-Manage pre and post award for contracts and grants for the division including NIH, HRSA, State, Federal and private agencies.-Reconcile monthly ledgers, and compile fiscal information to be used to prepare annual budgets, financial reports, and projections utilizing information from University ledgers, Query Database (QDB/FPM), and University online financial reports.-Manage complex accounts including program project grants and training grants.-Provide guidance to PIs for funded projects to assure proper expenditure.

-Assisted company’s transition from medical paper documents to electronic health records-Manage optical frame inventory orders and managed vendor accounts such as Luxottica, Safilo, Marchon, and Marcolin-Verify insurances through companies such as VSP, Eyemed, Davis, Medi-Cal, March Vision, and MES-Front desk management, which included scheduling appointments and checking in patients-Perform pre-test for patients using auto-refraction, peripheral vision, eye pressure and retinal photo machines prior to patients’ exam-Serve as the leading customer representative to handle patient, vendor, and other optometrists’ inquiries and resolve disputes-Provide sales strategy and train new employees-Submit electronic claims, which includes reviewing for accuracy in service, identifying appropriate codes, modifiers and ensuring timely submission for full reimbursement

-Assisted Principal Investigators and Research Administration in communicating with grant providers concerning current and proposed research studies, resolved administrative problems, prepared and processed forms for re-budgeting of grants/contracts, no-cost time extensions, and prior approval to spend funds.-Prepared monthly financial status reports projecting personnel expenses to the end of the grant period and identified alternative sources of funding to ensure adequate salary support for faculty and staff.-Tracked and reconciled expenditures and appropriations.-Maintained financial records for current and expired contracts and grants as required by University guidelines.-Analyzed and audited monthly payroll ledgers; initiated corrective actions and monitored such actions until reflected on subsequent ledgers. -Reviewed Notice of Awards from sponsor, and verified funds awarded in order to confirm that the account(s) have been set up properly in accordance with University and funding agency guidelines.

-Identified, investigated, and resolved member and provider complaints and appeals adhering to CMS, DHCS, MRMIB, and NCQA standards and regulations.-Reviewed pre-service authorizations, concurrent, and post-service medical necessity; benefit coverage appeals and reconsiderations, and complex provider claim disputes.-Intake, acknowledged, and prepared case files and routed complaints to appropriate internal department for investigation and resolution.-Prepared and analyzed monthly appeal and grievance reports to meet internal and external reporting requirements.

-Intake all complaints from members and providers received by the A&G department from the L.A. Care Member Services department, as well as via mail, fax, and website-Enter all cases into the A&G database and assign cases based on current workflow-Support the A&G department in performing all functions related to the receipt, tracking and handling of all complaints received.-Maintain confidentiality when communicating member and provider information, assist with the communication and coordination between Case Coordinators, RN’s and management

-Coordinated L.A. Care member enrollment eligibility for Vision to Learn services to increase free and timely access on vision assessments in order to mitigate and treat preventable conditions.-Increased utilization of databases through verifying eligibility using QMEIS and MEIS-Reconciled Vision to Learn fiscal records and validated responsible parties for payments-Reviewed fiscal data for accuracy to ensure L.A. Care policies & procedures and regulatory agency compliance are met prior to submission to state agencies-Developed performance metrics and trend analysis to assess access to care, aiming for target populations to determine gaps in services and improve outcome-Developed a provider management reconciliation criteria in collaboration with the L.A. County Department of Health Services, Managed Care Services Division to ensure accurate reflection of Safety-Net providers' capacity to include specialists within the DHS Network to serve members across the county