Experience

City of Pittsburgh, Department of Personnel & Civil Service Commission
• 1 - 100 Employee
• Human Resources Specialist

  • Mar 2022 - Present


Allegheny Health Network

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

• Pre-Service, Insurance Verification

  • Dec 2018 - Mar 2021

  Essential Duties and Responsibilities• Ensures accurate, timely, and thorough documentation and completion of all necessary paperwork, according to established standards.• Ensures accurate and timely data entry into the EPIC system for each patient, according to established standards.• Utilizes telephone voice response systems and website solutions to obtain information on patients' eligibility status with insurance companies.• Works with patients to obtain complete and correct insurance information, discusses eligibility results and alternative payment methods.• Properly analyzes various payor eligibility responses to find the information needed to complete verifications.• Obtains and confirms insurance pre-authorizations when necessary.• Follows all HIPAA, compliance, privacy and confidentiality standards.• Maintains patient confidentiality at all times.• Demonstrates professionalism and courtesy to patients, families/guests and other team members.• Communicates clearly and effectively.• Communicates with vendors, patients, referring physicians, co-workers and all team members in a courteous and professional manner.• Provides thorough and accurate information to all callers.• Maintains self-control when dealing with difficult patients and/or situations. Involves manager or team leader when necessary.• Completes all paperwork in a timely and accurate manner.• Promotes a positive and supportive relationship with referring community and fellow employees.• Performs other duties as assign Show less

• Call Center Representative

  • Sep 2017 - Dec 2018

  Upheld AHN and Highmark standards of great customer service, created an excellent patient experience, while performing the daily task of scheduling ones for Primary Care Physician appointments. Doing so on a daily average of 70 calls. Utilized EPIC to perform said daily tasks.


Kuhns deli HighWood
• Deli Cook

  • Aug 2017 - Sep 2017


Goehring, Rutter & Boehm

• Call Center Data Tech

  • Jun 2017 - Aug 2017

  This temporary assignment offered a wealth of experience in a short period of time, to be taken away and use to enhance my career path. This temporary assignment offered a wealth of experience in a short period of time, to be taken away and use to enhance my career path.



UPMC Health Plan

• United States
• Insurance
• 700 & Above Employee

• Technical Specialist

  • Feb 2005 - Jul 2016

  Technical Specialist Jan. 2013 – July 2016 • Troubleshooter for request concerning computer system issues negatively effecting claims. • Assisted in developing an Access Database used in acquisition of The New Pittsburgh Children’s Hospital. • Oversaw and coordinated network designs while managing and maintaining multi-million-dollar Vendor and Member accounts. • Analyzed, designed, and implemented communications solutions necessary for successful transition of accounts. Team Leader Jan. 2009 – Dec. 2012 • Lead a team of ten in designing a tailor-made application implemented by local hospitals. • Motivated team staff members to accomplish deadlines, while boosting productivity by 70% in the role of Project Manager. • Discovered training needs of team staff members and provided Agile coaching. Show less



Highmark Blue Cross Blue Shield

• United States
• Insurance
• 300 - 400 Employee

• Claims Adjuster

  • Feb 2000 - Feb 2005

  • Exercised acute attention to detail in processing claims. • Proficient awareness of commercial and institutional claims; coordination of benefits; including Medicare\Medicaid insurance plans. • Thorough knowledge of medical claims payment policies and procedures as related to medical claims payments and adjustments. • Exercised acute attention to detail in processing claims. • Proficient awareness of commercial and institutional claims; coordination of benefits; including Medicare\Medicaid insurance plans. • Thorough knowledge of medical claims payment policies and procedures as related to medical claims payments and adjustments.