Melina Osorio Email and Phone Number

• Cared for boy, aged 12 months ensuring safety, well-being, and development.• Established and maintained daily routines for meals, naps, and activities.• Engaged child in educational and age-appropriate games, crafts, and outings.• Managed household tasks, including meal preparation, laundry, and light cleaning as well as provided daily updates to parents.

• Cared for girl, aged 3.5 months ensuring safety, well-being, and development.• Established and maintained daily routines for meals, naps, and activities.• Managed household tasks, including meal preparation, laundry, and light cleaning as well as provided daily updates to parents.

• Responsible for answering phones, prepared training material for Preschool and Transitional Kindergarten professional development (PD) workshops.• Assisted with registration at PD workshops, laminated, faxed, scanned documents and updated share drive folders according to PD workshops.• Worked closely with Reprographics department, to ensure printing of all handouts, posters, business cards and any other printing jobs needed for PD workshops were completed in a timely manner.• Worked closely with Pro Courier, our transportation courier to ensure materials for PD workshops were transported to and from different school sites/school districts in a timely manner.• Placed warehouse orders and outside orders (Office Depot, Lakeshore) for department, maintained inventory of all resource books on hand, along with classroom material that was ordered from Lakeshore to give to teachers at PD workshops.• Assisted with setting up and break down of PD workshops, gathered data from sign in sheets and evaluation forms from participants and provided it to my director for quarterly meeting reports.

• Responsible for processing refunds for multiple vendors due to payment discrepancies with information provided from Claims department.• Processed Credit Memos, Debit Memos, Cash Advances and submitted check requests for Return to Provider refunds.• Worked closely with the Medical Payment Systems & Services (MPSS) department and assist the unit with various tasks, such as, scanning of refunds, check mailings, Remittance Advice extractions and any necessary clerical work during down time.

• Responsible for performing revenue/data entry in an accurate and timely manner, responsible for monitoring, analyzing, correcting and resubmitting claims to healthcare payers.• Responsible for entering claim adjudication and transferring claims to next payer for successful claim adjudication using Welligent (EHRS).• Researched billing errors and reconciled billings.• Verified insurance eligibility for clients and kept client charts up to date, processed EOBs, in charge of correspondence and followed up with healthcare payers on unpaid claims until adjudication was received.• Assisted with cycle reports and was heavily involved in the transition from paper claims to electronic claim submissions through Office Ally.

• Assisted supervisors in developing a successful and cohesive unit, with high level of productivity to achieve department's overall performance metrics.• Provided leadership for Member Service Representatives in Call Center environment and served as back up to Supervisors.• Responsible for ensuring that front-line staff delivered high quality and efficient service to members and providers who contacted Member Services Call Center Department.• Responsible for Supervisor queue, monitored ACD phone system, created and modified Member Services Technical Procedures all while making significant contribution to high member retention and satisfaction.• Reduced call escalations by empowering agents with necessary tools, knowledge, and decision-making authority.

• Provided excellent customer service and responsible for answering large volume of calls.• Gathered information, researched/resolved inquiries and logged member calls while using standard scripts and following technical procedures.• Assisted members with: Primary care provider (PCP) changes, plan transfers, and grievances.• Assisted with authorizations, ID card requests and general inquiries.• Covered for receptionist's breaks/lunch and acted as Lead while Leads/Supervisors were in meetings.• Assisted with member walk-ins, MIU updates, and Ansafone report, covered Supervisor Queue, Medicare Queue and acted as preceptor to academy representatives.