Experience

Universal Health Care

• United States
• Insurance
• 100 - 200 Employee

• Authorization Specialist

  • Nov 2010 - Present

  St. Petersburg, FL  Data entry of pre-service requests and clinical information  Served as a mentor by training new team members on authorization guidelines  Notification of approved and denied authorizations to providers  Prepared and mailed patient education materials (Case and Disease Management)  Worked inbound and outbound calls pertaining to authorization guidelines

• Member Services Representative (Provider Services)

  • Nov 2010 - Present

  St. Peterburg, FL  Answered High Volume Calls in a call center atmosphere  Researched assigned ticket issues and take appropriate action to resolve and meet quality standards  Updated and maintained information in Fortuna account database  Acted as single point of contact for members and providers in order to facilitate and expedited interactions with the company  Provided knowledge of HIPPA guidelines as it pertains to inbound and outbound calls

• Member Retention Specialist

  • Nov 2010 - Mar 2013

  St. Petersburg, Florida  Answer High Volume Calls in a call center atmosphere  Complete Outbound Verification Calls for new Enrollees  Follow a book of business through their first 100 days with Universal Healthcare  Assisted nurses with transition of care (TOC) and continuity of care issues (COC) during onboarding  Extensive use of Microsoft programs such as Excel, Word, and Outlook  Educate members about preventative screenings and respond to any concern/issues.  Assist in training… Show more  Answer High Volume Calls in a call center atmosphere  Complete Outbound Verification Calls for new Enrollees  Follow a book of business through their first 100 days with Universal Healthcare  Assisted nurses with transition of care (TOC) and continuity of care issues (COC) during onboarding  Extensive use of Microsoft programs such as Excel, Word, and Outlook  Educate members about preventative screenings and respond to any concern/issues.  Assist in training new team members  Assisted credentialing with provider configuration.



State of Florida

• Government Administration
• 700 & Above Employee

• Personnel Technician I

  • Jul 2005 - Oct 2007

   Conducted new employee orientation and training  Processed and monitored Other Personnel Services (OPS) payroll  Provided employment and salary verifications  Assisted employees with benefit enrollment, time sheets, payroll and compensation  Performed classification and personnel action requests  Created on-demand checks and warrant cancellations in SAMAS.  Prepared reports by collecting, analyzing and summarizing data and trends  Prepared and maintained job… Show more  Conducted new employee orientation and training  Processed and monitored Other Personnel Services (OPS) payroll  Provided employment and salary verifications  Assisted employees with benefit enrollment, time sheets, payroll and compensation  Performed classification and personnel action requests  Created on-demand checks and warrant cancellations in SAMAS.  Prepared reports by collecting, analyzing and summarizing data and trends  Prepared and maintained job postings in state database (People First) and posted in local newspaper  Maintained disciplinary files  Conducted fingerprinting/background screenings in office by submitting to FDLE and FBI electronically.  Managed personnel files as Custodian of Records for department  Assisted with administrating HR policies and procedures  Collected and analyzed data from documents to aid management for areas of improvement (Random Moment Samplings) Show less



IIR Support Services

• Payroll Clerk

  • Jun 2003 - Jun 2005

   Processed time sheets, production records and time cards (ADP for Windows / Paychexs Software)  Updated payroll records by entering changes in exemptions, insurance coverage,  Processed employment verifications  Processed and issued annual W-2 forms to employees  Extensive use of Microsoft programs such as Excel, Word, and Outlook  Posted payroll to general ledger and maintained employee’s files  Computed payroll adjustments, benefit accounts and reconciled insurance