LaQuita Buckholtz

**** ****** ****, ************ ** 32208

904-***-**** (hm) 904-***-**** (cell)

abi244@r.postjobfree.com

RANGE OF EXPERIENCE

I have over 15 years of professional experience in various capacities to

include recruiting, data collection and research; social services,

healthcare/ homecare services, health insurance and financial services. My

work experiences include Home Care Program Administrator, Data Collection/

Research Supervisor, Professional Customer Service (face to face and call

center), Financial Services (Branch Banking/Telecommunications). I posses

extensive knowledge in public and private sector governmental documentation

processes to include M/W/DBE, JSEB, SBA, 8a and 501(c)(3), AHCA, Medicaid

Certification and Contract Compliance.

KSA-KNOWLEDGE, SKILLS & ABILITIES

Knowledgeable of computer software programs to include: Word, Excel,

PowerPoint, Outlook and Access. Skilled at prioritizing, completing

multiple tasks simultaneously; providing deliverables within a specified

timeline. Ability to collaborate and work well within a team setting or

make successful solid independent decisions; communicate effectively with

subordinates, peers and superiors; to include executive level management.

PROFESSIONAL EXPERIENCE

Better Care of Jax, Administrator 2006-Present

Responsible for planning, organizing, directing and supervising daily

functions of Social Services Agency to ensure agency compliance with

County, State and Federal Regulations to include Agency for HealthCare

Administration (AHCA), National Provider Database, Agency for Persons with

Disabilities (APD), Medicaid Provider of Services (Med-Waiver), Department

of Elder Affairs (Area Agency on Aging) and Department of Education

(Vocational Rehabilitation).

Maintained rapport and met regularly with other agencies, individual

providers, prospective & current clients. Collaborated with Psychiatric

Treatment Team to include Doctors, Nurses, Counselors and Case Managers to

assist with goal setting and be readily available to apply verbal de-

escalation and/ or physical intervention when necessary.

D. Wilson Consulting Group, LLC, Data Collection/ Research Analyst 2007-

2009

Prepare, submit and maintain S/M/W/DBE, JSEB, SBA and 8a certifications;

exercise independent judgment and initiative in the administration and

accountability of all local, state and governmental applications

Data collection provided for the following availability/disparity

studies: Alaska Department of Transportation & Public Facilities, Montana

Department of Transportation, Pima County and the City of Tucson, Arizona

and Colorado Department of Transportation.

Traveled to client site and assist with the data collection process by

performing database cleaning and scrubbing; provide supervision and

guidance to data collection staff; assists in the development of database

management procedures to organize, code, and enter data for

availability/disparity studies; Conduct extensive internet search for

RFP, RFB, RFQ's.

Performed research of contracting documentation and materials in a

variety of formats for the purpose of disparity/availability studies and

conduct research involving discriminatory law findings, forecasting and

goal setting; Ensure total accuracy of documentation for possible

publishing in library, online, law reference material and/or Supreme

Court Hearings.

Aetna Life & Casualty Insurance Company, Provider Relations Specialist 2004-

2006

Received inbound calls requiring technical assistance for web user;

Analyzed, researched, and utilized available systems and in house

documentation then followed up with the provider and internal departments

with detailed responses and further direction if needed; made outbound

calls to providers and other insurance carriers to research and resolve

inquiries and/or request;

Adhered to HIPAA and applied medical necessity guidelines, determined

coverage, analyzed benefits, completed eligibility verification,

identified discrepancies, interpreted EOB's, issued referral

authorization/referral status, knowledge and understanding of: UB92/HCFA

1500, identified over utilization and assisted in the claim adjudication

process.

Advised of credentialing process for non-credentialed providers, reviewed

and interpreted contracts for credentialed healthcare providers (Medical,

Dental, DME, PT, OT, ST, RAP's, etc.)

Citigroup/Logistics Corporation, Credit Analyst/ Sales 2000-2004

Received inbound and made outbound calls regarding commercial credit

application, analyzed credit applications for clients via Dunn &

Bradstreet, established credit limits from $5,000 to $1 million; provided

follow-up calls regarding credit worthiness of applicant, providing

authorization for approval and/or explanation of denial.

Received inbound calls in call center environment, reviewed personal

accounts for credit limit increases, provided verbal approvals, initiated

written denials and additional related concerns, i.e. billing fraud

investigations, death of consumers, etc.

WorkSource- Department of Veteran Affairs, Employment Specialist 1998-2001

Recruited, interviewed, screened Veteran applicants; served as liaison

between potential employee and employer

Referred qualified Veteran applicants to various employers and negotiated

starting pay for potential employee; providing Veterans with market rate of

pay for field in which they were trained and employers with average rate of

pay for position within employment market

Assisted DVOP/LVER with TAPS training to ensure a positive transition from

military to civilian life; referred Veterans to appropriate organizations

for additional entitled benefits.

EDUCATION

Fair Housing Law (Fair Housing Act 42 U.S.C.3601) Jacksonville Area Legal

Aid

B.B.A., Organizational Management, Edward Waters College

A.A.S. (60+) Human Services-Addictions Counselor, Florida Community College

@ Jacksonville

Wilson Consulting Group, LLC

Wilson Consulting Group, LLC

Wilson Consulting Group, LLC

Wilson Consulting Group, LLC

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