Experience

Veterans Home Of California

• United States
• Government Relations Services
• 1 - 100 Employee

• Staff Services Analyst

  • May 2020 - Present

  • Prepare Month-End Pre-Billing for submission to the Headquarters Medical Billing andCost Recovery Unit by initiating, monitoring, reviewing, correcting and concluding thepreparation of pre-billing processes utilizing an electronic financial system• Provide Medicare Part A Stay information to the (AGPA-R) for triple-check monthly meetings toensure accuracy and claim submission approval. Compile and post ancillary, pre-billingcharges for compliance with Medicare Part A stays, HMO billing, and invoicing of Hospice services. • Enter information into the electronic financial system, make corrections as needed to pay sources and flags to facilitate the monthly medical billing process. Research Medicare and Medi-Cal claimdenials, correct errors, and provide documentation necessary for claims approval toensure maximum revenue and reimbursement• Collect and analyze resident financial records for accurate assessment for application of Medi-Cal benefits, apply specific laws, rules, and policies governing the California Veterans Homes, Medicare, and MediCal programs• Responsible for health insurance verification, identifying uninsured applicants and residents, and advising applicants and residents and their responsible parties of their insurance enrollment eligibility. Perform an initial analysis of admission applications to verify all required insurance and financial information is included prior to application approval• Monitor resident’s health insurance coverage, verify health insurance enrollment, and advise residents and their responsible parties on enrollment eligibility. File for or assist residents and theirresponsible parties with applications for various benefits, such as, Social Security, MediCal, and Medicare (A,B, & D)• Maintain an understanding of various federal veteran benefits as they apply to fees assessed and collected by the Home• Maintain current resident health insurance information• Track monthly collection of delinquent fees



Paradise Valley Hospital

• Hospitals and Health Care
• 300 - 400 Employee

• Utilization Review Technician III

  • May 2019 - Present

• Utilization Review Coordinator

  • Jul 2018 - Present

  • Review level of care, length of stay, and readmission rates by completing monthly UR reports for the hospital (Reports include: Inpatient ALOS, over LOS, ALOS by MD, inpatient reviews, ADM patient days, ADM admissions, ADM discharges, GMLOS by MD, readmission rates, and readmission rates by MD)• Review and update insurance authorizations daily on Meditech, Sharepoint, and Insurance Auth Tool• Complete insurance authorizations for HMOs, calling and faxing insurance companies for authorization approvals and denials, contact liaisons for denials and peer to peer• Complete case management/discharge planning/coordination of care interview for newly admitted patients• Monitor daily Congestive Heart Failure (CHF) patients and maintain CHF compliance with Corporate by setting up hospital follow-up appointments• Assist social work with monitoring homeless and psych patients daily by setting-up hospital follow-up appointments • Awarded: 2019 Get With The Guidelines - Stroke Silver Plus Quality Achievement Award



AMN Healthcare

• United States
• Staffing and Recruiting
• 1 - 100 Employee

• Credentialing Coordinator

  • Jun 2018 - Jul 2018

  • Complete client, state, and online applications on behalf of providers’ and assist in reviewing requirements including licensure, certifications, screens and other critical documents• Communicate professionally in a timely manner using various mediums of communication such as email, phone, or internal communication mediums such as notes to facilitate a team approach to gathering all required documents• Collaborate with Credentialing Analysts to review all incoming new client requests or contract revisions for Credentialing requirements, for assigned facilities in order to identify unique requirements.• Provide administrative support to the Credentialing Analysts teams by completing check requests, scheduling drug screens, completing followup calls, creating FedEx labels, etc.



Autism Learning Partners

• United States
• Individual and Family Services
• 700 & Above Employee

• Behavior Technician

  • Dec 2016 - May 2018

  • Utilize Applied Behavior Analysis techniques to support individuals diagnosed with Autism Spectrum Disorder and other developmental disabilities• Design and practice treatments to clients from ages 1-18 years old• Collect data on child’s progress in targeted areas• Awarded Behavior Technician of the Month • Utilize Applied Behavior Analysis techniques to support individuals diagnosed with Autism Spectrum Disorder and other developmental disabilities• Design and practice treatments to clients from ages 1-18 years old• Collect data on child’s progress in targeted areas• Awarded Behavior Technician of the Month



CSUSM Hope and Wellness Center

• Peer Educator

  • Jul 2017 - Dec 2017

  • Collects demographic information and evaluation forms from all training and program participants and compiles these statistics appropriately, adjusting presentations based upon participant feedback.• Assist with marketing and promoting health-related programs and SHCS• Assist with planning and implementing the Health Fair, Great American Smokeout, World AIDS Day, Breast CancerAwareness, and other health activities.• Work collaboratively with all members of the Healthy Cougars (PAWS) program, SHCS Staff• Continually update personal health knowledge



RB Sushi

• United States
• Food and Beverage Services
• 1 - 100 Employee

• Hostess

  • May 2015 - Dec 2016

  • Handle customer's special inquiries confidently and effectively• Provide friendly, fast, and attentive customer service to all guests• Responsibly handle cash and card information • Assist and offer help to other team members to ensure the restaurant runs smoothly• Train new coming hostess on restaurant's safety protocols and guest service expectations• Organize and manage small and large scale reservations and keep guests informed on waiting time • Handle customer's special inquiries confidently and effectively• Provide friendly, fast, and attentive customer service to all guests• Responsibly handle cash and card information • Assist and offer help to other team members to ensure the restaurant runs smoothly• Train new coming hostess on restaurant's safety protocols and guest service expectations• Organize and manage small and large scale reservations and keep guests informed on waiting time



WET SEAL RETAIL INC

• United States
• Retail
• 1 - 100 Employee

• Sales Associate

  • Nov 2014 - Jan 2015

  • Answer questions regarding store and merchandise• Computer sales prices, total purchase and receive and process cash or credit payment• Greet customers and ascertain what each customer wants or needs• Maintain knowledge of current sales and promotions, policies regarding payment and exchanges, and security practices • Recommend, select, and help locate or obtain merchandise based on customer needs and desires• Responsible for cleanliness of store • Answer questions regarding store and merchandise• Computer sales prices, total purchase and receive and process cash or credit payment• Greet customers and ascertain what each customer wants or needs• Maintain knowledge of current sales and promotions, policies regarding payment and exchanges, and security practices • Recommend, select, and help locate or obtain merchandise based on customer needs and desires• Responsible for cleanliness of store



MWR Aquatics

• Pool Attendant

  • May 2010 - Aug 2010

  • Responsible for organizing files and answering phone calls• Provide assistance to customers• Maintain the cleanliness of the pool and work environment• Monitoring swimmers in the pool • Responsible for organizing files and answering phone calls• Provide assistance to customers• Maintain the cleanliness of the pool and work environment• Monitoring swimmers in the pool