Microsoft Office Manager
Resume:
Moe Al-Jumaili
Phoenix, Arizona 85020
***********@*****.***
_
Overview
Critical thinker, punctual, results oriented, team player, and self-motivated.
Proficient in Microsoft office, Water Hammer, Auto Cad/loop, Cms, Microsoft Photoshop, and RX claim.
Confident presenter with engaging and affable demeanor.
Three years’ experience effectively and efficiently working under extended periods of high pressure working for the U.S. Army.
Problem solving skills drawn from academic education as well as years of practical and professional experience.
Over 5 years of management and leadership experience over highly specialized and task oriented teams.
Fluent in English, Farsi, and Arabic.
Education
Mostensariya University: 2003-2007 Baghdad, Iraq
B.S. Civil Engineering
Work Experience
CVS Medical Billing Specialist: August 2016- present
Maintain and release all-ship-verified claims for all third party claim accounts within established time frame as assigned Resolve errors and make claim edits assigned in work queues
Follow work list prioritization of accounts for resolving accounts and/or submitting claims
Contact payers and patients when necessary for PFS processes
Request relevant information from appropriate Revenue Cycle and clinical departments as required through the course of the PFS processes
Make necessary adjustments to patient demographic, insurance, and account balance information
Complete A/R adjustments and request other adjustments where permitted and appropriate
Adhere to all regulatory compliance areas, policies and procedures (including HIPAA and PCI compliance requirements), and "leading practices"
McKesson: Dec, 2015 – present
Enrollment Specialist
Process new members and group enrollments in system.
Process adds/terms/changes to member record on system.
Research and update member eligibility.
Update member’s info and drug benefits.
Submit changes to individual plan benefits, new group additions and group changes.
Maintain annual group renewals monthly.
Maintain group eligibility reports.
Work the Termed But Paid reports and mail letters.
Work Delinquent reports in regards to Marketplace business.
Work closely with claims and accounting to ensure member notes are up-to-date.
Expert Global Solutions (EGS)
United Health Care (prior authorization): May, 2014 - Dec,2015
Pharmacy Tech
Processing prescriptions (from intake to order completion).
Taking inbound calls from provider and
Entering mail order prescriptions and verifying the appropriate information.
Completing outbound calls to patients, physicians and pharmacists while ensuring a high level of accuracy and maximizing productivity.
Contacting patients, pharmacists and doctors’ offices to resolve claims issues using RX claim.
Respond to client inquiries regarding authorization approvals and PBM on-line applications
Contact providers for additional information to facilitate coverage determination reviews
Notify physicians, providers and members of coverage determination request decisions
Working with ALL Medicare Part D plans and working through the different checks and balances
• Processing prescription edits for age, cost, diagnosis using RX claim.
EGS
Best Buy: Nov, 2013 – May, 2014
CSR 11/2013, Team Leader 01/2014
Manage a team of CSRs under operations manager direction.
Ensure time management and entries for all team employees.
Coaching new and underperforming team members.
Handling call/chat escalations to supervisor.
Conducting monthly one-on-one reviews.
Process and submit new and existing member enrollment, disenrollment and member maintenance transactions.
Research and reconcile the errors and rejections received on the daily/monthly reports.
Perform outbound member calls.
Contacting members to validate or acquire additional information needed to process the enrollment and enrollment related functions.
Work with other departments to resolve member issues.
International Rescue Committee, IRC:2013-2016 Phoenix, Arizona
Interpreter
Assists in service delivery to clients by providing accurate interpretation.
Works with case managers, employment specialists and other staff members to assist in
communication with clients.
Responsible for ethical and confidential translation services.
Conducting cultural awareness orientations.
Council of Representatives of Iraq: 2010-2013 Baghdad, Iraq
Office Manager
Overseeing all employees within the Representative’s staff.
Approving time-sheets and resolving payroll issues.
Setting schedules and organizing staffing needs.
Overseeing all in/out of office correspondence with parliament and governmental entities.
Conducting interviews and responsible for hiring and talent acquisition.
Translated documents, briefs and news for the Representative.
United States Army: 2005-2010
(McNeil Tech, Global Linguist Solutions, Titan/L3)
42nd Infantry Division, 101st Airborne, and 82nd Airborne.
Linguist and Logistical Support
Provide real-live translations during meeting between US Army commanders and their Iraqi counter parts.
Translate documents and manuals as required by job function and mission needs.
Local Advisor providing weekly security and economy reports about the area of operations.
Provide translations during Iraqi Army training by US Army trainers.
Attend the district council’s meetings and provide meeting minutes in English to the battalion commander and staff.
Go out on combat missions providing live translations and route guidance based on knowledge of local area.
Volunteer Experience: 2013
Catholic Charities Community Services, Phoenix, Arizona
Volunteer Interpreter
Attended meetings with case managers or other staff and their clients to interpret
Translated meetings of confidential material
Experienced in direct translation services, especially in high stress and emotional scenarios for the client
Certifications/Awards
Pharmacy tech license # T044885
US Army recommendations by commanding officers
Community Interpreter Certificate by IRC.
Patient Relationship Solutions by McKesson.
References
Ned Maleh, Supervisor, CVS. 480-***-****
.
Dhiren Chauhan, Supervisor, Catholic Charities Community Service. 602-***-****
Paul Shannon, Major, US Army. 480-***-****
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