 Assisted clients by interviewing clients and their families to gather specific information to determine preliminary eligibility for programs and make appropriate referral services. Accepted referrals from agencies and interviewed individuals referred to determine the nature and degree of problem, eligibility for program and make appropriate referral. counseled individuals, families and groups by developing a client treatment plan to ensure that individuals receive appropriate services and interventions. Maintained presentations and issues for health promotion materials (brochures, pamphlets) to educate and motivate individuals.

Humana Behavioral HealthClinical Specialist UM Irving, TX 2015-2016• Provide clinical support to the provider’s and case manager’s, quote human one mental health benefits• Provide Letter of agreements, process after hour’s protocol’s• Complete Patient Discharge • Create Inpatient, Intensive outpatient. Residential, and Partial House Authorizations as well as outpatient Authorizations• Document all calls and attach clinical information receivedLIFESYNCH Behavioral Health Irving, TX 2012-PresentCustomer Care Specialist Provide perfect service support and guidance to members in a multi-channel contact center environment; inbound, outbound, web and email.  Accountable to manage problem resolution to meet service specific requirements utilizing internal systems; Dimensions, CCP2, CGX, Avaya ACD & Empower, Impact 360, Provider Portal tools. Manage inbound contacts from providers and members to a one call resolution to reduce call regeneration supporting 60+ contacts per day.  Delegated to handle concierge service request to resolve providers and member claim disputes.  Contributed to Associate Engagement impact planning with process and procedure input to simply routines and encourage teambuilding

Clinical Guidance Specialist Irving, TX 2016-2017 • Make outbound calls to members to inform and enroll in Care Management program that focuses on health and behavior change • Recognize and respond to crisis situations from members appropriately• Research through several channels to locate a working contact number for members indicated as UTC• Document all calls to ensured process that was done while engaging with member and Adhere to URAC standard, state and federal regulation

Taking inbound calls, providing mental health benefits to members and providers. Assisting with provider credentialing, as well providing claim status. requesting additional information needed for claim process completion.

Medical Claims Processor San Antonio, TX 1996-1994• Provided claims processing and resolution to provider’s and members• Prepared denial letters for procedure’s• Provided perfect service on Inbound calls• Mailroom clerk mail distribution• Copier paper and toner • Service call and reports for supplies