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Click here or scroll down to respond to this candidateCandidate's Name , AS, BSHCS, MBA, DMDoctor of ManagementLeadership & Organizational ManagementStreet Address
Cellular: PHONE NUMBER AVAILABLEEmail: EMAIL AVAILABLESummaryHealthcare Services Professional who effectively resolves complex claims, demographic and contracting issues in a high volume, fast paced environment, improving customer satisfaction and fostering continued business. Demonstrated ability for creating a harmonious work environment that inspired a team spirit and increased productivity.Online Adjunct Certified Advanced Facilitator for higher learning education, teaching, evaluating, and grading pre-graduates and graduate students seeking multiple degrees in the School of Business, Healthcare, Management, HPI courses, and General Education.Life & Health 218 Independent Insurance Agent catering to the Senior Market Medicare, Life, Annuities, Critical Illness, and AD&D plans, #219 Variable Annuities Independent AgentNotary Public, State of Florida (active)AccomplishmentsAdvanced Certified Online Adjunct Instructor for higher learning education; preparing pre-graduate and graduate students with knowledge and skills, to enhance and improve academic skills and future careersMarketing hurricane claim losses (temporary position)Directed the successful cleanup of projects for hospitals, hospital-based groups, and participating providersExpedited HEDIS regulatory requirement status with participating providers that ensured regulatory complianceNegotiated Settlement Agreements of claim issues and ensured timely and accurate provider payments for corrected claimsArranged one-time Letters of Agreement for individual members and non-participating physicians that ensured timely and accurate reimbursement for submitted claimsMaintained an accurate current listing of all providers within the American Chiropractic NetworkHandled the accurate processing of demographic and licensing changes, and physician terminations and additions, for the largest volume customer accounts in South FloridaEnergy consultants B2B - Contracted energy rates for commercial businesses located in deregulated states for lower electric/gas ratesProfessional ExperienceIndependent Life, Health, Variable Annuities Sales Agcent, Medicare Advantage & Medicare Supplemental Plans 2023-presentGo HealthCustomer service selling Medicare & Medicaid Plans 2021-2022USA Medicare Advisors 2019-2020Independent Insurance Agent, Life & Health,selling Medicare Supplement Policies Plans G and Plan N;wrote Plan D Drug Plans for clients, Critical Illness Plans.Sabbatical 2016-2018Caregiver for great grandson(granddaughter went back to full time employment)Amerilife Insurance Company 2015-2016Life & Health #218 Agent Independent Sales Agent Life,Medicare Supplements, Critical Illness, Retirement, AnnuitiesBankers Life & Casualty Insurance Company 2014-2015Life & Health #218 AgentIndependent Sales Agent Life, Medicare Supplements, CriticalIllness, Retirement, AnnuitiesGrantham Military University 2010--2017Part Time Adjunct Online Instructor School of BusinessTeach, evaluate graduate courses, and grade graduate students seeking multiple degrees in theSchool of Business, Management, HPI coursesUniversity of Phoenix, Phoenix, Az.,Western International University, Phoenix, Az.Axia Online, University of Phoenix, Phoenix. Az. 2006-2014Advanced Certified FacilitatorPart Time Adjunct Online Instructor Associates Program.Adjunct Online instructor, Graduate courses MBA, Bachelor of Science Healthcare Services, Associates Programs for Business Management, Healthcare Service Courses, General Education, and Distance Learning.Teach, evaluate, and grade students seeking Graduate degrees, bachelors degrees, and Associates Degrees online.United Power Consultants, Inc, Pompano Beach, FL. 2011-2013Office ManagerEnergy consultants B2BContracting energy rates for commercial businessesin deregulated states for lower electric/gas ratesAdministrative responsibilities with employeesMaintaining relationships with customersApplying leadership and organizational management skillsMarvin AdvertisingManagement Telemarketing Personnel 2005-2006Managed the telemarketing department in a business-to-business organization(out-going calls).Managed and was responsible for strategic planning and organizational leadership.Managed and was responsible for new project management programs; and graphicarts.UNITED HEALTH GROUP, Sunrise, FL 2003-2005Senior Network Account RepresentativeManaged hospital-based physicians, risk management, skilled nursing facilities and ancillary provider accounts. Responsibilities for tasks and successful processing of contract negotiations by loading contracts and addendums in the Provider Network Department data system. Maintained and focused on the resolution of complex provider relation issues, including the implementation of best practices systems, process improvements, and customer service satisfaction. Administration of several successful team lead programs for the ORS claims adjustments program in the managed care plan.SANFORD BROWN INSTITUTE, Lauderdale Lakes, FL 2004-2005Instructor Medical Assistant and Ultrasound ProgramsInstructor, part time, taught Anatomy and Physiology courses.UNIPRISE (UNITED HEALTH CARE SEGMENT), Sunrise, FL 2001-2003Customer Service SupportHandled all marketing plan information for participating providers and members. Achieved first call resolution and call monitoring skills. Successfully applied coaching skills in assisting team members with product and service information.MIKE PERL, MD, Coral Springs, FL 1993-2001Registered Medical AssistantProvided general office assistance and handled accounting functions for a prominent internist. Educated patients on the use of medication and the importance of exercise, proper nutrition. assisted in minor surgery and administered blood draws.MULTIPLE SCLEROSIS FOUNDATION, Ft Lauderdale, FL 1991-1993Program Services Representative (Part time)Handled incoming calls for the definition and prognosis of multiple sclerosis disease. Provided information to multiple sclerosis members regarding proper nutrition, exercise programs, and durable medical equipment. In addition, provided callers with information and results from the clinical trial studies for Multiple Sclerosis patients.INDEPENDENT #218 HEALTH AND LIFE AGENT, State of Florida 1981 - PerpetualContracted with 3600 employee local hospital account for auto and homeowners insurance in South Florida. Represented Blue Cross/Blue Shield Major Medical and Managed Care Plans in South Florida, and wrote mass marketing reimbursement employer/employee enrollment accounts throughout the U.S.EducationDM, Doctor of Management, Leadership and Organizational Management DegreeUniversity of Phoenix (UOP), Phoenix, AZ; Dissertation published in ProQuest Library, UMI Dissertations Publishing, 2014, 3707398; Perceptions of administrators on stewardship and empowerment for telemarketing organizations in Southeastern United StatesM.B.A., Global Technology Management, American InterContinental University (AIU), Weston, FLB.S., Health Care Services (BSHCS), University of Phoenix (UOP), Plantation, FLA.S., Medical Assisting, Keiser College, Fort Lauderdale, FLPublicationsDissertation Published in ProQuest Library, 2014, 3707398Edited and wrote a thirty (30) page paper entitled Gangs University of Phoenix COM/215Professional Development218 Health & Life Insurance Agent License, State of Florida240 Health Insurance Agent License, State of Florida219 Variable Annuity Agent License, State of FloridaNotary Public State of Florida (Active License)Certified School Board of Broward County Substitute TeacherPre-nursing courses, OSHA, HIV, AIDS, Violence, CPRUnited Health Group training courses (internal applications)Accredited Claims Adjuster (ACA) Certificate of Completion Pre-LicensingQualification T320 Apprentice Public Adjuster All LinesUniversity of Phoenix Certified Advanced FacilitatorSpecial Matters Expert (SME) Grantham UniversityMembershipsThe Academy of Management, Birmingham, AL., Volunteer Reviewer for author manuscript publicationsAlumni Association Network (AAN); Vice President, Marketing & ResearchNational Association of Professional WomenBusiness & Professional WomenWoman 2 Woman Business Group (W2WB)University of Phoenix (UOP) Alumni Association (mentoring students)American InterContinental University Alumni AssociationThe Glass Hammer Womens NetworkCambridge Whos WhoUSA Honor SocietyThe International Womans Leadership AssociationLinkedIn MembershipSkillsMicrosoft office: Word, Excel, PowerPoint, Microsoft Outlook, Microsoft SharePoint,Proficiency in CRM, Outlook Express, Lotus Notes, Adobe, Angel, and Blackboard |
