T
Oct 2020 - May 2021 (7 months)
Processed deposits, withdrawals, transfers, cashier's checks, and money orders while assisting customers with account maintenance and banking services. Balanced cash drawers accurately and handled confidential customer information.
Customer Service Representative
Ply Gem
Jan 2019 - Oct 2020 (1 year 9 months)
Assisted customers with orders, account inquiries, and order tracking, processing transactions to support accurate, timely fulfillment. Maintained confidentiality of customer information and ensured responsive service.
Education
Degrees, certifications, and relevant coursework
University of Phoenix
Bachelor of Science in Business Administration, Human Resources
2023 -
Currently pursuing a Bachelor of Science in Business Administration with a concentration in Human Resources.
Gretna High School
High School Diploma, High School
Earned a High School Diploma in 2012.
Tech stack
Software and tools used professionally
Availability
Location
United StatesAuthorized to work in
Job categories
Skills
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