Sandy Thompson

• Monitored children's progress through ongoing assessments of their abilities and interests.
• Assisted in developing and implementing lesson plans to meet the individual needs of each child.
• Attended professional development workshops to stay current on best practices in early childhood education.
• Participated in parent and teacher conferences to discuss student progress or any other concerns related to childcare services provided.
• Organized and planned age-appropriate reading, crafts, and music lessons.

• Reviewed, evaluated, and determined the validity of employee grievances and appeals.

. Gathers pertinent and relevant information from the member and/or provider regarding the grievance/appeal, determines the appropriate resolution of the grievance/appeal per standard policies and procedures; and notifies the appropriate parties of the resolution and ensuring that all internal processes are completed to resolve the issue.
3. Composes written correspondence to members in accordance to plan policy and CMS Guidelines.
4. Conducts non-biased,

• Coordinated meetings with affected parties to discuss grievance issues.
• Provided guidance and advice on labor relations policies, procedures, laws, and regulations.

• Provided customer service to clients regarding their insurance claims inquiries.
• Monitored incoming calls for volume levels during peak periods in order to ensure that calls were answered promptly.
• Gathered and analyzed information from customers, evaluated claim eligibility, and completed necessary paperwork for processing.
• Assisted customers with the completion of forms related to their insurance policies or claims process.

· Research problem claims accounts, reverse and reprocess as necessary.

· Responsible to help work special projects with respect to overpayments.

· Summarize claims in excess of authority and submit to manager for approval.