Customer Service Community Outreach
Resume:
Salvacion Anquilo
********@***.***
OBJECTIVE:
To obtain a challenging position where my experiences, capabilities, and enthusiasm to work will benefit organization and offer opportunities for personal growth and career advancement.
SKILLS:
Computer literate
Medical Terminology and Coding (ICD-10, CPT, HCPCS, and CRBRVS)
Medical and Workers Comp Medical Only Claims Processing
Excellent understanding of claims procedures, rules & guidelines, and all aspects of claims adjudication (COB rules, multiple surgeries, lab/radiology, etc)
Community Outreach and Health Educator
Facilitator
Community Outreach Coordinator
Cashiering
Customer Service
Canvasser
Cashiering or Money Handling
Researched and Data Gathering for Presentation
PROFESSIONAL EXPERIENCES:
CASHIER 09/2018 - present
Checking out Customers by scanning products, received cash or credit/debit card for payment
Scanning checks by inserting checks on machine and let them sign on computer register in front of them
Customer service by assisting customers on what they are looking for which aisle they can see the product or food that they needed
Advise them to go to Customer Service if they need to reimburse their money and resolve any transactions
COMMUNITY OUTREACH HEALTH EDUCATOR 2010 - 2018
Drive around the Valley reaching out Low Income Families distributing handouts and brochures regarding Sexually Transmitted Diseases and Pregnancy Prevention referring to the nearest Health District Office for free condoms and affordable sliding scale payment for every services, connecting and linking families to needed resources and assisting with the facilitation of group connections with different Clinics and Non Profit Organizations for Sexually Transmitted Diseases
Conducting telephonic outreach on a day to day basis with assigned call list and should assigned to expect .25 - .50 of their work time attending focused opportunities on providing educational presentation on Human Immunodeficiency virus and Pregnancy Prevention, Tobacco Cessation, Health Insurance Advocate for Medicare and Medicaid to target audiences
Coordinating with different partners how their Program help HIV and Pregnancy Prevention and borrowed they Facilities for presentation expected to collaborate with internal public. health programs, and occasionally participate in country formed workgroups working in day and night shift participating as a member or chair of the department task forces and committees for strategic planning, service delivery designs and other topics; provide leadership and coordination with other health organizations, volunteer health agencies and other public health departments for the development and implementation of community health promotion projects work with state agencies to coordinate programs and exchange information
Assist in coordination and participate in community outreach initiatives and events. Lead as contact for community partners and engage them to assess community needs and help develop new and innovative outreach approaches within the scope of HIV and Pregnancy Prevention and organized and conduct health education meetings and conferences for community groups, civic, and religious organizations.
Community Outreach events may take of the form of tabling at local food shelves, health fairs, community festivals develop contacts and partnerships with community agencies and individuals, schools, health care professionals and social service providers in order to conduct health care problems or needs.
Prepare and assemble educational materials including web resources, brochures, exhibits, posters, newsletters, slides and other audio-visual materials and develop new or adapt existing materials for use with diverse cultures or communities, translate or arrange for the translation of materials for use with non-English speaking populations
Develop and conduct training sessions for county staff, for staff members of other public health government agencies or non-profit and schools for volunteer personnel concerning health programs and facilities, or public health issues, and conduct information sessions on developing multicultural competency skills and culture beliefs.
Plan and prepare publicity material including news releases, radio and television copy and related art materials for public health education activities; appear on camera or radio to discuss topics related to public health programs or issues
Compile and maintain health information containing web resources, books, media, slides and other materials, compile and maintain a health information resource file for use by other staff members
Assist in compiling and preparing statistical and narrative sections of annual reports and other agency publications and provide recommendations regarding department funding of projects
Receive and respond to inquiries from the general public related to information concerning health services and health educational resources
REIMBURSEMENT TECHNICIAN 06/2015 – 06/2016
WPAC, Department of Veterans Affairs Office
1085 Palms Airport Drive, Las Vegas, NV 89119
Michelle Tidwell, Supervisor 702-***-****
Verification of Veteran’s Insurance coverage for inpatient and outpatient services
Verifies benefits, policy number, precertification requirements, Insurance contact information, and effective dates of coverage
Responsible for billing activities including consideration of professional services and facility services, sharing agreements, Medicare and pharmacy billing, ensures that all billable cases are identified and that bills are generated
Obtain information required for tort cases, workers compensation, OWCP, and personal injury cases
Validates claims for billing purposes ensuring eligibility and referring questionable coding for review
Responsible for billing, including humanitarian, tort, workman’s compensation and no-fault auto accidents
Researches and resolves problems and posts payments, adjustments, denial codes, and non-payment collections
Perform follow-up on explanation of benefits received from third-party carriers to maximize revenue and reviews payments to ensure consistency with Insurance policy terms
Applies payments to the appropriate bill or refunds to the applicable party
Uses the electronic explanation of benefits and electronic funds transfer system to verify liability, validate accuracy of payment, resolve discrepancies and follow-up on old accounts
Provides input for responding to Congressional inquiries, explains eligibility and entitlements to Veterans and researches and responds to questions on billing and account status
MEDICAL & WORKERS COMP ADJUSTER: 1991 – 2007
Different Third Party Administrators and Self-Funded
Check patient eligibility, effective and termination date, verify employment status need to be Full-time student or Employee, length of Employment and number of hours completed.
Dependent- should be lawful spouse, resides with the employee and Full-time student for unmarried child who is capable of self-sustaining employment reason of mental and physical disability, primarily dependent upon the covered employee for support
Request supporting papers: Marriage Contract and Divorce Decree, Explanation of Benefits and payment and Coordination of Benefits, Duplicate claims, Lab request, pathology report, x-ray report, operative report, and invoices for details regarding procedures vs diagnosis
Conduct claims evaluation with attention to details including insured and provider names, addresses, deductible, con-insurance, available discounts, and amounts payable. Process group PPO/COB health Insurance claims form paper claims submission for outpatient, inpatient, and prescription claims.
Documents all decisions approved or denied in the paper file and computer processing system
Paid claims per Plan Benefits and Guidelines and perform customer service regarding their deductible, co-pay, eligibility, underpaid or overpaid for reimbursement claims status. Determining and calculating the type of level of benefits based on established criteria with provider contracts. Responsible for claims per Plan Benefit and Guidelines whether eligible or ineligible for accurate payment in a timely manner.
Set up data from C-4, C3 and C1 into Claims Management System, Input and review notes in Claims Management System as instructed by Claims Adjuster, review and analyzed reports for Accept and Closed Claims, and send letter to Employer and Employee.
Handle mails, fax, photocopying medical reports and filing.
VOLUNTEER JOBS:
DEMOCRAT CANVASSER 2006 – 2012
Parkway, Las Vegas, NV 89109
Drive around the Valley visiting Union members encourage them to vote and endorsed Democrat Candidate. Call Union members to participate this coming election and remind the names of all Nevada Democrat candidates.
Drive around the Valley urging people to think before they sign on Bob Beers proposal and encourage them to vote this coming Election
STATE HEALTH INSURANCE ADVOCATE 2000 - 2007
Division of Aging and Disability
3100 W Sahara, Ste 103, Las Vegas, NV 89102
Marilyn Wills, Director 702-***-****
Assist elders regarding Insurance Eligibility, underpaid status, enrollment, and refer them to Division of Aging office for accuracy.
Link to different Community partners to meet their needs.
ELECTION CLERK 2000 - 2012
Election Department, 965 Trade Drive, Suite A, North Las Vegas, NV 89014Sandra, Volunteer Coordinator 702-***-****
Duties: Assist voter, accompany to voting machine and verify ballot information
RECRUITMENT ASSISTANT/FIELD REPRESENTATIVE 2000 – 2007
Bureau of Census, Department of Commerce
600 Las Vegas, Suite 500, Las Vegas, NV 89101
Jose Bolano, Field Recruitment Supervisor/Sharon, Field Rep Supervisor
Publicized Census jobs among referral sources and potential applicants, locates testing space and maintain contact with donors, contact test sessions, and reports progress and problems to Assistant Manager.
Conduct testing for applicants, check testing materials and submit to Recruitment Supervisor for the results.
Data gathering from household lists and send reports to main office before midnight.
Contact Project Staff, select a sample of households and obtain information from the tenant file
Interview tenants in their homes requesting verification via letter mailed to third parties.
Keep accurate records (on paper and on the computer). Communicate progress on a regular basis with field supervisor via phone, mail, e-mail and mandatory status reports.
PUBLIC RISK MANAGEMENT 2012
Lake Mead Recreation, National Park Service 702-***-****
601 Nevada Way, Boulder City, NV 89005
Randy/Amanda Rowland, Supervisor
Using binoculars how many people wearing lifejacket and how many are not for behavioral theory study and diversity.
Modify what kind of boats, time, activities, gender, age and lifejacket usage for mortality and morbidity catastrophic.
Data collection for presentation for injury prevention qualitative and quantitative reports.
Assist people at Visitors Center, regarding maps and different activities that they can enjoy inside the Parks, such as: hiking, biking, camping, fishing, jet skiing, & kayaking etc.
Assist children hiking and Educational Installation, Stars etc.
Assist Supervisor for Nevada Wet Project, water education for teachers
EDUCATION & TRAINING:
01/2013 – 12/2014 Liberty University – online class
1971 University Blvd
Lynchburg, VA 24502
Graduate studies – MPH
06/2012 National Park Service, U.S. Dept of Interior
Risk Management and Customer Service
CPR/First Aid and Leadership Training
09/2010 – 05/2012 University of Nevada Las Vegas
4505 S. Maryland Parkway
Las Vegas, NV 89154
Graduate studies – MPH
05/2008 – 09/2010 Department of Business and Industry
Division of Industrial Relation
1301 N. Green Valley Pkwy, Ste 200
Henderson, NV 89074
Safety and Health Practitioner (Certified)
06/1995 – 06/1997 Community College of Southern Nevada
6375 W. Charleston Blvd.
Las Vegas, NV 89160
LPN, switched to Heath Info Tech
03/1975 – 03/1979 Polytechnic University of the Philippines
Manila, Philippines
Bachelor of Science in Commerce – Mktg
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