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Click here or scroll down to respond to this candidateCandidate's Name
Street Address NW 18TH AVENUE #204DELRAY BEACH, FLORIDA Street Address
EMAIL AVAILABLEPHONE NUMBER AVAILABLE or PHONE NUMBER AVAILABLEOBJECTIVEOpportunity with an organization that expects and rewards resultsQUALIFICATIONS:EXPERIENCE:HUMANA - BOCA RATON, FLCare Manager Support II 2018 presentAssist Care Managers with DCF notification for members, preparing 701B's for delivery to CARES on time to prevent state penalties. Processing of 2515/2506 to DCF and contacting hospitals as to admissions and discharges to SNF, HOME, REHAB or EXPIRATION of members, termination/confirmation of member services and scheduling.Authorization Data Analyst 2016 2018Working with care managers to process plan of care and 2515/2506 forms, contact Primary care Physicians and Department of Children and Family services for Humana members while trying to stay within Humana compliance.AEC / HUMANA DELRAY BEACH, FLMedicaid/Billing Specialist 2014 2016 Consists of accounts receivables. Making sure that long term care/Long term capitation payments are applied or taken back for services rendered or not and if correct payments were applied in conjunction with the state. Downloading/uploading of 834's, typing/printing of letters that may have to be sent to members due to moving to different regions, out of state or re-instatement. Making updates to member files in Silverlining regarding changes in health coverage or enrollment/disenrollment, printing reports regarding monthly member enrollments and checking to see if there are multiple Medicaid/Personal Identification numbers or overlapping of enrollment dates.Claims Processor 2009 2013 Entering contract and non-contract claims for processing. Auditing and corresponding with the care managers and providers concerning discrepancies.ATLANTIC JET SUPPORT-COCONUT CREEK, FLAccounting Manager / 2007- 2009 (Lay Off.) Manager for all AP/AR functions. Which consists of making all payments and receiving payments via mail or wire transfers, reconcile invoices and credit cards, sending invoices, checks and statements via federal express or email, printing and posting of payments received and post to correct distribution account. Correct repair orders and invoice amounts via receiver reconciliation also received invoices and worked on sales quotes.ACXESS / INNOVATIVE SOFTWARE TECHNOLOGY-BOCA RATON, FLAccounting/Office Assistant 2006-2007 (Company Relocated toTexas) Responsible for the pickup of mail and shipment of packages also the booking of invoices into Quick Books and processing of checks to be mailed or distributed within the company. Directing calls to the appropriate extension and in charge office supplies.PEACHTREE SETTLEMENTS-BOCA RATON, FLData Entry Operator 2005-2006 (After Relocating from Chicago)Responsible for data processing of various business and statistical/medical data for market leading financial services organization.SYSCO FOOD SERVICE-CHICAGO INC. DES PLAINES, ILAccounts Payable Associate 2004-2005 (I Relocated to Florida.) Processing of mail to be entered into the system for payment, making sure invoices are signed by different departments managers and matching invoices with POs. Coding invoices to GL accounts, applying discounts and vouchering invoices in the system for payment. Also printing invoices and EDIS to attach with checks processed to be sent to vendors, creating spreadsheets as to which vendors need to be paid immediately and creating general ledger numbers and short names for vendor invoices that will be scanned into the system and working on claim reports and also journal entriesEDUCATION:ROBERT MORRIS COLLEGE CHICAGO, ILAssociate in Applied Science 1987Computerized Business SystemsSOFTWARE: Windows 95, 98, 2000, 11, NT and XP, 10. Novell, Excel, Word, Access, Lotus Notes, AS400, Outlook, Oracle, Liberty, Quick Books Pro, Quantum, AECAS, Q, Mevsnet, Silverlinings, FLMMIS, AR, Paris, Medicaid Reconciliation and Customer Care Portal 2 (CCP2) and CGX.REFERENCES AVAILABLE UPON REQUEST |
