Nicole Fontana, Popm Email & Phone Number

Casselberry, Fl, Us

Rockledge, Florida, United States

Serves as a liaison between internal business partners to facilitate the development and implementation of technical initiatives and solutions to meet business needs. ▪ Spearheaded the planning and implementation of a new technology system including preparing and documenting business requirements, organizing user acceptance testing, and guiding issue management and resolution. Documented functional requirements for business partners, helped to translate them into functional specifications, and managed the change process from requirement gathering to final implementation.▪ Analyzes potential impact of changes to current business plans and works with stakeholders to document requirements, processes, and workflows in developing ongoing strategy plans and root cause analysis. ▪ Designs reports, trends, scorecards and dashboards and shares with senior leadership and stakeholders. Compiles, analyzes, and interprets key performance indicators and creates recommendations to business leaders. ▪ Serves as subject matter expert on the compliance regulations, standards and procedures that guide complaint handling. Manages compliance data for CMS and NCQA audits.

Rockledge, Florida, United States

Collaborated with other Health First stakeholders to resolve issues presented by our members or their representatives pertaining to the authorization or delivery of clinical and non-clinical services. ▪ Prepared thorough and well-documented case files for case reviewers, including physicians. Collaborated within and outside the organization to resolve issues in a timely and compliant manner.▪ Composed correspondence responses to stakeholders related to member issues, status, and determinations in compliance with rules related to procedures and timeframes. ▪ Developed and implemented department training documents. Facilitated Member Assistance Panel hearings with members and leadership.

Rockledge, Florida, United States

Coordinated utilization management, case management, and provider dispute intake activities by researching provider inquiries and requests. ▪ Reviewed clinical documentation and verified procedure and diagnosis codes to ensure accuracy of information provided. Performed reviews on inpatient authorizations and assisted customer service with authorization information.

Melbourne, Florida, United States

Served as the primary liaison who communicated the specifications, availability, and criteria for a variety of financial programs such as Medicaid, Medicare, Social Security Disability, and other financial opportunities to patients. ▪ Assisted patients with the submission of financial statements and applications. Analyzed patient financial information and shared results with senior management. ▪ Prepared patient fee schedule accounts and reconciled outstanding balances by obtaining demographics, insurance information, liability information, and victim compensation information.

Cocoa, Florida, United States

Provided academic support for new and currently enrolled students on issues including registration, degree audits, academic planning, and career aspirations. ▪ Mentored students to guide, inform, and empower them to achieve their educational, personal and career goals in a high- volume call center via instant message, telephone, and email. Documented plans of action and advised students on available resources.▪ Exhibited sensitive and diplomatic management of confidential information, acting as gatekeeper. Used emotional intelligence, judgment, and discretion by identifying issues that needed escalation and managed them appropriately. ▪ Proctored exams for academic credit. Organized and inspected incoming submissions to the Admissions and Records Department for completeness to expedite processing.