Experience

Health Services For Children With Special Needs

• United States
• Hospitals and Health Care
• 1 - 100 Employee

• Analyst

  • Jul 2022 - Present

• Pre-Authorization Representative

  • Aug 2018 - Jul 2022

  Review and interpret medical record documentation for patient history, diagnosis, and previous treatment plans to pre-authorize, plan and determine procedures to avoid financial penalties to patient, provider, and facility. Utilize payor-specific approved criteria or state laws and regulations to determine medical necessity or the clinical appropriateness for admissions, office services, and durable medical equipment in terms of type, frequency, extent, site and duration for DC Medicaid recipients. Accomplishment Highlights• Identified and cultivated new relationships with 6 new Physical, Speech, and Occupational Therapy providers.• Consistently requested to complete special projects and communicate with service providers. Show less



Quick Quality Fix

• Field Sales Representative & Technician

  • Jun 2015 - Aug 2018

  Cold called and visited area property managers, apartment complexes, local distributors, and home improvement stores to sign contracts for services related to professional appliance repair, installation, preventive maintenance, and service. Accomplishment Highlights • Successfully secured enough new and renewed contracts to fill 14 tech appointments per day on average. • Created website and maintained contact submission requests. Cold called and visited area property managers, apartment complexes, local distributors, and home improvement stores to sign contracts for services related to professional appliance repair, installation, preventive maintenance, and service. Accomplishment Highlights • Successfully secured enough new and renewed contracts to fill 14 tech appointments per day on average. • Created website and maintained contact submission requests.



Charlotte-Mecklenburg Schools

• United States
• Primary and Secondary Education
• 700 & Above Employee

• Middle School Mathematics Teacher & Sports Coach

  • Mar 2012 - Jun 2015

  Planned, organized, and directed General Business Principals and Computer Application lessons and activities for over 150, 6th, 7th and 8th graders. Utilized software tools such as Gaggle and Google Classroom to keep students engaged online and in-person. Coached multiple teams: Boys and Girls Track, Girls’ Basketball, and Football (Assistant Coach.) Accomplishment Highlights • Increased class scores throughout tenure: First Year: 81%, Second Year: 84%, and Third Year: 86%. • Only 1 behavior related incident in classroom throughout tenure. • Track Team Won District 2014. • Increased Girls’ Basketball average points from 4 to 28 in one season. Show less



Wells Fargo

• United States
• Financial Services
• 700 & Above Employee

• Banker

  • Aug 2010 - Mar 2012

  A leading banking institution where I answered questions and counseled Premier Banking customers as it pertained to their accounts. Lead my team in up-selling while maintaining above average customer satisfaction ratings. A leading banking institution where I answered questions and counseled Premier Banking customers as it pertained to their accounts. Lead my team in up-selling while maintaining above average customer satisfaction ratings.



KLR Insurance

• India
• Insurance

• Account Manager

  • 2008 - Aug 2010

  Insurance agency started and run by Karl Roberts (applicant) that specialized in individual Life and Health insurance products. Established and maintained relationships at multiple levels with clients, consultants, and brokers through the use of consultative skills and analysis of account needs/service requirements for health and life products throughout the Charlotte, NC Metropolitan area. Insurance agency started and run by Karl Roberts (applicant) that specialized in individual Life and Health insurance products. Established and maintained relationships at multiple levels with clients, consultants, and brokers through the use of consultative skills and analysis of account needs/service requirements for health and life products throughout the Charlotte, NC Metropolitan area.



Anthem, Inc.

• United States
• Hospitals and Health Care
• 700 & Above Employee

• Account Executive

  • 1998 - 2008

  Account Executive | Individual Markets Account Representative | Group Retention & Ancillary Sales Developed and implemented marketing strategies to effectively sell portfolio of individual, group, and Medicare HMO insurance products. Increased client satisfaction and sales through on-time delivery, resolution of issues, and value-added services. Provided leadership, training, and coaching to area producers by consistently visiting various Broker and related communities. Accomplishment Highlights • 6-Time Blue Achiever’s Recipient (exceed annual sales quota.) • Achieved 95% retention rate for Group Portfolio Products (self-insured and fully funded.) • Introduced new Medicare HMO product in Central VA, 87% close rate. • Sales Person of the Year, Runner-Up. • Retention Team of the Year, (2 Years in a Row.) • Retention Team of the Year, Runner-Up. – 2 Years. Show less