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Professional Summary

Committed to both internal and external customer satisfaction: hard work and accountability: strive to always improve my skills and go above and beyond for the success of the team. Looking to obtain a challenging position in a professional environment with the philosophy of patient/customer support & complete satisfaction.

Core Strengths
  • Strong medical ethic
  • Computer proficient
  • Customer service expert
  • Leadership skills
  • Complete Non-Clinical Revenue Cycle
  • Strong analytical & organizational skills
  • Healthcare billing proficiency
Professional Experience
02/2018 - Current Lead Precertification Specialist Trustees Of The University Of Pennsylvania | Philadelphia, PA
  • Report directly to the Manager / Supervisor of the Financial Clearance department.
  • The first point of contact for the Precert Specialists staff, workflow, and system issues.
  • Assists in the development and implementation of appropriate policies, training, and workflows.
  • Subject matter expert for insurance verification, benefit and precertification obtainment for all HUP scheduled outpatient surgical procedures and inpatient admissions via telephone and online tools.
  • Call insurance companies to ascertain pertinent information regarding policies and payment benefits for patients.
  • Verify that patients have the proper insurance coverage prior to any procedures.
  • Follow specific security rules and guidelines to protect sensitive data, including patient medical records and payment card information.
  • Retain strong medical terminology understanding in an effort to better comprehend procedures.
10/2017 - 02/2018 Patient Service Representative Delancey Internal Medicine Rittenhouse | Philadelphia, PA
  • A primary point of contact for patients and providers.
  • Greet, check-in & check outpatients.
  • Scheduled and confirmed patient appointments with patients and healthcare professionals.
  • Explained eligibility details and affordability options to patients with kindness and respect.
  • Collect co-pays, answer phones, schedule appointments.
  • Obtain referrals and pre-certifications.
  • Complete daily cash collection deposit.
  • Train staff on front desk policies and procedures.
08/2015 - 08/2017 Collections Specialist II DaVita Healthcare Partners | DeLand, FL
  • Research, appeal, resolve claim rejections, underpayment and denials.
  • Initiate collection follow-up of all unpaid or denied claims.
  • Analyze contracts between DaVita and insurance companies to ensure proper billing and payment.
  • Respond to written insurance communications as indicated with appropriate action in a timely manner.
  • Document all follow up and communication in the patient's account.
  • Verify details of transactions, including funds received and total account balances.
  • Complete weekly/monthly AR variance reports, improving workflow process.
  • Review outstanding balances and identify accounts in need of collection processing.
  • Advised process improvements to secure prompt and regular receipts for the organization.
  • Meet/Exceed monthly and quarterly goals.
  • Maintain audit accuracy rate of 98% & above.
  • Provide onsite training on BC/BS policies and collection process.



08/2014 - 07/2015 Patient Intake Specialist DaVita Healthcare Partners, INC | Deland, FL
  • Verify benefits & eligibility for outpatient kidney dialysis laboratory testing.
  • Update all billing systems & associated systems with patient demographics & insurance accurately and timely.
  • Maintain audit accuracy rate of 96% and above.
  • Rank in the top 3% of high performing teammates monthly.
  • Improved operations by working with team members to find workable solutions.
02/2011 - 06/2014 Financial Services Representative Hospital of the University of Pennsylvania | Philadelphia, PA
  • Verify benefits & eligibility for scheduled, direct admit, transfer & emergency room admissions.
  • Update demographics in EPIC, and SMS registration systems.
  • Document account status in Ontrac
  • Contact patient or financially responsible member to discuss their financial obligation
  • Complete financial assessments with non-insured patients being transferred for admission from outside hospital
  • Initiate contact with insurance carriers within 24 hours of admission & obtain pre-certification.
  • Collect co-pays, deductible, and self-pay patient payments.
  • Post patient payments, and reconcile accounts for hospital & clinical practices for bank deposit.
  • Maintained an accuracy rate of 97% and higher.
02/2003 - 01/2011 Billing Coordinator- Heart & Vascular Laboratory Hospital of the University of Pennsylvania | Philadelphia, PA
  • Batch and verify all required elements such as ICD-9, CPT-4 codes, referrals and pre-certification for charge entry.
  • Charge entry and code correction for completed Echo & Stress test.
  • Increase revenue by decreasing rejections with new billing procedures.
  • Trained new team members on company policies and accounting systems to keep team operations productive and efficient.
  • Accurately reconciled patient payments for account posting.
  • Managed daily operations for the billing department staff.
  • Meet monthly and year-end closing accounts reconciliation.
Community Service
  • Freedom Playground restoration project-2015
  • United Methodist Church- Feed the homeless program -2015
  • Camp Boggy Creek restoration project -2016
  • Give Kids the World fundraiser -2016
  • Journey's End animal sanctuary clean-up project-2017


Certifications

AAHAM-Certified Revenue Cycle Specialist- Institution

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Skill Highlights
  • Impeccable business acumen and prioritization skills for strong Portfolio Management
  • Superior problem-solving and analytic skills leading to process improvement and cost reduction.
  • Leads complex operational and strategic initiatives across global geographies
  • Expertise in developing business processes and metrics to measure them
  • Agile and Waterfall methodologies
Accomplishments
  • Lead of Project Management Office (PMO) and Portfolio Management framework
  • Directed establishment of agency-wide virtual call center (VCC) and National Service Delivery Team (NSDT) for Financial administration and Human Resources
  • Global Program manager at Intel Corporation, managing staff that included Project Managers, developers, Quality Assurance and contractors
  • Oversee capital purchase budget greater than $15 million dollars
  • Coordinated staffing and planning activities to support the security of all IT systems for 60 sites worldwide
  • Led implementation of ITIL Service Level Management project team consisted of 30 analysts and developers. Standardized over 60 business processes and services from Finance, Human Resources (HR) and Information Technology (IT) organizations
  • PMI-PMP, FAC P/PM Level III, and ITIL Certifications
  • Recipient of the National Earth Team Individual volunteer Award- Facilitated Agricultural Water Enhancement Program (AWEP) project proposal that was awarded over $1.3 million in funding
Experience
PMO- IT Specialist, 03/2011 to Current US Department of Agriculture-NRCS Portland, OR
  • Led deployment ofMicrosoft Project Server and Project Online resulting in Improved ResourceUtilization and improved Earned Value Management; on-time and on-budgetprojects for the entire NRCS Portfolio
  • Designedconfiguration and deployment of MS PowerBI Portfolio dashboard. Suite of twelveunique dashboards for a portfolio of 13 Investments containing more than fiftyunique projects. Dashboards provided foraccess, extraction and presentation of data for the purpose of businessintelligence analysis
  • Created Requirements Management Plan for Enterprise Architecture team by designing new Requirements process and implementation of IBM Rational Requirements Composer
  • Developed and implemented Program Management Office (PMO) to transform IT project management (PM) structure to a centrally managed and streamlined support organization. Provide policy, planning and project data insight to senior management for their use in ranking key operational and budgeting decisions


Program / Project Manager (PM), 03/2000 to 07/2008 Intel Hillsboro, OR
  • Developed Business Intelligence (BI) strategy and established project scope to evaluate overall health of IT Operations and HR environments through standardized measurement practices. Output of BI project utilized by different across IT and HR business groups, all global geographical regions, up to the Vice-President level
  • Implemented ITIL Service Level Management Problem Management process by deploying BMC Remedy Service Desk software. Led project team consisting of 30 analysts and developers for standardization of Service Level Management process and represented more than 60 services from Human Resources (HR) and Information Technology (IT) organizations
  • Global Program Manager for team of six Project Managers responsible for the migration of 60 sites, 5,000 nodes, 150 automated-tape library units and over a petabyte of data. PM for deployment of Enterprise Backup and Restore server. Designed disaster recovery project plan, training, and drill scenarios for delivery to all sites worldwide. Established baseline budget and completed ROI analysis
  • Managed a budget of over $11 million dollars, including purchase justification for hardware and software design, licenses, and maintenance
  • Gathered business requirements, prioritized needs, and built use-cases for projects. Collaborated in the planning, design, development, selection and deployment of new software implementation. Defined project success criteria and facilitated the process of generating, documenting and implementing As-Is and To-Be business process workflows
  • Effectively managed project stakeholders' expectations by coordinating communication plans, defining project success criteria and disseminated project progress documentation to involved parties throughout project life cycle for multiple, simultaneous projects
 ​
Education
BA: Philosophy Loyola University of Chicago Chicago, Illinois, US

Minors - English, Business Administration

Certifications

Project Management Institute - PMP

FAC P/PM, Federal Acquisition Certification for Program/Project Managers -Lvl III

Information Technology Infrastructure Library (ITIL) Practitioner - IT Service Level Management Certification Foundation Certification

COR Level 1 - Federal Procurement

Software

ARIS, BMC Remedy v7, Cisco Jabber VTC, IBM Rational, ERIS GIS, JIRA,

Microsoft Project Server, MS Office 365, MS Power BI, MS Sharepoint, Mindjet MindManager, Metastorm Provision, Pentaho Kettle 4.0, Tableau Desktop v5.0, SAP Business Objects Desktop Intelligence, Salesforce, and VidYODesktop

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Summary

Ability to work with varying amounts of service related inquiries and perform needed research for resolution. Self-motivator who applies individual initiative to complete the job responsibilities. Experience working in a Software and/or service company environment. Experience working in a call center environment. Experience working with a Human Resources and/or benefits administration software. Over 5 years Customer service work experience Payroll, Benefits, and Human Resources knowledge. Experience in working with clients in a fast paced, complex, deadline oriented service environment

Skills
  • MS Office applications (Word and Excel)
  • Strong organizational Skills
  • Excellent Communication skills-verbal, written and digital(email,chat,text)
  • Problem resolution
  • Spreadsheet development
  • Insurance processing
  • Health insurance processing
  • Insurance eligibility verification
  • ICD-9
  • CPT Coding
  • Epic
  • Ability to Multi-task
  • Employee Relations
  • Exceptional telephone etiquette
  • Claims appeal procedures
  • Report Analysis
  • Medical Terminology
  • Medical Billing
Work History
Medical Billing /Referral Coordinator, 03/2019 to Current
Lamar Medical Center Augusta, Georgia
  • Precisely evaluated and verified benefits and eligibility
  • Advance knowledge of appointment scheduling and insurance/prior authorization guidelines
  • Responsible for entering and tracking all internal and external referrals using EPIC referral tracking module
  • Demonstrates knowledge of basic computer programs and electronic medical record navigation skills
  • Evaluated patients' financial status and established appropriate payment plans
  • Advanced problem-solving and analytical skills
  • Flexibility and ability to work in , and stressful situations
  • Demonstrates level of interpersonal skills necessary to effectively communicate with patients, staff and physicians' personnel with whom daily interactions must take place
Medical Billing And Collections Specialist, 08/2016 to 04/2018
Pediatric Partners of Augusta Augusta, GA
  • Utilized ALLSCRIPTS to manage and confirm patient data, such as insurance, demographic and medical history information
  • Communicated effectively with staff, patients and insurance companies by email and telephone
  • Verified patients' eligibility and claims status with insurance agencies
  • Responded to correspondence from insurance companies
  • Evaluated patients' financial status and established appropriate payment plans
  • Determined prior authorizations for medication and outpatient procedures
  • Communicated with patients for unpaid claims for HMO, PPO and private accounts and delivered friendly follow-up calls to ensure proper payments were made according to contracts
  • Collaborated with medical and administrative personnel to maintain patient-focused, engaging and compassionate environment
Employee Support and Resolution Representative, 05/2012 to 10/2014
ADP Augusta, GA
  • Provide accurate timely resolution to over 50 inbound telephone calls
  • Used multiple tools and resources to develop an accurate and comprehensive response to inquires
  • Interface and collaborate with third party vendors to find resolution Research, investigate, analyze and resolve issues of varying complexity Support a seamless interaction with Positive Defining Moments for the employees of various clients
  • Assisted less experienced representatives with handling complex employee inquiries
  • Documented calls and issues in case management tool
  • Made outbound calls to employees as applicable, to provide timely and accurate resolution
  • Provided support through use of an internal knowledge base tool and applicable Human Resource, Benefits and Payroll systems Participation in the development and documentation of processes and procedures, appropriate escalation of technology issues, feedback to improve training programs, and escalating client feedback
  • Ability to consistently follow processes and procedures Proficiency in using a PC and Microsoft applications
Benefits Representative, 09/2011 to 05/2012
ADP Augusta, GA
  • Served as a member of an Administrative Service Center Team
  • Respond telephone calls, emails, and facsimilies that are sent to the Benefits Call Center for all customer supported by the Service Team
  • Worked closely with a clients Human Resource staff and employees respond to benefit related inquiries and questions
  • Worked closely with a client's benefits provider(s) to resolve eligibility issues and to escalate service and/or claims issues on behalf of employees
  • Establish and maintain effective relationships with clients and gain their trust and respect
  • Provide tier one support to HR/BAS clients and their employees who contact the service center
  • Communicate benefit changes and policy as necessary
  • Research and resolve complex employee benefit problems and questions
  • Perform all Quality Assurance (QA) procedures as specified in the client's Administrative Procedures document
Education
Medical Billing And Coding Miller Motte Technical College - Augusta GA
Certificate Medical Coding and Billing : Continuing Education: 2003
Augusta State University - Augusta, GA
Diploma: Cosmetology, 1998
Cosmetology
High School Diploma: 1995
Augusta Technical College - Augusta, GA
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Professional Summary

Detail-oriented aircraft mechanic trained in directing, trouble shooting, monitoring or performing preventive and unscheduled maintenance on aircrafts. Through the Air Force I was schooled in turboprop and turboshaft engines but work with the T-56 on the C-130. Thorough knowledge of standard industry hardware and materials with a continuous drive for new knowledge.

Skills
  • Strong Algebra and general math skills
  • Hourly shift management
  • Personnel development
  • Customer-oriented
  • POS systems
  • Merchandising
  • Bank deposit procedures
  • Detail-oriented
  • Strategic thinker
  • Staff training and development
  • Opening and closing procedures
  • Goal-oriented
  • Customer relations
  • Effective leader
  • Efficient multi-tasker
  • Employee scheduling
  • Conflict resolution
  • Organized
  • Strong communication skills
  • Superior attention to detail
  • Knowledge of aircraft hardware and materials and processes.
  • Deicing of aircraft
  • Military maintenance requirements
  • Crew coordination
  • Quality assurance
Work History
Engine Specialist 04/2017 to Current
United States Air Force Reserve Command Marietta, GA
  • Went to technical school for Aerospace Propulsion in the United States Air Force where I learned tool knowledge, turboprop and turboshaft engines, and also hazmat training.
  • Performed scheduled and unscheduled inspections to check flight readiness of aircraft.
  • Monitored parts department and placed orders for maintenance supplies on a consistent basis.
  • Assisted with aircraft and equipment transport and movement.
  • Removed and installed aircraft subsystem assemblies such as engines, rotors, gearboxes, transmissions and mechanical flight controls.
  • Complete all paperwork requirements for each task, including recording maintenance actions in aircraft logbooks.
  • Oversaw inventory, equipment maintenance and bay cleaning.
  • Performed routine preventive maintenance to ensure that building systems operated efficiently.
  • Supported technicians in equipment maintenance and repair.
  • Lubricated shafts, bearings and gears to maintain optimal performance.
  • Diagnosed faults and developed resolution plans.
  • Maintained an orderly and safe work environment by enforcing tool control and FOD awareness, prevention and safety at all times.
  • Conducted and oversaw safety protocols, including flight line foreign object prevention walks.
  • Aided crews in joining, wrapping and sealing sections of pipe.
  • Promoted shop safety by working in a safe manner.
Store Manager 06/2013 to 04/2018
Southfitters Albany, GA
  • Interviewed job candidates and made staffing decisions.
  • Counted cash drawers and made bank deposits.
  • Managed staff of 8 sales associates, and 2 assistant managers.
  • Assigned employees to specific duties to best meet the needs of the store.
  • Reordered inventory when it dropped below predetermined levels.
  • Instructed staff on appropriately handling difficult and complicated sales. Hired, trained and evaluated personnel in sales and marketing.
  • Examined merchandise to verify that it was correctly priced and displayed.
  • Planned budgets and authorized payments and merchandise returns.
  • Trained and developed new associates on POS system and key sales tactics.
  • Generated repeat business through exceptional customer service.
  • Conducted store inventories once per quarter.
Education
High School Diploma 2011 Southland Academy - Americus, GA
Associate of Science: Focused on Biology 2013 Darton State College - Albany Georgia
Additional Information
Security clearance and obtain a CAC ID card
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Professional Summary

Experienced and self-motivated School Psychologist specializing in cognitive and psychological evaluation and interpretation.

Skills
  • Assessment and evaluation
  • Interpretation of evaluation results
  • Development of IEP goals
  • Behavioral support plans
  • Verbal and written communication
  • Computer and technical skills
  • Targeted interventions
  • Team collaboration
  • Experience with diverse populations
  • Crisis intervention
Work History
School Psychologist, 09/2019 to 05/2020
ProCare Therapy, St. Vrain Valley School District Longmont, Frederick, CO
  • Utilized formal and established testing protocols to evaluate educational, emotional and behavioral needs of students.
  • Consulted with teachers and parents to gain in-depth understanding of students.
  • Met with students to conduct individual assessments and determine academic and mental health needs.
  • Collaborated with educators, school administrators and external professionals in development of Individualized Education Plans (IEPs).
  • Observed students in classroom and play environments.
Gifted Testing Specialist, 08/2017 to 09/2019
Dr. Terri Lucero, Peak Exceptional Services Northglenn, CO
  • Meet with students to conduct individual assessments and determine cognitive and academic strengths and needs
  • Provide detailed reports which include recommendations for schools, programming, educational needs, and social and emotional needs
  • Establish rapport with students and their parents in creating a comfortable test setting to facilitate valid assessment results
School Psychologist, 10/2002 to 06/2017
Aurora Public Schools Aurora, CO
  • Utilized formal and established testing protocols to evaluate educational, emotional and behavioral needs of students
  • Effectively communicated evaluation results to parents and IEP team
  • Collaborated with educators, school administrators and external professionals in development of Individualized Education Plans (IEPs)
  • Developed functional behavior assessments and behavioral intervention plans for students to increase academic achievement and engagement
  • Built positive and productive relationships with students, parents, educators and community resources
  • Worked with students individually or in groups to target skills as per IEP goals and referral concerns
  • Provided support for students with varying levels of need, including students with severe social/emotional needs in center-based programs
School Psychologist, 09/1996 to 05/2002
Grand Forks Public Schools Grand Forks, ND
  • Conducted 100+ psychoeducational assessments per school year
  • Effectively communicated results of assessments to IEP team
  • Developed IEP goals and behavior plans to address social and emotional needs of students
  • Consulted and collaborated with parents and staff in multiple schools to provide recommendations and develop interventions to increase student engagement
  • Attended meetings, trainings, and conferences as required
  • Provided referrals for community resources and mental health professionals for families and students
Education
Master of Science: School Psychology, 1996
Minnesota State University Moorhead - Moorhead, MN

Bachelor of Arts: Psychology, 1993
Minnesota State University Moorhead - Moorhead, MN
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Education
Bachelor of Arts: Political Science, 2017
Queens College of the City University of New York - Flushing

Minor: Urban Studies

Spanish Translator Certificate: Bilingual Translation Studies(English-Spanish), 2016
CUNY Hunter College - New York
Economic Analysis Certificate: Latin American Economic Analysis- Online Course, 2018
Latin American Strategic Center of Geopolitics(CELAG) - Ecuador
Work History
Immigration Logistics Volunteer, Dec 2017 to Jun 2018
The New York Immigration CoalitionNew York, NY
  • Worked in conjunction with the Mexican consulate to provide its citizens with passports, consular IDs, and legal documents
  • Assisted presenters at workshops and coordinated legal clinic events called "Key to the city"
  • Served as interpreter for attendees that needed immigration legal consultations
  • Registered incoming guests that entered the event location and referred them to their appointment site    
Administrative Support/Team Leader, 05/2013 to Current
Rite Aid PharmacyJackson Heights, NY
  • Maintained, distributed and managed important files within the manager's office and made decisions in a deadline sensitive environment
  • Provided a high level of customer service in a pleasant, upbeat and professional demeanor both  in person and by phone to customers, vendors, upper management and stakeholders
  • Trained new associates showing them how to handle the cash register and also instructed them on the Rite Aid guidelines and procedures
  • Acquired a strong ability to communicate effectively within a multi-cultural environment and with people from various cultures and countries
Naturalization Services Volunteer, 06/2017 to 10/2017
Make the Road New YorkQueens, NY
  • Processed client intakes into the Make the Road New York case system  
  • Filled out case forms with sensitive information 
  • Served as interpreter between immigration lawyers and clients
  • Collected information about clients through interviews
  • Informed clients with questions regarding  the naturalization process
  • Set up appointments for naturalization clients through phone calls
File Clerk, 03/2016 to 08/2016
German&Rubenstein LLPNew York, NY
  • Classified, scanned documents and named files accordingly into digital folders
  • Used Trialworks to find, correct, add, delete information from all legal documents that the firm had represented
  • Used Fileit to save documents into the firm's online database
  • Answered high volume of phone calls from clients in a professional demeanor
Sales Representative(Seasonal Position), 07/2013 to 08/2013
St. John's University BookstoreJamaica, NY
  • Effectively communicated with and supported sales, marketing, and administrative teams on a daily basis
  • Provided a high level of customer service by processing payments and online orders with high efficiency
Sales Representative(Seasonal Position) (Also on Fall & Spring 2012), 08/2011 to 09/2011
CUNY Queens College BookstoreFlushing, NY
  • Provided a high level of customer service by approaching customers, welcoming them and  helping them locate their desired goods
  • Processed payments and online orders
  • Answered a large number of phone calls from customers and school professors
Logistics and Outreach Volunteer, 04/2011 to 06/2011
Senator Kirsten Gillibrand's NYCNY
  • Worked together with the Logistics team during political rallies and other special events
  • Presented NYC residents out in public with the Senator's planned Agenda and her valuable accomplishments as Senator for NY
  • Made a high volume of phone calls in a pleasant and professional demeanor to ensure the participation of registered voters in upcoming elections 
Skills

Language:


Computer:

  • Fluent in Spanish
  • Intermediate level in French
  • Professional knowledge of Microsoft Word, Power Point and knowledge of Excel and Outlook
  • Professional knowledge of Mac OS, Internet Explorer, Google Chrome and Adobe Reader.
  • Strong internet research, proofreading and editing skills and data entry
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Summary

To find a position where I can use my interpersonal bilingual and leadership skills and abilities to help others and our community.

Experience
Patient Care Advocate
July 2017 to Current
Express Scripst Tempe, AZ Handling customer service inquiries from members, providers, physicians and internal and external clients related to pharmacy benefits. Working to research and resolve problems in a timely manner. Assisting members in understanding and maximizing the use of their pharmacy distribution program.
Immigration Case Manger
June 2016 to June 2017
Friendly House Phoenix , AZ Conducting intake interviews and orientation sessions. Assisting clients with their Immigration applications for Citizenship, family petitions, U-Visa, DACA, Provisional Waivers, Permanent Residency and work permits. Met with clients regularly as require for case follow-ups. Developed and maintained accurate case work maintaining confidentiality of all records. Retrieving documents from electronic databases. Organizing, maintaining and indexing case files.
Legal Assistant
May 2013 to September 2015
Florence Immigrant & Rights Project Phoenix, AZ Provided unaccompanied children with know your rights presentations at Immigration Detention Shelters. Performed individual intakes to identify immigration relief. Provided pre-court counseling sessions and representation before the Immigration court, U.S. Citizen ans Immigration Services and family court. Extensive client contact including indigenous children who have suffered abuse, abandonment, neglect or other emotional or physical trauma. Worked on immigration and juvenile court forms under the attorney's supervision. Performed referrals services to match clients who were released, matching clients with social and legal services nationwide. Administrative clerical work including filing management, data entry, and directing incoming calls to the appropriate staff members.
Sales Supervisor/Sales Associate
February 2012 to April 2013
Curacao Phoenix, AZ Completed an eight week Management Development Course. Executing events with vendors to improve customer loyalty and meet sales goals. Running daily sales reports, inventory, and transfers. Daily auditing fine jewelry. Recruiting and training new sales associates to met their personal sales goals while delivering a great customer service. Managed and handled returns, customer concerns, new credit card stored accounts and staff schedule to insure floor coverage.
Counter Manager/Sales Associate
October 1998 to May 2010
Macy's West Scottsdale, AZ Provided professional customer service while meeting sales goals and credit solicitation goals, with a knowledgeable and positive attitude. Trained and couched sales associates to achieve their personal productivity. Planned and coordinate special events in support of sales goals.
Team Leader/Cashier
January 1992 to October 1998
Tokyo express Inc Phoenix, AZ
  • Completed daily sales reports while delivering outstanding customer service, creating a positive atmosphere for both customers and co-workers.
  • Closing, opening and balancing cash registers and safe.
  • Supervising up to ten employees.
Education
Communications/Psychology/Early Childhood Development, 12/2000 Paradise Valley Community College Phoenix, AZ
Customer Service Representative Rio Salado Community College Phoenix, AZ
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Professional Background
Goal driven oriented professional with a strong medical and customer service background. Self-motivated, adaptable, resourceful individual. Ability to listen and identify issues with an effective resolution. Excels at multi-tasking in a fast pace environment, completing projects or goals within time and budget constraints. Superior telephone and customer service skills along with computer proficiency in Microsoft Word, Excel and Power point.  
Professional Experience
09/2018 to Current
Sr. Financial Clearance Representative Uh Ahuja Medical Ctr. Beachwood, OH

Currently my responsibility is being able to be 10-15 days out making sure my surgery cases are approved without any glitches. I work as a team and unit with my coworkers making sure we complete our surgery authorization be it by online or by telephone and we are in constant communication with our physicians office that we take great pride in getting this job done and we also make sure that the other coworker is taken care of as well. While under great pressure we strive to make our department meet our goals daily. Currently I'm responsible for obtainng authorizations for inpatient & outpt surgeries and procedures also Interventional and Cardiac Cath procedures and RBC.

12/2017 to 09/2018
Quality Analyst Trainer UH Ahuja Medical Ctr Beachwood, OH

As Analyst Trainer I was responsible for helping to training new hires for various areas in Patient Access and making sure they had what they needed to suceed and grow in their new roles within Pt Access. Analyst Trainer were responsible for Status changes and Ebew Lists and tracking of employee errors and being able to present these errors at our monthly meetings. Being on call for employees and coworkers with any insurance question or issues in which they would need help to resolve. Being more familar with sreadsheets and excel. Being able to discuss denials with our staff and why we recieve these denials and what staff can do to help prevent these denials.

Employee engagement. Not pointing out the bad but encouraing the good in our staff. Asking what they may need from us as a whole. Training , small lunch & learning sessions for the employees.

05/2014 to 12/2017
Financial Counselor UH Ahuja Medical Ctr. Beachwood , OH

The responsibility as a Financial Counselor would be to identify Self Pay patients and work with financial assistance if need be.

The responsibility to close and submit and reconcile all cash check & credit card collections from coworkers and satellite locations.

The task of taking incoming calls and if need be facilitate to the appropriate group and or individuals within billing and the hospitals.

Resolve any account issues.

The responsibility to quote upcoming surgeries and or procedures that the patient would have going over deductible copays and out of pocket expense for the patient. Clear Quote Application & POS collection.

The ability to be able to verify insurance coverage and using online submission with Availity, Commercial Insurances and Medicaid, Medical mutual and other online verification.

The Financial Counselors would also know how to obtain precertification and authorizations and Appeals.

Maintaining and establishing a relationship with all parties involved throughout a patients encounter.

05/2011 to 04/2013
Financial Clearance Representative University Hospitals CMC Beachwood , OH Responsibilities includes every patient on the Soarian work list be verified for the following departments assigned such as Ophthalmology, Plastic surgery and Cardiac Stress Echo's. Calling various insurance companies and finding ways to work efficiently in gathering details in a time based environment and if Peer to Peer or additional documentation is needed I would relay this back to the Physicians office in a timely manner.
02/2010 to 05/2011
Intake Specialist Ravenwood Mental Health Center Chardon, OH Screening Intake calls to assign to the appropriate programs within the Mental Health and Substance Abuse programs. Gathering insurance information and coverage for each Clinicians program and getting the first authorization started and mapping out what financial responsibilities the patient would be looking at. Obtaining MACSIS numbers for those who weren't already in the system qualifying patient for any financial assistance that Ravenwood would offer and setting up payment arrangements. Daily bank deposit preparations and entering each program in the system for every patient.
02/2007 to 02/2009
Coding Specialist Kaiser Permanente Brooklyn Heights, OH Daily encounter auditing constraint's for over 20 Providers in Internal Medicine and Family Practice for correct Coding and documentation occurrences. Yearly Presentations for all departments of Medicine to keep the Physicians current with ICD-9 and CPT codes and coding guidelines. Traveling to various locations within Kaiser Permanente. One on One consultations with Clinicians to ensure they would meet the 90% mark and the end of the year grading term.
04/2002 to 01/2009
Insurance Coordinator Laurelwood Counseling Center Beachwood, OH

Patient Registration and Insurance verification and account reconciliation.

Financial counseling for patients who were Self Pay or payment arrangements for those who required individual therapy or Intensive outpatient services.

I worked the Authorizations and insurance denials and chart audits collections of copays and coinsurances.

Banking deposits and scheduling and other various front end duties. Chart/New patient preparations as well.

Education and Training
1985
High School Diploma: College Prep Courses 2002 Shaker Heights, OH
1990
Medical Assisitant National Education Ctr/Remington Garfield Heights , OH
1986
Did Not Complete: Real Estate & Law Enforcement Community College Cleveland , OH
2002
Graduated: Coding & Reimbursement Bryant & Stratton Willoughby, OH
Certifications
CHAA Certified