Customer Service

Erica Subramaniam

Issaquah, Washington

Tel. 425-***-****

Email: *******@******.***

Skills:

Virtual Call Center / IT Support / Help Desk Experience: (utilized Virtual Desktop Integration, VM Ware, IP telephony System, installed/configured/updated proprietary mobile and desktop applications) 5 plus years of experience setting up home networks (or equivalent technical training), experience in a customer service environment, understanding of wired and wireless home networks using multiple network technologies such as cable modems, routers, printers, etc. (DNS, DHCP, WAN, LAN, TCP/IP, Port Forwarding). Semi-Bilingual in Spanish, EZ-CAPS HEALTH X, ESSETTE, MEDI-TECH, ICD-9, ICD-10, DATA ENTRY/ FAX/SCAN/COPY 10 KEY, EKG, IV CERTIFIED.

Case Manager: Assess and evaluate in-patient and discharge needs. Identify barriers to discharge, T.A.R. refer all complex high-risk patients to appropriate disciplines for assist. Interaction Adjudicator with hospital staff as well as patient members to assure patient satisfaction and patient is moved appropriately throughout the continuum of care process. Working Knowledge of Medicare and Medi-Cal, Commercial Insurance. Use of Milliman and InterQual criteria. Collaborate with medical staff to assure continuum of care and resolve any quality-of-care issues. Participates with all members of healthcare team in patient care conferences to assure the best patient outcome. Nurse Instructor: I am a Board Approved Nursing Instructor from the BVNPT, to teach theory Educator

& clinical to LVN students. 1 have created & implemented pre-nursing curriculum as an Independent Contractor.

Item - Writer: N.L.N, in NY, NY and Expert Panel member for the NCSBN in Chicago, IL. Teach theory and clinical instructions according to approved B.V.N.P.T. course syllabus effective teaching methods; develop daily lesson plans; advises and tutors students; remains current in applicable program teaching field; participates in faculty meetings, instructional seminars and in-service training sessions. Participates in school activities such as faculty meetings, student functions, graduation exercises, advisory board meetings. Staff Nurse: Provides nursing care to patients; prepares patients and cares for them during treatment. Administers medications subcutaneously, intramuscularly, intradermal, subdermal, and/or oral; takes Biometrics - temperature, pulse, respiration and blood pressure, and pain assessment of patients as necessary. Applies and changes dressings and administers treatments including catheterizations, irrigations, and enemas; collects specimens for laboratory analysis. Assists doctors and registered nurses in the administration of special treatments, examinations, and intravenous therapy; charts treatments and medications and maintains pertinent medical records. Assists doctors and registered nurses in the administration of medical records; assists in the preparation and implementation of patient care plans; participates in patient education and rehabilitation programs. Observes patients' condition and behavior and reports significant changes to the supervisor; may participate in physical, occupational, and group therapy programs. May act as a team leader over nursing assistants, supportive services aides, licensed psychiatric technicians, or other licensed vocational nurses as assigned. Education:

St. Francis Medical Center - School of Nursing - Lynwood, California Glendale Career College - Teaching Adult Learners Certification Professional Certifications:

BCLS, ACLS, PALS, NRP, DSD-Director of Staff Development, CPR Instructor, IV/Phlebotomy, CAPPA - Lawrenceville, Georgia - Childbirth Educator

Professional Organizations: NLN, NCSBN, ARCGLA, CAPPA, AHA EXPERIENCE:

2018 - Broad Path Healthcare Solutions – (seasonal position) Remote Member Services Associate – Provided great customer service to all health plan members, receiving inbound health plan calls pertaining to benefits, eligibility, physician coverage, enrollment, and more, input data and navigation of systems all while on calls. Utilized various software, ASD, and VDI such as: Centrix, Pulse Duo, Avaya, Omni, and Bhive. I am English/Spanish semi-bilingual, computer literate, multi-tasker, and company team player, and extensive Call Center management skills.

2006 to 2018 - Nurse Field Reviewer (Seasonal)- Change Healthcare / Altegra Health Alpharetta, GA Knowledge of HEDIS technical specifications, abstraction processes, and procedures as pertinent to this area of HEDIS. Ability to us professional judgement to drive performance from a remote team including establishing expectations and holding the team accountable for meeting results. Ability to work independently, managing multiple priorities with demanding timelines. Proficiency in Excel, Word and Adobe Acrobat. Must have proficient computer skills and demonstrate an immediate and high level of comfort using data systems.

09/ 2011 – 01/2012 - (Contract Nurse / Chart Reviewer) - Medi Scan Nursing Services Woodland Hills, Ca Hired to Review Charts for Medi-Care & Medi-Cal Audits, by state contracted companies specializing in the Mentally 111 and Senior (SPD) populations.

2011 – Present (IP - Case Manager) - Monterey Park, Ca Worked for an IPA group that managed all Capitated and Non-Capitated patients under the various insurance groups. Performed approvals, denials, transfers for patients that required higher levels of care, authorizations for service, outpatient referrals, worked with the CA – CCS program regarding coverage for all eligible diagnosis and episodes. Promoted procedures and educational programs to reduce the number of in-patient stays. Used Milliman and InterQual guidelines.

(TARs Case Manager) - Medical Gatekeepers, Inc. –Los Angeles, Ca - 1 work as a TARs Case Manager on a per-diem basis. Ensure accuracy in preventing Medi-Cal Denials and Appeals for contract client of the company. Chart Review and Post-Discharge reviews. Evaluate the quality of necessary medical services; assist in medical case management policies and procedures and regulations of Medicare, Medi-Cal, and Commercial Insurances

2010 - 2010 - (Field Nurse) AltaVista Home Health Services - Covina, Ca 2008 - 2009 (Staff Nurse-M/S) Hollywood Community Hospital - Hollywood, Ca 2007 - 2008 Ca - (Nurse Instructor) American Scientific Institute - Los Angeles, 2007 - 2008 Ca - (Nurse Instructor) College of Nursing & Technology - Reseda, Ca 2006 - 2007- (Nurse Instructor) Bryman/Everest College - Alhambra, Ca 2004 - 2005 Ca - (Nurse Instructor) Casa Loma College Nursing School - Hawthorne, Ca

(Staff Nurse - Trauma/ER Dept) California Medical Center & Trauma - Los Angeles, Ca 2004 -2005 - (Nurse Instructor) American Career College -Los Angeles, Ca 2003 - 2003 - (Nurse Instructor) Glendale Career College - Glendale, Ca 2004 - 2005 - (Nurse Instructor, Community Educator, and First Aid/CPR Instructor American Red Cross of Greater Los Angeles - Los Angeles, Ca 2000- 2004 - (PER DIEM- CONTRACT NURSING ASSIGNMENTS) Renaissance Nursing Agency / Pro - Cel Nursing/ MSN/ Maxim Healthcare/ Pro-Care Nursing 1999 -2000 /2002-2004 - (Staff Nurse - ER & Medical Surgical Units) Gardena Memorial Hospital - Gardena, Ca

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