Celeste Jimenez Email & Phone Number

Sherman Oaks

El Monte, California, United States

Formulate and run advanced SQL queries, determining and outlining criteria in order to obtain the data required to maintain accurate databases, generating a decrease in requests to our department. Analyze data in order to discover trends, encourage research, and influence management decisions.Utilize SSRS to extract capitation data, assess amounts received and deducted, guarantee accurate payments and member eligibility, resulting in proper member updates and a decrease in claims inquiries.Corroborate processing transactions; ensure all the necessary eligibility files are processed, uncover errors, and collaborate with the processing team to revamp as needed, maintaining accurate updates to our databases, diminishing additional requestsProcess over 120 requests per day, across five platforms, supporting multiple departments and hundreds of healthcare providers by fulfilling requests to verify member eligibility and coordination of benefits, and updating databases in order to ensure timely care for our patients.Demonstrated attention to detail, accelerated learning abilities, and success in mentoring my team, resulting in my promotion and assignment of more tasks.

Long Beach, California, United States

Trained five other team members in innovative office practices and in producing enhanced reports in order to become suitable liaisons between insurance carriers and clients, resolving issues that require negotiation and excellent customer service, bringing about strong relationships and satisfied clients.Responsible for creating proposals and presentations inclusive of budget and benefit analysis for fifteen businesses of up to 200 employees in order to prepare for their annual renewal, applied detail-oriented practices to continuously monitor transactions and guarantee accuracy. Communicated with employees and employers of changes in the industry.Intensified the use of technology and applied spreadsheet modeling skills in order to streamline the company’s business processes and produce efficient reports that facilitated management decisions.HR: Processed payroll, interviewed potential hires, new hire onboarding.

Irvine, California, United States

Work closely with a Mathematics professor in order to prepare class material resulting in an improvement in students' grades and an increase in communication and management skills.

Long Beach, California, United States

Apply leadership skills by leading a class of 26 students and helping them prepare for class material through activities resulting in an increase in test scores.