Billing and credentialing coordinator

• Nov 2022 - Present

Sales Development Representative

• Jan 2023 - Present

Regulatory Ops - Coordinator

• Jun 2020 - Present

● Review cases received in A&G and assign appropriate coordinators for research and processing. ● Verify members are currently active in the system prior to assigning cases. ● Sending out correspondences to members regarding their concerns being received. ● Review cases received in A&G and assign appropriate coordinators for research and processing. ● Verify members are currently active in the system prior to assigning cases. ● Sending out correspondences to members regarding their concerns being received.

Billing Supervisor

• 2017 - 2018

● Responsible for office administrative, compliance, payroll, and Medicare audit submission. ● Responsible for monitoring products and ensuring the products are available for patients. ● Manage the facility daily to ensure it is kept up to par and operations run smoothly. ● Responsible for office administrative, compliance, payroll, and Medicare audit submission. ● Responsible for monitoring products and ensuring the products are available for patients. ● Manage the facility daily to ensure it is kept up to par and operations run smoothly.

Credentialing Coordinator

• 2016 - 2017

● Responsible for updating and maintaining provider contracts. ● Responsible for keeping credentialing and re– credentialing providers updated with policies. ● Responsible for monitoring licensure and eligibility for providers within specific time frames prior to Re submitting for contracting. ● Responsible for updating and maintaining provider contracts. ● Responsible for keeping credentialing and re– credentialing providers updated with policies. ● Responsible for monitoring licensure and eligibility for providers within specific time frames prior to Re submitting for contracting.

Cerritos

• 2015 - 2016

Grievance and Appeals Start-up for members cases. Manage caseload for members and submit outreach to business partners, and Care Centers. Send Acknowledgement, Written Responses requests, Quality review requests, and closure letters to members in written correspondence and more. Grievance and Appeals Start-up for members cases. Manage caseload for members and submit outreach to business partners, and Care Centers. Send Acknowledgement, Written Responses requests, Quality review requests, and closure letters to members in written correspondence and more.

Appeals & Grievance Coordinator/Member Services

• 2012 - 2015

(Received AARP, Medicare Complete, and Secure Horizons member complaints. Monitor Case Load and ensure to close out each case by CMS guidelines. Prioritize according to urgency to ensure a case does not go out of compliance. Responded to all members’ grievance and appeal concerns in written letter format, insurance eligibility review, answer phone calls, computer systems review, supplies etc.) (Received AARP, Medicare Complete, and Secure Horizons member complaints. Monitor Case Load and ensure to close out each case by CMS guidelines. Prioritize according to urgency to ensure a case does not go out of compliance. Responded to all members’ grievance and appeal concerns in written letter format, insurance eligibility review, answer phone calls, computer systems review, supplies etc.)

Party Host

• Feb 2006 - Aug 2014