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)

Contact this candidate