Sebrena Cannon
Inverness
Summary
Dynamic professional with a proven track record in healthcare authorization, technical support, customer service, and banking roles. Experience includes expertly navigating insurance guidelines to ensure medical necessity compliance, facilitating seamless communication among stakeholders, and maintaining meticulous records for regulatory adherence. Skilled in providing comprehensive customer support, clarifying insurance policies, and promoting banking products. Proficient in CRM systems, HIPAA compliance, and adept at handling high-volume transactions with precision and efficiency. Driven professional with a strong background in providing conflict resolution. Resourceful in gathering relevant information regarding disputes, providing appropriate documentation, and guiding both individuals and groups to reach satisfactory agreements and settle complicated issues. Devoted to adhering to ethical guidelines and laws throughout all casework.
Overview
8
8
years of professional experience
Work History
Resolution Coordinator
Walmart
Remote
11.2024 - 02.2025
- Communicated effectively with other departments regarding progress made towards resolving customer issues.
- Reviewed existing processes for resolving customer issues and proposed changes where necessary.
- Engaged in conversation with customers to understand needs, resolve issues and answer product questions.
- Navigated through computer systems to review information and respond appropriately to callers.
Coverage Review Representative
Broad path Healthcare Solutions
08.2023 - 01.2024
- Reviewed and evaluated prior authorization requests for medical procedures, medications, and services, ensuring they meet established guidelines and criteria for approval
- Liaised with healthcare providers to gather necessary clinical information, clarify authorization requirements, and provide updates on the status of prior authorization requests
- Accurately entered and processed prior authorization decisions into the healthcare system, ensuring timely and efficient handling of requests to support patient care
- Addressed and resolved any issues or discrepancies related to prior authorizations, working collaboratively with healthcare providers, insurance companies, and patients to ensure a smooth authorization process
Claims Specialist
Continuum Global Solutions
02.2021 - 08.2023
- Answered inbound calls from patients, healthcare providers, and insurance policyholders to provide information and assistance regarding the status and details of medical claims
- Clarified policy coverage, benefits, and eligibility requirements to callers, helping them understand their insurance plans and how they apply to their medical claims
- Guided callers through the process of submitting medical claims, ensuring they understand the necessary documentation and procedures required for accurate and timely submission
- Investigated and resolved any issues or discrepancies related to medical claims, such as denied claims or payment errors, by communicating with relevant parties and providing clear explanations and resolutions
Call Center Representative
Alorica
03.2020 - 01.2021
- Provided timely and accurate responses to customer inquiries via phone, email, and chat, addressing questions, concerns, and issues related to products or services
- Troubleshot and resolved customer complaints and issues, utilizing problem-solving skills and company resources to ensure customer satisfaction and effective resolution
- Accurately documented customer interactions, inquiries, complaints, and resolutions in the company's customer relationship management (CRM) system to maintain comprehensive and up-to-date records
- Stayed informed about product updates, company policies, and industry trends to provide accurate information and support to customers, ensuring a high level of service and professionalism
Bank Teller
Planters Bank
Indianola
07.2017 - 03.2020
- Accurately processed a variety of financial transactions, including deposits, withdrawals, transfers, and payments, ensuring compliance with bank policies and procedures
- Provided exceptional customer service by addressing customer inquiries, resolving issues, and offering assistance with banking products and services, ensuring a positive customer experience
- Verified cash amounts, maintain cash drawer limits, and balance the cash drawer at the end of each shift to ensure accurate accounting and prevent discrepancies
- Identified customer needs and promote relevant bank products and services, such as savings accounts, loans, and credit cards, contributing to the bank's sales goals and customer satisfaction
Education
High School Diploma -
Gentry High School
Indianola, MSSkills
- Customer Support Expertise
- Customer Engagement Calls
- Zendesk Proficiency
- Slack
- Salesforce
- Insurance Authorization Management
- Accurate Data Entry
- Claims Management
- Skilled in Prioritizing Tasks
- Medical Terminology Proficiency
- HIPAA Regulation Adherence
- Production Expertise
- Computer Navigation Proficiency
- Experience calculating and formulating billing amounts
- Proficient in claims management software and healthcare information systems
- Strong knowledge of medical coding and billing processes (CPT, ICD-10, HCPCS)
- Excellent analytical and problem-solving skills
- Exceptional attention to detail and accuracy
- Effective written and verbal communication abilities
- Demonstrated Empathy
- COBRA Compliance Expertise
- Efficient in Task Execution and Organization
- Effective Multitasking
- Skilled in Microsoft Excel
- Google Sheets
- CRM platforms
- Database Management Expertise
- Problem-solving abilities
References
References available upon request.
Timeline
Resolution Coordinator
Walmart
11.2024 - 02.2025
Coverage Review Representative
Broad path Healthcare Solutions
08.2023 - 01.2024
Claims Specialist
Continuum Global Solutions
02.2021 - 08.2023
Call Center Representative
Alorica
03.2020 - 01.2021
Bank Teller
Planters Bank
07.2017 - 03.2020
High School Diploma -
Gentry High School
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