Everett Johnson II

Experience

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  II Chronicles

  Jan 2000 - now

  Freelance Musician

  Freelance Gospel Jazz Musician, Alto Saxophone

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  Publix Supermarket

  Jan 2006 - Jan 2007

  Produce, Cashier, and Stock Clerk

  • Accountable for providing high-level, positive interactions with customers.• Data entry, cash management.• Customer service included assisting customers with shopping needs

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  Aetna

  Jan 2007 - Jan 2015

  Customer Service Representative (Dental & Disability)

  • Answers questions and resolves issues based on phone calls/letters from members, providers, and plan sponsors. Triages resulting rework to appropriate staff. Documents and tracks contacts with members, providers and plan sponsors. • Explains member's rights and responsibilities in accordance with contract. • Processes claim referrals, new claim handoffs, nurse reviews, complaints (member/provider), grievance and appeals (member/provider) via target system. • Educates providers on our self-service options; Assists providers with credentialing and re-credentialing issues. • Responds to requests received from Aetna's Law Document Center regarding litigation; lawsuits. • Handles extensive file review requests. Assists in preparation of complaint trend reports. Assists in compiling claim data for customer audits. • Determines medical necessity, applicable coverage provisions and verifies member plan eligibility relating to incoming correspondence and internal referrals. • Handles incoming requests for appeals and pre-authorizations not handled by Clinical Claim Management .• Performs review of member claim history to ensure accurate tracking of benefit maximums and/or coinsurance/deductible. Performs financial data maintenance as necessary. • Uses applicable system tools and resources to produce quality letters and spreadsheets in response to inquiries received Zobrazit méně

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  Parksimple

  Jan 2015 - Jan 2016

  Parking Attendant
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  Step Up For Students

  Jan 2016 - now

  Responsible for assisting operations management with managing the day-to-day activities in the SUFS service center department, including but not limited to: quality control, customer service delight, and ensuring all service channels are working at an optimal level. Responsible for maintaining data integrity, instilling best practices for customer confidentiality and maintaining adherence to state/federal compliance with the programs. Demands a high degree of adaptability and flexibility in a fast-paced, rapidly changing environment. Zobrazit méně Responsible for assisting operations management with managing the day-to-day activities in the SUFS service center department, including but not limited to: quality control, customer service delight, and ensuring all service channels are working at an optimal level. Responsible for maintaining data integrity, instilling best practices for customer confidentiality and maintaining adherence to state/federal compliance with the programs. Demands a high degree of adaptability and flexibility in a fast-paced, rapidly changing environment. Zobrazit méně Create, lead and manage the training program for the Operations Department. This includes, but is not limited to: the development of training content, delivery of instructor led training sessions as necessary, providing on-demand training when there is an area of weakness, planning training for a large group when updates to policies, procedures or systems are made, as well as supporting the team with continually improving processes. Support the operations team in its mission to deliver a positive and impactful training experience to the staff while ensuring documentation is always kept up-to-date. Zobrazit méně • Responsible for handling inbound and outbound calls in a call center environment from new andexisting customers regarding a variety of request.• Maintain complete and accurate records of client interaction including phone calls and/or emails,utilizing internal and external software.• Key data from application images into applicable system.• Accurately processes applications and determine eligibility by reviewing documentation andcalculating income in accordance with established guidelines.• Seek and suggest efficiencies for manual and online entry operations.• Identify processing deficiencies and initiate corrective actions by informing management.• Research and identify potential application processing issues. Zobrazit méně

  • Director, PEP

    Jan 2025 - now

  • Assistant Director, FES-EO, FTC

    Jan 2023 - Jan 2025

  • Senior Operations Manager

    Jan 2021 - Jan 2023

  • Operations Manager

    Jan 2020 - Jan 2021

  • Assistant Operations Manager

    Jan 2019 - Jan 2020

  • Learning And Development Specialist

    Jan 2017 - Jan 2019

  • Customer Resolution Specialist

    Jan 2016 - Jan 2017
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  Philippi Missionary Baptist Church - Jacksonville, FL

  Jan 2022 - now

  Senior Pastor