EDUCATION

Purdue University Global- Indianapolis, IN

Master of Science in Health Care Administration

June 2022

Bachelor of Science in Health Care Administration

November 2020

Summa Cum Laude

Broward College- Davie, FL

Associate of Arts in Nursing

December 2009

Silver Key Honor Society

AREAS OF STRENGTH

Thorough understanding of financial and budgeting processes and principles

Solution drive while dealing with problems and conflict

Diligent and goal-driven to meet team’s objections

Able to prioritize and multitask in a fast-paced changing environment

Capable of maintaining a high level of confidentiality regarding sensitive information

Skilled in communicating with all levels of staff

EMPLOYMENT

Ciox Health

CRI Program Coordinator 11/2022- Present

Demonstrates initiative and judgment in performance of job responsibilities.

Communicate with co-workers, management, and hospital staff regarding any issues with denial accounts.

Function in a professional, efficient, and positive manner

Customer-service focused and exhibit professionalism, flexibility, dependability, and desire to learn.

High complexity of work function and decision making

Strong organizational and teamwork skills

Receives and enter new denial accounts from denials clients into the system, ensuring accurate and complete documentation.

Conducts thorough research on denial accounts, reconciling discrepancies, and gathering relevant information to understand the nature of the denial.

Analyzes clinical data to identify trends in clinician and coder processes, providing insights to improve denial management and prevent future denials.

Facilitates onboarding training for new team members, ensuring they are equipped with knowledge and skills required prior to denial account training.

Initiates and complete payor follow-up calls to obtain updates and clarification on denial accounts, working closely with insurance companies to resolve issues.

Read payor denial letters and determine the type of denial based on clinical and coding rationale provided by insurance companies.

Communicates potential concerns or problems to CRI Denials Supervisor

Maintains confidentiality and security with all privileged information.

Assists with additional work duties or responsibilities as evident or required.

St. Lucie Medical Center, Port Saint Lucie, FL

HIM Coordinator 10/2021 –05/2022

Initial on-site point of contact when HIM Leader is off-site for Facility Leadership and Medical Staff.

Assisted Facility HIM Clerks and Birth Certificate Clerks with questions.

Assisted Facility HIM Leader in employee training and development.

Entered applicable unbilled reason codes (URCs) into HPF and MEDITECH daily.

Adhered to documented and established workflow guidelines as it relates to managing facility

HPF/MPF work queues.

Assists in the processing of walk-in requests for the Release of Information.

Requested and returns paper records from off-site storage as applicable.

Retrieved discharged medical records from various nursing units and ancillary departments as needed.

Assisted in reconciling retrieved medical records against patient discharge listings working closely with patient care units to ensure receipt of all records no later than the morning after discharge/visit.

Ensured that facility-based HIM function productivity and quality standards are maintained or exceeded.

Cleveland Clinic Primary Care, Vero Beach, FL

Patient Access Specialist 1/2021 –10/2021

Interviewed patients (face-to-face/phone) to validate existing patient medical records and insurance information

Obtained required signatures for all consent to treatment forms, including federal, state, and county forms.

Initiated and coordinated referrals for financial assistance programs.

Verified insurance plans utilizing electronic eligibility tools and access web portals

Knowledgeable of insurance rules & regulations regarding payment for services.

Responsible for taking the necessary steps to prevent medical record duplications or incorrect patient selection while adhering to HIPPA regulations

Contacted physician and clinical providers to validate and clarify information on orders, schedules, or other requirements such as patient instructions.

Utilized electronic reports, worklists, and queues to identify claims requiring updates to ensure accurate and timely billing.

Scheduled professional and technical patient appointments using multiple software applications.

Men’s Wearhouse, Jensen Beach, FL

Operations Manager 5/2007 – 3/2021

Responsible for driving sales and overseeing a $1.1 million store budget while managing day-to-day store operations.

Reviewed and analyzed P/L on a weekly, monthly, quarterly, and annual basis against the company goals

Directly involved with recruiting efforts to fill vacant store positions while overseeing daily operations

Assisted employees with benefits enrollment and processed weekly payroll

Administered quarterly and annual employee performance evaluations

Ensured legal compliance with state and federal regulations and applicable employment laws while adhering to company policies

Experienced using PeopleSoft to screen candidates and process new hire paperwork including electronic I-9 forms.

Provided world-class customer service by building quality relationships with customers

Served as a coach and role model to the store team by providing constructive feedback and demonstrating servant leadership.

Store Manager

Provided the leadership needed to operate the store efficiently and effectively.

Assisted in administering benefits, compensation, and employee performance programs.

Suggested new procedures and policies to continually improve the efficiency of the HR department and organization, and to improve the employee experience

Created the synergistic atmosphere and high-quality work environment that is the foundation for offering customers an exceptional shopping experience.

Marketed the store tuxedo rental business by attending bridal shows and marketing to prom customers.

Train new employees on business practices related to driving tuxedo rental volume.

Prepared and reviewed fiscal reports, daily agenda, and audits timecards.

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