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Click here or scroll down to respond to this candidateCandidate's Name
PHONE NUMBER AVAILABLE EMAIL AVAILABLE Port Richey, FLPROFESSIONAL EXPERIENCECSTS - Customer Service and Technology Solutions, LLC., Spring Hill, FLGrievance & Appeals Specialist September 2022 - PresentCoordinate, track, & log appeals and grievance from receipt to resolution ensuring timely completionAct as a liaison to correspond and communicate with providers, members, and insurance carriersPerform administrative activities by documenting authorizations, reviewing insurance decisions, and forwarding treatment authorization to providersConduct research, including requesting member records, organize documentation, and prepare written summaries of cases including the resolution for appeals /grievance files when requiredFlorida Joint Care Institute, Trinity, FLScheduling Specialist November 2020 - September 2022Managed scheduling and rescheduling of patient appointments while addressing direct inquiriesUpdated the patient information using the Allscripts/Rivit/Modern Med software for all patientsCollected copayments, coinsurance, deductibles, and outstanding balances during patient visitsBilingual translator for patientsNYC Health & Hospital/Lincoln, Bronx, NYClerical Associate III Inpatient Unit/Telemetry August 2011 - June 2019Managed patient call bell, code emergencies and route all patient requests to assigned Nurse or Head NurseAdhered to coding procedures and promptly contacted the designated Hospital personnel to address patient coding issuesAdmitted and discharged patientsOrganized and coordinated transportation and follow-up appointments for discharged patientsPerformed clerical duties in relation to records, files, and invoicesSustained and ordered unit suppliesEDUCATIONMonroe College, Bronx, NYBachelor of Science in Health Service Administration August 2010Relevant Coursework: Visiting Nurse Services, NYC Department of Health; Office of Vital RecordsSKILLSKnowledge of Medical Terminology and ProceduresMicrosoft Office: Excel (Proficient), Word (Intermediate), PowerPoint (Proficient), and OutlookExperience with Salesforce, EClinical, Allscripts, NextGen, Uniportal, AdjundicationBilingual in English and SpanishTyping 60 WPM |
