Shirley Gaitan

Experienced Leader

San Antonio, TX 78223

aczgky@r.postjobfree.com - 210-***-****

Dedicated, performance-driven, and results oriented professional, offering 15+ years management experience in healthcare, retail, and banking. Exceptional leader and expert in management of healthcare services operations and administrations. Core competencies include: Leadership/Management Business Development Client/Provider Relations Project Management Strategic planning & execution Utilization Management Time Management Process evaluation & improvement Multi-tasking WORK EXPERIENCE

Membership - Implementation Team Lead

FCE Benefits Administrators - April 2016 to March 2017

• Oversee and lead the workflow in the department while managing daily tasks to include but not limited:

• Process contribution reports while keeping constant contact with account managers, clients, and members regarding any discrepancies with funding and hours being submitted.

• Implementing, reviewing, and revising daily enrollments of all benefits.

• Review federal contracts, provider certifications/credentialing and client funding Client Relations Team Lead

- January 2016 to April 2016

• Responsible for managing all client relationships involved directly with the organization. Main priority is ensuring strong relationships with every customer, client, and insurance carrier we serve. Maintain a daily review of budgets, policies, plans, and procedures to ensure benefits are being carried out properly.

Auditor

- June 2015 to January 2016

internal reviews of all medical billing and claims that are paid through the company. Review every high dollar medical, dental, and vision claims by making sure all coding, billing, payment, and benefits are paid out accurately and timely before any payments are issued. Customer Advocate

United Healthcare - September 2006 to June 2015

• Trainer/Mentor for all customer service analysts

• Responsible as subject matter expert for training new hires – with use of telephone techniques inbound/ outbound provides service and education of medical/pharmacy claims, billing, benefits for providers and consumers.

• Participates and coordinates as part of an Engagement Team Leader

• Project team leader

EDUCATION

Bachelor of Business Administration in Management

Texas A&M

December 2014

Associates of Business Administration in Business Management Northwest Vista College

December 2012

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