Built a grounds up software application for claims processing.

Reviewed medical bills for inconsistencies and incorrect billing practices. Analyzed all charges found on a medical bill and determined opportunities for savings.

I began this journey as a Customer Support Representative. Shortly after starting, I was taking over some leadership responsibilities. Within 4 months I was promoted to Supervisor of the Customer Support team. Unfortunately, the company was going through a rough patch and had to lay off the Customer Support team. The company had to close a month after the layoffs.

Proficient in Argus, Auto Auth, RTMS, CFS, Facets, and Custom View applications* Analyze and make determination of benefits from clinical data* Solve patient, pharmacy, and broker issues* Determine and communicate explanation of benefits given to members, pharmacies, brokers, doctors, and BSC employees* Troubleshoot problems with pharmacy claims processing* Prior Authorizations and Data Entry* Shadow and mentor new team members* Worked on Drug Criteria Medicare… Show more Proficient in Argus, Auto Auth, RTMS, CFS, Facets, and Custom View applications* Analyze and make determination of benefits from clinical data* Solve patient, pharmacy, and broker issues* Determine and communicate explanation of benefits given to members, pharmacies, brokers, doctors, and BSC employees* Troubleshoot problems with pharmacy claims processing* Prior Authorizations and Data Entry* Shadow and mentor new team members* Worked on Drug Criteria Medicare webpage update* Collected and compiled data as a member of CMS Audit team* Work with members and brokers to gather data for processing reimbursement claims* Member of TeamBuilders event planning team * Responsible for all weekly employee engagement activities Show less

Provide technical support for consumer electronics* Problem solving skills, resolving customer issues and complaints via phone and email* Set up and maintained standard operating procedures* Daily utilization of Salesforce and Onforce* Wrote documentation for solutions to customer issues* Mentor and trainer to new team members* Maintain a high level of confidentiality with all buyers and sellers* Coordinate meetings with managers and other leads for special projects… Show more Provide technical support for consumer electronics* Problem solving skills, resolving customer issues and complaints via phone and email* Set up and maintained standard operating procedures* Daily utilization of Salesforce and Onforce* Wrote documentation for solutions to customer issues* Mentor and trainer to new team members* Maintain a high level of confidentiality with all buyers and sellers* Coordinate meetings with managers and other leads for special projects and tasks Show less

* Team lead of Audit team. Performing internal audits per ASQ guidelines for all operations* Wrote, edited, and maintained all standard operating procedures for entire facility* Interact with patients, insurance companies and doctor's offices internationally* Familiar with HIPAA laws and regulations* Attended ASQ Quality seminars* Proficient with MS Office, Mainframe and customized mainframe base systems* Excellent telephone skills, maintaining up to twenty incoming… Show more * Team lead of Audit team. Performing internal audits per ASQ guidelines for all operations* Wrote, edited, and maintained all standard operating procedures for entire facility* Interact with patients, insurance companies and doctor's offices internationally* Familiar with HIPAA laws and regulations* Attended ASQ Quality seminars* Proficient with MS Office, Mainframe and customized mainframe base systems* Excellent telephone skills, maintaining up to twenty incoming phone lines * Procurement Specialist maintained inventory for all supplies and drugs Show less

* Entered and filled prescriptions* Assisted the Regional Manager and traveled throughout the district to fill in gaps.*Wrote department schedules*Procurement specialist ordered and maintained logs for all medications

Verified payroll, scheduling, and benefit management* Set up, negotiated, and maintained vendor contracts* Excellent phone skills managing up to ten incoming phone lines and assessing the needs of patient and clients* Special projects leader, planned and organized all facility events and seminars* Worked as a triage medical assistant verifying and assessing the order of necessity for each individual patient and doctor* Performed Phlebotomy and other tasks including… Show more Verified payroll, scheduling, and benefit management* Set up, negotiated, and maintained vendor contracts* Excellent phone skills managing up to ten incoming phone lines and assessing the needs of patient and clients* Special projects leader, planned and organized all facility events and seminars* Worked as a triage medical assistant verifying and assessing the order of necessity for each individual patient and doctor* Performed Phlebotomy and other tasks including documenting medical histories, vital signs and other laboratory duties* ICD-9 and CPT coding expert Show less