Intake Specialist
Resume:
Madeline Sierra
*** ***** ******* *** *** ~ Brooklyn, New York 11218
***************@*****.***
SUMMARY OF QUALIFICATIONS
Highly skilled Administrative professional with over 20 years of experience in the health care industry. Adept at prioritizing and managing deadlines with the ability to work successfully under pressure. Excellent communication and interpersonal skills. Successfully collaborates with team members to make recommendations that improve quality and production.
Bilingual English/Spanish
Extensive knowledge of HIPPA protocol
WORK EXPERIENCE
GHI / EmblemHealth
Intake Specialist
July 1995 - February 2016 New York
Accurately documented all certified mail into the system.
Received mail and documents; checked on manifest for correct Department and certified numbers.
Opened and sorted correspondence; validated and prioritized outgoing mail.
Stamped and handled Grievance and Appeals, abiding by established guidelines.
Transferred the Correspondence within the time frame allotted. Transferred all other mail to its prospective Departments within the company as well as to our other branches.
Sorted and prepped Hospital, Medical, Dental, Foreign claims and Correspondence to be scanned and filmed for other Departments.
Sorted Subscriber, Provider, EmblemHealth, GHI, HIP, Attorney at Law, Department of Taxation, Vytra, Dental, and Hospital checks.
Entered information regarding the sender, check amounts and date received into electronic database; prepared for check transfer to the Accounting Department.
GHI / EmblemHealth
Junior Analyst
June 1990 - July 1995 New York, NY
Inputted subscribers missing information on claim forms (name, address, and date of birth).
Filled in Doctors information and their category (Top) as to identify their Specialty.
Translated foreign claims currency into US dollars.
Contacted Subscriber or Currency Exchange offices to verify country where services were rendered for accuracy of claim payments.
Deciphered foreign claims for all departments throughout company and from our other branches.
Mailed out claim forms.
Generated ALGS letters and mailing them out for missing information to speed up processing.
Updated information for subscribers and providers within the Dental Department.
Inputted adjustments for the Adjustment Department.
Generated ALGS letter to HIP Subscribers and Providers.
Claim retrieval on our old system; logged and voiding out checks
EDUCATION
Sarah J. Hale Vocational High School
High School Diploma
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