Yaritza Z C. Email & Phone Number

United States

Prepare, process and submit applications for provider enrollment withmedicare.● Track and monitor the progress of applications, ensuring timelyfollow-up to avoid delays in reimbursement.● Assist providers with renewals and updates to enrollment status,including changes in location, tax id, or other relevant information.● Collaborate with internal teams and credentialing specialists to verifyand update provider credentials, licenses, and certifications.● Ensure that provider enrollment meets compliance standards andpayer-specific guidelines.● Maintain accurate and up-to-date provider information in enrollmentdatabases, including provider numbers, effective dates, and contractdetails,● Audit and reconcile enrollment records to ensure accuracy and resolvediscrepancies.● Verify and correct data discrepancies to ensure the accuracy ofinformation.● Organize and maintain digital records and databases for easy accessand retrieval.

Texas, United States

Managing, coordinating, and resolution of member and provider complaints, grievances, and appeals ensuring compliance with state and federal regulatory requirements.Entered patient and provider appeals information into VAM software.Verified medical insurance coverage and benefits for each patient Medicare /Medicaid.Monitoring and auditing closed claims reviewing the outcome and communicating the findings to the appropriate agents. Review of clinical and medical records for completeness, assign cases to proper departments for review.Consult with supervisor, and other personnel in resolving denial and appeal questions. Organize volume of work and work-flow so that performance standards and proper procedures for appeals resolution according to client requirements are addressed.

United States

Respond to consumer inquiries via phone, email, or social media channels in a timely and courteous manner.Address and resolve consumer complaints, escalating issues as necessary.Provide accurate and detailed information about products, services, and company policies.Document all interactions and resolutions in the customer database.

United States

Provide assistance and support to customers about products and services related to Medicaid/Medicare and qualified health plans.Handled 100+ calls a day to assist consumers with enrollment, eligibility process, disenrollment and reinstatement. Provided technical support for locked accounts and password resets.

Reston, Virginia, United States

Handled 150+ calls a day for CT Department of Labor serving as a front line provider for determination of monetary eligibility for unemployment insurance compensation benefits. Reviewed and responded to 50+ emails a day assisting claimants with account concerns or questions. Conducted audits on unemployment insurance accounts to verify over payments, errors, and/or issues on their claim.Conducted wage verification on customers accounts to confirm income, employment status, and verifying all proper documents were submitted to support the weekly benefit amount on claims.Conducted audits on customers unemployment insurance accounts to identify if claims had identity issues to correct and assigned to adjudication for review.

United States

Handled 150+ calls as a temporary worker for CT Department of Labor assisting customers with processing new, additional, and continued insurance claims. Assisted customers with applications to secure data were entered correctly.Analyzed information provided to determine eligibility for insurance benefits, and assess the need for non-monetary hearing. Made adjustments to the system wage file.Investigated and resolved held claims exceptions.Entered work search waivers for customers, processed information requests, entered field office denials, and processed statements of late filing.

United States

Preparing patient prescriptions select, count, label and package the appropriate drugs, forms, strengths and quantities for each prescription.Greeted and answered customers' questions and concerns, and processed insurance claims and collected payments. Stocking and distributing medications to different departments or facilities, maintained records of prescriptions, orders, inventory and charges.Contact health care providers to obtain refill authorizations or clarify prescription information.Followed the policies and procedures of the pharmacy setting to ensure safety and quality. Sterilized equipment and surfaces, dispose of expired or unused medications and report any errors or incidents.

New Haven, Connecticut

Performed cleaning and sanitation tasks in an organization to maintain clean and sanitary environments for workers and visitors.Handle duties such as mopping, sweeping, and disinfecting surfaces to ensure a safe and hygienic workplace. Distributing linens and tracking the linens used in each department, also refilling toilet paper and other paper products as needed.

New Haven, Connecticut

Created and implemented various extracurricular activities focused on social and mental development.Maintained and balanced household finances to ensure timely and accurate payments. Prioritized family caregiving, utilized productivity strategies, and adapted to changing priorities.

Business Office Technology, Medical Administrative Assis, 3.0

Nha Cetification, Phlebotomy Technician/Phlebotomist, 3.0

NHA Certified Phlebotomy Technician

Certificate Of Achievement, Phlebotomy Technician/Phlebotomist

General Sudies, General Studies, 3.0

Diploma