Experience

Little Flower Children and Family Services of New York

• United States
• Non-profit Organizations
• 100 - 200 Employee

• Assistant Residence Manager

  • Oct 2017 - Present

  Collaboratively with the Clinical team and Program Director ensuring residents needs are met, provided supervision of individuals’ supports, maintenance of assigned programs, and implementation of individual service plans. Assisted individuals with developmental disabilities in attaining their needs, desires, and dreams through a person-centered planning focus. Assured high-quality services by providing an environment that is conducive to their welfare of the individuals and in accordance with federal, state, local, and organization regulations and policies.



AABR, Inc.

• United States
• Individual and Family Services
• 100 - 200 Employee

• Medicaid Service Coordinator

  • Sep 2015 - Aug 2017

  Assessed the needs of an individuals’ eligibility for enrollment in OPWDD and Medicaid related program and services. Assisted the individual in making informed choices that benefit the person. Provided translation and interpretation of services. Developed written correspondences and ensured documentation of services. Maintained the individual confidentiality of needs and services requested. Planned and facilitated monthly billable contacts with individuals, advocates and service providers to meet Medicaid Service Coordination regulations, determined unmet needs, review and evaluated service requests. Met annually at individual’s primary residence and semi-annually at individual’s day program and/or group residence. Maintained caseload for 40 assigned individual the agency supported including medical and clinical documentation. Completed applications, and/or gather additional required paperwork in a timely and complete manner.



AgeWell New York

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

• Provider Relations Representative

  • Apr 2015 - Sep 2015

  Worked closely with Provider Relations team in the maintenance of Age Well provider database. Operated as liaison with large provider organizations, IPAs, hospital physician group administrators and internal departments. Oversaw provider information updates in proprietary systems and directories. Monitored and resolved provider issues received through internal tracking. Initiated research to obtain information on requests or complaints. Assisted in auditing provider database to ensure integrity of provider data. Performed data entry, ran reports and update information in proprietary systems. Maintained the master in-network provider logs. Communicated with the provider network telephonically and through email as needed.



Aerotek

• Musicians
• 1 - 100 Employee

• Office Administrative Assistant

  • Oct 2014 - Mar 2015

  Performed administrative duties which included: managing Outlook calendars, maintenance of confidential and personnel files, delegating all incoming and outgoing emails, scheduling and prepared for weekly meetings with Management Staff and Care Team. Performed administrative duties which included: managing Outlook calendars, maintenance of confidential and personnel files, delegating all incoming and outgoing emails, scheduling and prepared for weekly meetings with Management Staff and Care Team.



HealthCare Partners, New York

• United States
• Hospitals and Health Care
• 100 - 200 Employee

• Administrative Office Assistant

  • Oct 2014 - Mar 2015

  Assisted the Appeals & Grievances Department; Addressed concerns submitted by members, appointed representatives and providers. Coordinated day to day administrative operations; assisted with the process for submission, intervention and resolution of appeals, grievances, and /or complaints from Health Care Partners members and related outside managed care agencies. Responded to complaints, grievances and appeals in a consistent fashion, adhering to all regulatory, accreditation and internal processing timelines and guidelines. Collect, analyze and interpret trend information to address and resolve non-routine business-related concerns. Report findings to the appropriate business and functional areas.



MJHS

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

• Contract Specialist

  • Jan 2013 - Sep 2014

  Assisted in contracting, network management and credentialing efforts to build and maintain a cost effective accessible provider network of PCPs, specialists, hospitals and ancillary providers. Coordinated network provider applications and the re-credentialing process. Review and verified submitted contract information to ensure correct entry into system, accurate preparation, and compliance with operations policies and procedures. Met tight deadlines for contract processing to ensure subsequent cross-departmental processes are initiated within their required timeframes. Assisted with data entry in the credentialing database, running weekly reports, updating and obtaining expiring documents. Responded to re-credentialing requests; Resolved issues related to contracting, credentialing, managed care participation, claims payment, demographic changes, referrals and accessibility. Served as liaison between network physicians, third-party vendors and interdepartmental staff providing operational support.