Experience

Humana

• United States
• Insurance
• 700 & Above Employee

• Network Accuracy Professional

  • Jun 2018 - Present

  Doral, FL Liaison between CPHP and contracted health networks/medical groups (collectively referred to as health networks), facilitate effective communications, represent CPHP with contracted health networks, and promote collaborative working relationships • Assist with the development of policies, procedures and analysis of regulatory/program requirements.

• In-House Account Executive

  • May 2016 - Jun 2018

  Miami/Fort Lauderdale Area Develop strong relationships with professional organizations to create a consistent network that will generate the necessary inquiries and admissions • Develop and expand relationships with key customers and consultants, and act as main strategic contact for CPHP • Demonstrate customer-focus, solid negotiation and leadership skills, and act as a strong team player.

• Member Orientation Associate

  • Nov 2012 - May 2016

  Miami/Fort Lauderdale Area Maintain relationship between new members and the health plan by ensuring all documentation is received and upon completion of enrollment • Initiating and completing various applications specific to their enrollment regulations • Expedite emergency clinical calls as needed • Perform miscellaneous job-related duties as assigned.



Jackson Health System

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

• Sr. Patient Finance Specialist

  • Jan 2007 - Sep 2012

  Miami/Fort Lauderdale Area Verify coverage requirements, exclusions and limitations of prospective patient, and patient insurance carrier coverage • Establish liaisons with insurance companies in order to obtain verification for patient admission, and clearance for ongoing treatment. • Experience with HMO, PPO, Commercial, Marketplace, Medicare, and Medicaid insurances, and Electronic Health Records.