Nurse Practitioner Customer Care
Resume:
Aaliyah Johnson
************@*****.***
Cordova, TN 38016
I am tremendously excited and interested in a career with your establishment. A notice on the web informed me that you are seeking qualified individuals for this position. Therefore, my discovery encouraged me to forward my credentials to you. I am confident that my combination of practical work and education has prepared me for making an immediate contribution to your company. Being self-motivated, dedicated, and reliable brings passion and a strong sense of success in whatever my endeavors in life may be.
I comprehend the level of professionalism and commitment required for long term- success in this field. My background and professional approach to education will provide your business with a highly productive and humble employee. Please take the time review my resume, as I am available for an interview at any time. Thank you for your time and deliberation. I look forward to meeting you in the future. Sincerely,
Aaliyah Johnson
DESCRIPTION
A devoted & skilled professional with various practices in all characteristics of management and character.
OBJECTIVE
To obtain a position that will allow me to further develop the skills and expertise at an optimum level.
Work Experience
12/06/16 – Present United Health Group – Brentwood, TN
• Manage the requests for NOA / NOE letters
• Prepare letters for audit review
• Identify gaps in compliance with letters and ensure letter corrections are made within regulatory timeframes
• Maintain extensive knowledge of regulatory and accreditation requirements
• Proficient in interpreting benefits, contracts, and medical policy
• Maintain knowledge of State rules, contracts, and Federal legislation / regulations as well as UHG guidelines
• Demonstrate flexibility, availability, and dependability to conform to position responsibilities
02/02/2015- 12/01/16 Anthem, Inc – Nashville, TN
● Customer Care Representative
● Respond to customer questions via telephone regarding insurance benefits, provider contracts, enrollment, claims, pharmacy benefits, initiate and complete emergent inpatient authorizations, OB notifications, Observation authorizations
● Document inquiry outcomes for accurate tracking and analysis
● Use computerized systems for tracking information and trouble shooting
● Perform in depth research for customer benefits, products, and authorizations
● Meet department goals
06/16/2014-12/31/2014 United Heath Group- Optum Nashville, TN OFFICETEAM- TEMP
● Schedule appointments for Nurse Practitioner
● Use computer systems to accurately map and route NP
● Outbound/inbound call and accomplish daily metrics
● Use salesforce calendars to link programs and appointments 02/3/2014- 05/30/2014 Waste Management Nashville, TN OFFICETEAM- TEMP
● Customer Service Representative
● Took inbound commercial phone call
● Review and resolve customer issues in a professional and timely manner
● Post and manage payments for accounts
● Sold company services to commercial businesses
● Created and managed excel files
● Gained expertise on company portals and software programs 6/1/2013-12/1/2013 The Mentor Network Charlotte, NC
● Enter billing for inpatient/outpatient services
● Checked insurance eligibility twice a month
● Design and implement office policies
● Establish standards and procedures
● Organize office operations and procedures
● Supervise office staff
● Monitor and record long distance phone calls
● Prepare time sheets
● Control correspondences
● Review and approve supply requisitions
● Liaise with other agencies, organizations and groups
● Update organizational memberships (Medical Records) Education
2018— Vattorot Community College- Dental assistant graduate 2013— Kirby High School—Memphis, TN—High School Diploma Volunteer Work
*Ministry Leader: Children’s Church Global Empowerment Tabernacle Church Murfreesboro, TN.
Praise and Worship Leader: Global Empowerment Church Dexterity
Microsoft Office
Microsoft Excel
NCTRACKS
Scheduling
Medical
Records
ALPHA
PowerPointKRONOS
AVATAR
Personal/Achievements/Awards
Captain of Volleyball at City University Of Liberal Arts FBLA (Future Business Leaders of America)
Outstanding Vocal Ability from STAX Music Academy 2007/2008 Certified CPR License
*References Upon Request*
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