Carematic SoftwareAugust 2015 to February 2016Subsequent Enrollment
Third-party claims Research FACETS Benefits and Eligibility verifications Open Enrollment Appointment Scheduling ICD-9 / CPT Codes Billing validation Customer Service Mandate Compliance HIPPA PEGA Health Insurance denials and appeals Coordination of Benefits CareFirst BlueCross BlueShield: ||Enrollment and Billing Tech 1 (Temp)|| MD Responsible for completion of all claims routes and workflow request Responsible for completion of Consumer Direct Subsequent change requests Maintained a high level of productivity in a high volume, high stress environment Responsible for quick resolution for any On & OFF Exchange issue and escalation Assisted in enrolling and processing applicants for CareFirst Consumer Direct products Assisting current and temporary associates in resolving all ACA and Pre-ACA accounts Real time assistance and training provide to temporary associate during open enrollment Research, analyze and assist with customers' accounts issues and system billing error report Assisted in the processing and enrollment of applicants for CareFirst Consumer Direct products Responsible of working multiple project such as Account Receivable, Suspense and Transfer Research, analyze and resolve customers account issues due to enrollment, system and billing error Accountable for performing all CD accounts changes in accordance with MIA and CareFirst regulations Provide direct support to customer service for all escalation related to enrollment and workflow request.
Unified Community ConnectionsApril 2014 to June 2015Project Administrator Middle River, MD
Managed PRN (float pool) Staff Managed various system projects Provide system training for new hires Oversees the management of grocery budget Record Individual Specialized Training to Data Base Manage Residential software to ensure the program is running efficiently Provide IT solution and technological support to over 18 residential housing Establishes and monitors systems to ensure each home is in good repair, clean and safe Provide administrative and project support to Chief Operating Officer and Residential Director Provides input to the Director of Quality Assurance for reportable incidents and takes corrective action Ensure residential Units are up to code according to the DDA, DMAS, COMAR regulations, CARF, and DHMH.
October 2012 to April 2014Arc of Baltimore: ||Community living Coordinator Baltimore, MD
Manages CNA, CMT, and direct staff Provide direct service and support to clients Provides emergency on-call support 24-hours a day Direct activities of professional and technical staff members Review and write individual Monthly goals and Individuals IP's Prepare and maintain records and reports, such as budgets, personnel record Recruit, interview, train, and hire qualified prospective candidates as needed Evaluate the work of staff to ensure that quality of work is provided to supported individuals Plan and administer housing budgets for programs, activities, and provide direct support services Establish and oversee administrative procedures to meet objectives set by the DDA, DMAS, COMAR regulations, CARF, and DHMH standard, directors, and/or senior management Develops, manages and monitors operating systems to ensure compliance with Agency policies and procedures and regulatory requirements.
Quality Enhancement Committee Participate in quarterly meeting to discuss ways to advocate and provide superior quality for individuals with developmental and intellectual disabilities.
United Colors of BenettonJune 2010 to October 2012Sales Associate Towson, MD
Met incoming customers and provided immediate assistance.
Listened to customer needs and preferences to provide accurate advice. Completed purchases with cash, credit and debit payment methods. Increased purchase totals by recommending additional items. Maintained up-to-date knowledge of customer buying habits. Resolve complaints by customers.
Answering the phone, and working the cash register.
Assisted in stocking the shelves with new product and replacing product within store.
Responsible for tracking sales and making sure the register was even at the end of the day.
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Companies Worked For:
Unified Community Connections
United Colors of Benetton
Mount St. Mary University
Job Titles Held:
Arc of Baltimore: ||Community living Coordinator
Bachelor of Science : Exercise
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