Enid M Moll

adm9oe@r.postjobfree.com ***** Hwy **, Hahnville, LA 70057 985-***-****

Objectives

Results-driven, confident administrative professional with 30+ years’ verifiable track record of creating and organizing correspondence, performing extensive research, making travel arrangements and maintaining liaison with other departments to ensure smooth office operations. Eager to leverage 18+ years of Medicare Managed Care experience and knowledge of providing administrative support for senior and executive leaders for the smooth operation of the company. Offers exceptional communication, secretarial, and problem solving skills to bring a remarkable change in the overall efficiency of the office.

Education

Southern University

May 1983 Business Management

Experience

Special Needs Plan Coordinator I 2017 – Present

Peoples Health Network, Inc. Metairie, LA

Scheduled Health Risk Assessment for members, Organize and Coordinator (ICT) Individualized Care Plan.

Responsible for generating Member and Provider Care Plan letters, Responsible for weekly audit control for accurate documentation.

Responsible patient coordinating with nurses.

Host weekly staff review meeting.

Weekly audit control for accurate documentation.

Responsible for generating Member and Provider care Plan letters.

Work with Marketing Team

Appeals and Grievances Research Assistant 2008 – 2017

Peoples Health Network, Inc. Metairie, LA

Administrative Services/Provider Services Network Development 2006 – 2008

Peoples Health Network, Inc. Metairie, LA

Maintains Excel reports for the tracking of data as needed, as well as ensures all reports and documents conform to expected professional standards with careful attention to detail and accuracy.

Responsible for creating, tracking and logging Appeals and Grievances cases into the A&G database.

Appeals and Grievances case assignments; research documents for Provider service Reps and A&G Regulatory Compliance Specialists.

Assists with the development of reports and spreadsheets as needed to aid in process improvements and daily production.

Perform and document daily expedited calls to members with the established CMS guidelines.

Responsible for processing referrals to the Independent Review Examiner (IRE).

Provides guidance to Member Services and Provider Relations regarding polices and procedures relating to the processing of appeals and grievances.

Exhibits very good written communication skills by thoroughly and accurately preparing documents as defined by the director.

Keeps abreast of policy and procedure changes and exhibits support for these changes.

Attends meetings as scheduled and ensures active participation and exhibits ability to transfer knowledge to daily activities.

Assist in the completion of special projects as assigned by the director.

Qualifications

Over 36 years’ varied and increasingly responsible experience in administrative and research capacities.

Highly skilled in remaining customer focused and service oriented to ensure timely and accurate performance and benchmark achievement.

Proven ability to handle multiple, competing priorities in an effective manner.

Thorough knowledge of written English; grammar, spelling, vocabulary and punctuation

Possesses a high degree of confidentiality to support protection of sensitive information.

Special Skills

● Customer service

● Record maintenance

● Proficient in Microsoft Office

● Letter drafting

● Events coordination

● Staff training

● Leadership

● Travel arrangements

● Meeting coordinator

● Multicultural interaction

● Office procedures

● Supplies management

Contact this candidate