Experience

Care Design New York

• United States
• Individual and Family Services
• 200 - 300 Employee

• Benefits and entitlement specialist

  • Jun 2018 - Present



Shields Consulting

• Company Owner

  • Jun 2018 - Present



MedData

• United States
• Hospitals and Health Care
• 400 - 500 Employee

• Patient Advocate

  • Nov 2016 - Jul 2017



Chamberlin Edmonds

• United States
• Hospitals and Health Care
• 200 - 300 Employee

• Heathcare Representative

  • Feb 2012 - Apr 2016



NCO Financial Systems

• Financial Services
• 700 & Above Employee

• Patient Advocate

  • Oct 2009 - Feb 2010

  Traveling liasion in Capital District hospitals working with uninsured patients. Determine eligiblity and oversee application process for Medicaid, CHP and FHP. Traveling liasion in Capital District hospitals working with uninsured patients. Determine eligiblity and oversee application process for Medicaid, CHP and FHP.



Fidelis Care

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

• Marketing Representative

  • Feb 2007 - Jan 2010

  Sole designee and FE for Medicaid & CHP & FHP assigned to St Marys Hospital, Troy, NY. Coordinated with hospital staff to provide financial assistance to qualifying patients; screened potential applicants and communicate requirements of eligibility via home visit, local healthcare providers office or at St. Marys hospital. Requested, verified and proofed supporting documentation. Roving Marketing Representative for Rensselaer County; actively supported and promoted Fidelis’ mission. Sole designee and FE for Medicaid & CHP & FHP assigned to St Marys Hospital, Troy, NY. Coordinated with hospital staff to provide financial assistance to qualifying patients; screened potential applicants and communicate requirements of eligibility via home visit, local healthcare providers office or at St. Marys hospital. Requested, verified and proofed supporting documentation. Roving Marketing Representative for Rensselaer County; actively supported and promoted Fidelis’ mission.



Wellpoint Anthem

• Insurance
• 700 & Above Employee

• Medical Representative

  • Jan 2004 - Jan 2007

  Coordinated inquiries for pre-determinations; insurance authorizations on behalf of Physicians, Hospitals and Members; review all pertinent insurance information to establish whether or not procedures were medically necessary; authorize procedures within the scope of plan’s coverage; and conduct applicable and necessary medical coding related to all inquiries. Coordinated inquiries for pre-determinations; insurance authorizations on behalf of Physicians, Hospitals and Members; review all pertinent insurance information to establish whether or not procedures were medically necessary; authorize procedures within the scope of plan’s coverage; and conduct applicable and necessary medical coding related to all inquiries.