Post Job Free

Resume

Sign in

Customer Service Managed Care

Location:
Norman, OK
Posted:
March 09, 2024

Contact this candidate

Resume:

Nicole Lacey

*** ********* **.

La Vernia, TX ***21

210-***-****

Education:

La Vernia High School (9-12) La Vernia, TX

(GRADUATED) May 1999

National Institute of Technology-Medical Assisting Program

(Graduated) April 2005

Career Point College-License Vocational Nursing

(Pinned) April 2015

Work History:

Gonzaba Medical Group-(April 2019-Current)

List attached of duties

*Managed Care Support Specialist-support all Managed Care

*Assist in all Audits

*Reports on PCP access, Case Manager workflow, Membership of Managed Care health plans, Hospice monthly enrollment

* Coordinate and Host meeting such as High Risk, Small Group, Quality Improvement, Amerigroup, and Humana sub-committee.

Conviva Care Solutions-Humana (April/2016-Feb/2019)

*Utilization Management-clinical review

*Medicare policies up to date

Guadalupe Regional Hospital-Seguin, TX (April/2013-March/2016)

*Collections/Billing/Appeals

*ICU Paperwork Prep

*Customer Service

Clinical Experience with Career Point College

*Country Care Manor-La Vernia, TX-Pharmacology

*Southeast Nursing and Rehab Center-San Antonio, TX- Fundamentals

*Meridian Health-San Antonio, TX-Medical Surgical I (Wound Care)

*Connolly Memorial Hospital, Floresville, TX-Medical Surgical II (*Wound Care)

*Alamo Heights Rehabilitation-San Antonio, TX-Mental Health/Leadership Dermatology of SA Dr. Steven Davis (February 2015-March 2016)

*Medical Assistant to PA

*Surgical Tech

*Back/Front Office Duties

Stratton Rehabilitation Clinic-San Antonio, TX Collection Specialists (February 2012-January 2015)

*Rehab specialist-MA

*Medical Billing

*Collections

*Appeals

-Completed all daily bills and collections on day-by-day basis

*Customer Service

-Helped at front desk when acquired

Touchstone Communities-San Antonio, TX

Medical Biller (October 2011-January 2012)

*Appeals

*Collections

- Completed Veteran Skilled Unit Homes, daily billing, and collections on day-by-day basis. The Scooter Store-New Braunfels, TX

Financial Support Manager (February 2009-September 2011)

*Account Auditing

*Insurance Verification

*Insurance Documentation Advisor

Obtained all Authorizations as needed to complete sale of Power-wheel chair

*Made good news call to all customers approved for PWCs

*Set up all Financials needed if customer paying Out of Pocket ProLab-San Antonio, TX

Night Manager (August 2005-January 2010)

*Medical Billing

*Dispatch technicians

*Result orientation for critical labs to all Nursing Homes Back To Health Chiropractic-San Antonio, TX

*Medical Assistant (February 2003-August 2005)

Computer Skills:

*Athena

*Access Database

*CGX-Humana Software

*Medicare Policy

*OneNote

*Aprima-Billing Software

*EDI Solutions-Billing Software

*Medisoft, ICD-9 and 10, CPT coding

*Proficient in Microsoft Word, Excel, Power Point, Outlook

*Internet, Payroll

*Billing, Data Entry, Accounts Payable, 10 key

References: Upon request

Personal and Future Goals:

My Future Goals are to Succeed and be the best employee that I can possibly be I am a self- starter that requires minimal or no supervision. I feel if given an opportunity I will succeed and be a real asset to your company.



Contact this candidate