Profile

I have extensive knowledge of the process and policies of Medical

Management and know what is needed to get the job done effectively and

efficiently. I am currently pursuing dual degrees in the health care

industry and would like to explore other avenues of employment within this

field while I complete the goals that I have set.

Education:

J. Sergeant Reynolds Community College - Richmond, Virginia

. Licensed Practical Nurse, Degree expected in Fall 2016

. Heath Care Coding Technician, Certificate / License expected in the

Fall 2014

Professional Experience:

UM Rep I Review Aug-13 - Present

Aerotek / WellPoint

Richmond Virginia

V Responsible for routing 70 + request per day including admissions,

psych testing, mental health maternity and all OON procedures needed

V Point person of direct inbound calls to the proper UM nurse Inpt /

Otpt

V Input information using dual systems

V Assist providers in understanding the process of appeals as needed

V LOI process and claims status on all request processed when needed

V Daily statistical reports generated to ensure compliance

V Other duties as assigned

Referral Coordinator Oct -10-March -13

Virginia Premier

Richmond Virginia

V Promoted from Vertexer, I became responsible to authorize request for

providers either thru auto approval or UR review

V Processed 50 + request per day including admissions, psych testing,

mental health maternity and all oon procedures needed

V Assisted in resolving issues with claims and any other discrepancy

stemming from authorizations approved and being processed for payment

V Answered calls from providers either to create, inquire or release

authorizations at various stages

V Other duties as assigned

Claims - Vertexer Dec -09 - Oct

- 10

V Entered corrected data as they came in through system in order to be

further processed by payment department.

V Other duties as assigned

Administrative Assistant May-06 - Oct-

09

Upaco Adhesives

Richmond, Virginia

V Maintained product inventory for three departments, Waterbase; Solvent

and Hot Melt

V Processed all work orders for product

V Back-up person to set up freight carriers for the shipping department

V Responsible for closing Batch Tickets out once product is pulled,

QC'd, Approved or rejected. Closed on an average of 140 batches per

month

V Converted entire Raw Materials MSDS Table of Contents to electronic

version for easier assess this included all archives of products not

being used

V Responsible for resolving issues that arose regarding product,

shipments, etc.

V Assisted Sales with various projects including research and analysis

of customer buying habits of product

V Processed request for samples, MSDS; COA's or any other documents

needed to new or existing customers

V Generated monthly reports for the Plant Manager to review and forward

to the Corporate office as part of the Quarterly Forecasting

V Screen incoming calls and forwarding them to the proper department

V Sent faxes, received and distributed mail and other documentation

Administrative Assistant/Customer Service Rep

Nov-03 - Dec -05

CareersUSA - Staffing Services

Various Industries

Cherry hill, New Jersey

V Service assignments dispatched to tech throughout east coast area

V Organized and dispatched serviced schedules

V Assisted in new accounts, deliveries and warranty upgrades

V Provided support for the techs when closing service calls

V Greeted potential clients and answered phones

Administrative Programs Specialist

April-01 - March-03

State Division of Licensing Programs - Operations Unit

Richmond, Virginia

V Developed, managed and maintained programs for agencies that received

violations from the State

V Scheduled informal conferences

V Proofread, edited and transcribed documents

V Assisted inspectors with correspondences and legal notifications

V Managed 50 various cases per month

Adverse Enforcement Administrative Assistant

State Division of Licensing Programs - Quality Assurance Unit

V Collection of civil penalties outstanding

V Assisted in trend analysis for various assisted living and children's

programs

V Prepared monthly and weekly status reports

V Proofread and edited manuals and documents for various programs

V Assisted Program Managers prepare for upcoming legislative matters

Administrative Assistant

Action Technicians Staffing Services August-00 - April-

01

Dupont-Richmond Zytel

Richmond, Virginia

V Created and maintained various manuals of procedures

V Assisted Engineers with their management of change (MOC) orders

V Scheduled traveling and hotel and demo promotion reservations

V Proofread and edited various documents for distribution

Computer Skills:

Pivitol Microsoft Suite 2010

CCMS Lotus Notes

IDX Cerna

AccuRoute WMDS / maxMC

TRIMED NASCO

AIMS RightFax

WCG

References Upon Request.

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