Celise Bullock
Experienced professional with over eight years in the field of customer support, health services and administration. Committed to providing quality support for staff and executives. Result-oriented with 100% high performance volume. Effective project management skills. Confident leader with ability to provide instruction. Creative problem solver and strong team player.
Work Experience:
Aergo Solutions – Iselin, NJ March 2019 – Present
Follow Up Representative
Calls insurance companies for status of appeals
Procure resolution letters
Able to note account in host systems
Comprehend both the client rights to multiple appeal levels
RWJ St. Barnabas Health – Rahway, NJ June 2018 – March 2019
Case Management Secretary
Responsible for coordination of various activities in the Case Management department including initiation of referrals and authorizations.
Responsible for the performance of clerical and administrative tasks to ensure the efficient activities related to Case Management
MedAvante – Hamilton, NJ May 2017 – June 2018
Project Coordinator
Answer inbound calls and emails, determine customer problems through asking appropriate questions, and help customers resolve issues.
Investigate, resolve and escalate issues to the appropriate internal team member
Log calls and resolutions through our Salesforce database system. May be required to enter clinical assessment data points into one or more systems
Work in a team environment supporting 24x5 call center May be required to schedule and or initiate clinical assessments
United Healthcare – Edison, NJ Aug 2015 – May 2017
Clinical Administrator Coordinator
Data entry, handling inbound and outbound calls, mailing, copying, faxing, preparing reports
Support the clinical care givers with live outreach, educating members about program benefits and assisting in managing member cases and documentation in the LTC for ABD+ and MLTSS members
Manage administrative intake of members and admission/discharge information post notifications
Work with hospitals, clinics and facilities to manage request for services from members and providers
Assist clinical staff with setting up documents/triage cases for clinical coverage
Horizon BCBS – Newark, NJ May 2007 – Jan 2013
Reimbursement Analyst
Partner with facility employees to identify and bridge financial gaps
Resolved open Accounts Receivables (AR's) claim payment issues
Assisting hospitals with their members benefit plans, managed pricing claims& contracts related to Workers comp, Medicare and other insurance policies
Reviewed diagnosis/procedure codes, eligibility and enrollment
Assisted department managers with business reporting and pricing
SKILLS & PROFICIENCES:
Hospitality and Admin Services • Effective Public Speaker • Event Coordinating and organizing Proficient in Microsoft Office Suite • Excellent communication skills • Conflict Resolution
EDUCATION:
Continental Academy – August 2007
Edison State University – Present (Psychology)