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Click here or scroll down to respond to this candidateCandidate's Name
EMAIL AVAILABLECell Phone: PHONE NUMBER AVAILABLEWork HistoryAmazon Flex January Street Address 2021 - December 1 2022Completed on-time deliveries by choosing best and most efficient routes. Operated vehicle safely in highly congested areas with no traffic violation. Verified daily deliveries against shipping instructions before delivering to customersLoaded truck and properly secured items to prevent damage for deliveries. DoorDash December 2 2021 - PresentDelivers high-quality products to our customers in a safe, courteous, and timely manner.Establishes and maintains outstanding relations with customers. Reviews and verifies invoices and purchase requests to ensure accuracy. Delivered food products to different locations throughout different towns in a safe, timely and accurate manner.Helped with food preparation and planning when needed. Kept delivery service vehicle and delivery area clean and organized while adhering to principles of sanitation and safety in handling food and equipment. Tonias Home Child Care. 2571 Lincoln Avenue. Cincinnati, Ohio 45231 January 2014 - December 31 2021Child Care AssistantEnsuring the children have good hygiene and changing diapers as necessary Cleaning interactive areas throughout the dayPreparing meals and snacks for the kidsOrganizing activities and developing curriculum for older children Developing a schedule for the children to maintain throughout the day Keeping records of each childs progress, interests and any problems that may occurMaintaining contact with the childrens parents and contacting them in the case of an emergencyAnthem Blue Cross and Blue Shield. 4361 Irwin Simpson Road. Mason, Ohio 45040March 1996 September 2013October 2005 September 2013Project ManagerAudited high profile quarterly reportsResponsible for leading a team of professionals in completing projects by a set deadline to uphold business initiativesCreating long- and short-term plans, including setting targets for milestones and adhering to deadlinesDelegating tasks on the project to employees best positioned to complete them Serving as a point of contact for teams when multiple units are assigned to the same project to ensure team actions remain in synergy Communicating with executives or the board to keep the project aligned with their goalsAdjusting schedules and targets on the project as needs or financing for the project changeFebruary 2003 October 2005Claims Processor IIProcess and adjust claims for Ohio Large Groups and ITS Home Plan Utilize Ultera to retrieve claimsPaid claims according to providers contractsMay 2001-February 2003Intake CoordinatorReceived inbound calls from providers, members and facilities Gather demographic information and load into database Authorize referrals for members to network physicians Ensure quality service while upholding accreditation requirements Educate callers and providers on medical management criteria March 2000 May 2001Finance AssociateAudit rates loaded in the claims processing system and compare with contractual obligations; initiate recovery process to recoup overpayment Audit the capitation payments and membership on a monthly basis and identify errors resulting in overpayments or underpaymentDevelop informational reports for all providers; analyze financial data, independently or as requested; summarize and communicate research/inquiry results effectivelyIdentify trends in specific member populations, analyze existing capitation risk arrangements and provide recommendations for future negotiations January 1999 - March 2000Provider Service RepresentativeResponsible for contracting with local physiciansProcess telephone and/or written inquiries and performing follow-up activities to ensure problem resolutionIdentify and address provider issues as they relate to customer concerns(internal and external)Credential providers to become network providers for members September 1996 - January 1999Utilization Management / Referral ProcessorReceived inbound calls from providers, members and facilities Authorize referrals for members to network providers Complete pre-certification process for member inpatient admissions Review complicated cases with nursing staff or physician reviewer for appropriate decision, communicating results to the primary care physician, specialist or external agenciesMarch 1996 - September 1996Intake SpecialistReceived inbound calls from providers, members and facilities Gather demographic data for inpatient admissionsAuthorize referrals for members to network providers Formal Education1994 Colerain High School. DiplomaSouthwestern Ohio College of Business. Degree not obtained. Courses: Medical Terminology, Communication, Clinical Research, Phlebotomy, AccountingSoftware CapabilitiesWindows 10, Windows 95/98/XP, Word, Excel, Access, PowerPoint, CC:Mail, IDX, AmiPro, MeDecision, Anthem Medical Management System (AMMS), Graphical Query Language (GQL), AS400, Nasco, Facets, Lotus Notes, ImagFlo, Ultera, Microsoft Outlook.Professional ReferenceJulia Wickens, Senior Human Resources Business Partner ATL, A Bureau Veritas Company6954 Cornell RoadBlue Ash, Ohio 45242PHONE NUMBER AVAILABLEHeather Carter, School TeacherGateway Charter Elementary1868 Grove AvenueFt. Myers, Florida 33901PHONE NUMBER AVAILABLEDeanna Degaro, Business Analyst IIIAnthem Blue Cross and Blue Shield4241 Irwin-Simpson RoadMason, Ohio 45050PHONE NUMBER AVAILABLE/pre> |
