Experience

MCMC

• United States
• Hospitals and Health Care
• 1 - 100 Employee

• Client Relationaship Coordinator

  • Oct 2018 - Present

  •Audits work for accuracy, makes necessary corrections to ensure thoroughness •Assists with assigning incoming cases •Completes daily reminders to case reviewers to ensure timely completion of cases •Makes calls as needed to ensure work product is as expected including scheduling as required •Follows up by phone to ensure client satisfaction. •Helps investigate client's problems and finds solutions. •Monitors all systems and reports to ensure all cases are being processed timely. •Act as first point of contact for team members when attempting to resolve and triage issues. • Manages reporting needs as assigned. •Completes QC review of each case upon the report submission by the reviewer prior to the case being submitted for closure •Maintains due list and follows up with reviewers who have past due cases



State of Florida

• Government Administration
• 700 & Above Employee

• Medical Disability Examiner

  • Jun 2016 - Oct 2018

  • Researches, develops, compiles, analyzes, and renders independent decisions relative to Social Security Disability Insurance, Supplemental Security Income and/or Medically Needy disability claims filed in the State of Florida. • Electronic Case Management is conducted utilizing multiple computer screens and typed case notes. • Inputs appropriate transactional processes in cases from beginning to closure, reviewing computer generated alerts to ensure timely processing • Maintains records and other reading materials related to services or benefits. • Plans, organizes and coordinates work assignments • Utilizes effective verbal communication skills and telephone techniques to develop and/or establish necessary factual medical and vocational documentation • Evaluates a variety of documents to determine their evidentiary sufficiency for decision-making purposes. • Evaluates data for accuracy and completion. • Authorizes purchase of specialized medical or psychological diagnostic services, when appropriate, for the purpose of documenting the severity of impairment. • Secures medical evidence of record needed to document the presence of "disabling" or "not disabling" impairments. • Identifies errors or problems and takes appropriate action. • Conducts fact -finding research. • Renders a formal decision of disability based on evidentiary requirements of Social Security law rules and regulations. • Understands and applies rules, regulations, policies and procedures relating to services and benefits



Dental Care Alliance

• Medical Practices
• 500 - 600 Employee

• Insurance Coordinator

  • Jun 2015 - Jun 2016

  • Verifies patient insurance benefits and inputs benefits into the electronic record system • Collects and processes payments from patients • Presents treatment plans to patients with the financial breakdown of needed treatment • Completes and maintains daily check and cash deposits • Processes bulk and individual insurance payments and post to patient accounts • Reviews outstanding AR reports and submits patient bills for printing and mailing • Completes patient referrals to specialists outside of the practice for fax, email, or mail • Inputs outside referrals from other providers into patient profiles •Assists patients with questions and concerns regards their financial account as well as their dental treatment planning • Answers phone calls related to all billing, insurance and account questions •Lowered the overall AR under the goal limits within 6 months of employment with the practice •Transcribed doctors medical notes during patient exams and procedures



Modern Periodontics

• United States
• Wellness and Fitness Services
• 1 - 100 Employee

• Insurance Coordinator

  • Jun 2014 - Jun 2015

  • Verifies patient insurance benefits and inputs benefits into the electronic record system • Collects and processes payments from patients • Presents treatment plans to patients with the financial breakdown of needed treatment • Completes and maintains daily check and cash deposits • Processes bulk and individual insurance payments and post to patient accounts • Reviews outstanding AR reports and submits patient bills for printing and mailing • Completes patient referrals to specialists outside of the practice for fax, email, or mail • Inputs outside referrals from other providers into patient profiles • Assists patients with questions and concerns regards their financial account as well as their dental treatment planning • Answers phone calls related to all billing, insurance and account questions • Lowered the overall AR under the goal limits within 6 months of employment with the practice • Follows up on unpaid insurance claims with various insurance companies • Submits required paperwork and documentation for the provider to obtain in network status with insurance companies • Significantly reduced the overall practice AR during my tenure • Created a new practice SOP for insurance claim submission • Trains staff on claim submission procedures and protocol • Transcribed doctors medical notes during patient exams and procedures



Aetna Life Insurance Company

• Insurance
• 700 & Above Employee

• Customer Service Representative

  • Feb 2012 - Jun 2013

  • Provides quality customer service to clients, plan sponsors, and department staff • Efficiently handles customer's written and verbal communication for the Jacksonville Service Center • Maintains a positive demeanor in interactions with both internal and external customers and constituents • Educates customers on their insurance benefits and policies • Selected as primary plan sponsor contact for several National Accounts • Handles Group Health inquires and complaints efficiently and effectively • Explains policy decisions and resolves problems on a timely basis • Develops and maintains both internal and external customer relationships



Transportation Security Administration (TSA)

• United States
• Government Administration
• 700 & Above Employee

• Transportation Security Officer

  • Jul 2010 - Feb 2012