Experience

Devoted Health

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

• Claims Operations

  • Nov 2018 - Present

  Waltham, MA



Conduent

• United States
• IT Services and IT Consulting
• 700 & Above Employee

• Senior Recovery Analyst

  • Oct 2018 - Nov 2018

  Greater Boston Area

• Recovery Analyst

  • Apr 2015 - Nov 2018

  Greater Boston Area As a Recovery Analyst I performed on site credit balance audits at hospitals in Massachusetts, New Hampshire, and Vermont for our clients. Conduent's clients include health insurance companies such as Blue Cross of Massachusetts, Tufts Health plan, Neighborhood Health Plan, and Cigna Healthcare. During our audits we analyze claim reports to identify trends and recover overpayments made by our clients. We apply legal principles and practices of subrogation to maximize recoveries and coordination… Show more As a Recovery Analyst I performed on site credit balance audits at hospitals in Massachusetts, New Hampshire, and Vermont for our clients. Conduent's clients include health insurance companies such as Blue Cross of Massachusetts, Tufts Health plan, Neighborhood Health Plan, and Cigna Healthcare. During our audits we analyze claim reports to identify trends and recover overpayments made by our clients. We apply legal principles and practices of subrogation to maximize recoveries and coordination of benefits (COB) practices to minimize overpayment.



UnitedHealth Group

• Hospitals and Health Care
• 700 & Above Employee

• Care Manager/ Sr. Clinical Administrative Coordinator

  • Jun 2013 - Apr 2015

  Waltham, MA As a Care Manager I'm responsible for welcoming new members to our plan by reviewing their benefits and by asking them health question to learn how to serve them better. I also have a case load of low need members that I check in with every 3 to 6 months.I keep track of member's medications, diagnoses and help hem navigate their plan. Member requests range from getting them to an in network doctor in their area to helping facilitate an authorization for an uncovered medication or procedure. I… Show more As a Care Manager I'm responsible for welcoming new members to our plan by reviewing their benefits and by asking them health question to learn how to serve them better. I also have a case load of low need members that I check in with every 3 to 6 months.I keep track of member's medications, diagnoses and help hem navigate their plan. Member requests range from getting them to an in network doctor in their area to helping facilitate an authorization for an uncovered medication or procedure. I work closely with other departments to make sure that all my members information is up to date and that their needs are being met. I had the opportunity to work on multiple projects as well. I was my team's liaison for our Flu Campaign that helped get our members vaccinated for the flu season. I also worked on building a performance incentive program for our team. Show less



Fallon Health

• United States
• Insurance
• 700 & Above Employee

• Member Service Representative

  • Mar 2013 - May 2013

  Worcester, MA We address member and provider inquiries received through Fallon Community Health Plan’s 1-800 numbers. We serve as the primary liaison for our members to obtain the information or support they need. Our main responsibility is to address and resolve member/provider concerns and servicing issues.We also Identify and communicate trends that are indicative of enterprise service issues.



Goji

• Insurance
• 1 - 100 Employee

• Insurance Representative

  • Feb 2013 - Mar 2013

  Westboro, Ma Consumer United is a venture backed start up company of over 100 professionals founded in 2007. We are focused on being the country’s biggest consumer web organization that allows individuals to find rates, coverage and companies that best fit their personal insurance needs. Our main product lines are Auto and Home Insurance.



eHealth, Inc.

• United States
• Insurance
• 700 & Above Employee

• Medicare Sales Agent

  • Jun 2012 - Jan 2013

  Maynard, MA We drive sales and revenue by assisting customers in making healthcare decisions over the phone, we are expected to meet monthly sales and performance goals, We remain current on products and processes in a multi-product environment, We abide by the Centers for Medicare and Medicaid Services (CMS) Medicare Marketing Guidelines and company policies and procedures, and make outbound calls to follow up on and close business.



Casa Esperanza Community Center

• Non-profit Organizations
• 1 - 100 Employee

• Development Associate

  • Jun 2011 - Apr 2012

  Roxbury, MA Address key short term and long term fundraising needs and ensure smooth and effective administrative functioning of the development department, including assisting in implementing quality assurance measures.



Casa Esperanza Community Center

• Non-profit Organizations
• 1 - 100 Employee

• Intern

  • Nov 2010 - Mar 2011

  Roxbury, MA I assisted with filling out MBHP billing forms, advocating for additional sessions for clients, filing and organizing client documents. I also taught GED classes and assists in ESL classes.