Experience

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  Belong Health

  • Albany, New York, United States

  • Community Services Care Coordinator

    • Oct 2021 - Present
    • Albany, New York, United States

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  UnitedHealth Group

  • Remote

  • Contact Tracer

    • Jun 2020 - Oct 2021
    • Remote

    Contact patients who have been diagnosed with Covid 19 and locate their contacts to try to minimize the spread. Educate patients and contacts on Covid 19 and how to reduce the spread. Accommodate patients with resources as needed.

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  Eclaro

  • 80 maiden lane manhattan ny

  • Customer Service Representative

    • May 2020 - Jun 2020
    • 80 maiden lane manhattan ny

    I worked for 311 call center. I was working the covid 19 project. I answered all covid questions. I provided information to testing sites. I set up food delivery to those who are quarantined.

• 

  Express Scripts

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

  • Client Benefits Analyst

    • Jul 2019 - Nov 2019

    The Client Benefit Analyst completes assigned operational tasks using standard appropriate tools and provides support to client requests under the direction of the Client Benefit Managers and other team members. Responsibilities include handling daily request tracking, researching operational issues and running reports for internal and external clients upon request; provide documentation related to completion of assigned tasks and identify operational or productivity enhancements. The Client Benefit Analyst will provide project and administrative support to the team and escalate issues, risks, concerns as needed.1. Provide operational support for assigned Client Markets (Commercial, Medicare, Health Plan, etc.) for going plan changes, new implementations, and renewal activity.2. Review, analyze and verify intent of assigned benefit set-ups as they relate to products and programs. Identify and communicate need for customization to support client benefit requirements; attend client calls/meetings as needed; attend internal validation meetings; run customized and scheduled reports, manage performance guarantee tracking and report distribution for internal/external clients as requested.3. Adhere to all organizational SOPs and Compliance standards; provide subject matter input as it relates to checklists and SOPs4. Assist with operation input related to new product development; identification, research and resolution of operational issues; provide training and mentoring for new team members, off-shore and contingent employee resources.5. Comply with Client document and retention requirements.

  • Customer Service Analyst

    • Jul 2019 - Jul 2019

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  Anthem, Inc.

  • Tampa/St. Petersburg, Florida Area

  • Managed Care Coordinator

    • Aug 2014 - Apr 2019
    • Tampa/St. Petersburg, Florida Area

    Coordination care for all aspects of healthcare for ~100-130 members under Florida’s MMA program including any underlying mental health and substance use•Implement efforts to improve systems and processes affecting the integration of multiple healthcare disciplines, e.g. (process improvement, risk management, patient safety, utilization review and credentialing and privileging).•Independently perform data analysis, research and resolving complex problems with success solutions•Maintain up-to-date knowledge of HIV Disease and its complications through web-based resources, trainings and other events•Retain expertise in Health Risk Assessment (HRA) assessment and stratification; additional assessments related to co-morbid conditions•Identify member medications (prescription and over-the-counter) and allergies, including drug, food, or environmental•Utilization of Interdisciplinary Care Team (ICT) approach with members and staff to include outside agencies•Regularly attend Interdisciplinary Care Team (ICT) meetings related to members currently in care based on AHCA standards •Develop, implement and assess individualized Care Plans for each member enrolled in the Care Management Program•Leverage various providers and other specialists as needed in order to coordinate all aspects of care•Attend trainings related to member medical conditions in order to maintain CEU’s and expand current learning base•Maintain knowledge for assisting members with questions related to claims, pharmacy and medical reconciliation•Experience in resolution of AHCA complaints including grievance and appeals

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  USAA

  • Tampa/St. Petersburg, Florida Area

  • Auto Claims Adjuster

    • Jan 2011 - Aug 2014
    • Tampa/St. Petersburg, Florida Area

    Investigate, settle, negotiate, and/or deny moderately complex claims. Explain coverage, and claims process. Set up appraisals for insured and claimant vehicles. Responsible for corresponding with policyholders, claimants, adverse carriers, witnesses, and attorneys to gather information for handling claims. Assist with motivating team members to achieve company goals and initiatives. Provide guidance and solutions to less experienced team members to resolve issues and provide support. Provide appropriate referrals to members based on their individual need and strong knowledge of P&C insurance industry products. Holds 6-20 Auto Adjuster insurance license in multiple states.

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  Quest Diagnostics

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

  • Billing Functional Lead

    • Sep 2008 - Dec 2011

    Compile daily reports Distribute reports to team members to ensure timely resolution Interpret and communicate procedural and billing guidelines to the team Assist in facilitating in classroom environment and group training sessions Assist with maintaining and updating departmental business rules Assisted with escalated calls and ensured they were resolved within 48 hours Performed all duties and projects that may have been assigned Mentored team members Trained new hires and existing team members Coached team regarding quality errors Provided side by side coaching Tracked and trend daily production and quality performance Proactively identify quality issues for new and existing team members Developed and implemented actions plans for improvement in conjunction with manager Exercised flexibility in changing job duties to address backlogAssisted with managing a team of 15-20 employees

  • Patient Billing Specialist II

    • Nov 2005 - Sep 2008

    Handle high volume patient phone inquiriesAssist with bill balances, payment plans, credit card payment, pricing, rebilling insurance companies, and general patient concerns.Process adjustments, refunds, transferring bills, mail returns, and manual sales.Utilize problems solving skills to resolve complex billing issues and customer complaintsMaintain tracking log of all escalated patient correspondence, providing status updates to leadership as needed.

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  JPMorgan Chase

  • Account Supervisor

    • Aug 2004 - Nov 2005

    Assisted with planning eventsEducated team members how to save accounts and updated the team with new strategies during meetings and huddles. Educated customers on products and services that the company offersAssisted customers who were dissatisfied, handling their problem with sensitivity and professionalism to retain their business.Created a bridge to sell program to assist with driving up sales in the credit card department.Assisted with other departments as needed to meet business needs.

  • Customer Service Representative/Escalation Representative

    • Nov 2000 - Aug 2004

    Handled inbound calls in a fast paced environmentCoached and motived other team members to sell products Created agenda and facilitated meetingsAssisted other departments as neededAssisted the internet team to assist online customersFacilitated meetings and training classes on new products

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  Sitel

  • Tampa/St. Petersburg, Florida Area

  • Customer Relations Manager

    • Jan 1999 - Nov 2000
    • Tampa/St. Petersburg, Florida Area

    Handled inbound callsResolved customer issues with dealerships and handled warranty questions.Created files, conducted research, and handle case issues on behalf of General Motors.Assisted on the Kana internet team to assist with research and provide customers with better options.

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  Dun and Bradstreet

  • Tampa/St. Petersburg, Florida Area

  • Customer Investigative Consultant

    • Oct 1998 - Jan 1999
    • Tampa/St. Petersburg, Florida Area

    Obtained, prepared, and interpreted information for database updateCreated and revised the business information report through phone investigations in direct response to business inquires.Met defined standard of performance

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  Dun and Bradstreet

  • Bethlehem, PA

  • Dun Support Specialist

    • Oct 1996 - Jan 1998
    • Bethlehem, PA

    Obtained, prepared, and interpreted information for database updateCreated and revised the business information report through phone investigations in direct response to business inquires.Met standard of performance using selling skills to obtain information used in reports.Facilitated Meetings