Nadine Sorapuru

504-***-****

adygk5@r.postjobfree.com

Qualifications Summary

Seasoned and versatile professional with extensive experience in Health Insurance Management, Health Healthcare Insurance Operations, Healthcare Financial Management, Case Management, Auditing of Claims, Partnered with Human Resources in support of Employee Benefits, ability to review, examine, and interpret regulatory, legal and financial documents for accuracy. Strong manager, with proficiency in training, coaching, and mentoring staff. Lean Six Sigma Green Belt.

Professional Experience (All Full Time Positions)

University Medical Center / LCMC New Orleans, Louisiana

Quality /Patient Safety / Infection Control Data Specialist Oct 2020 – Present

Related Competencies: Healthcare Administration and Management, Business and Finance Management, Lean Six Sigma Green Belt, 5S Methodology, Process improvement, Data Analysis, Patient Services, safety and satisfaction. Liaison between, Quality department and Case Management, Executive Team, Nursing Administration, and Clinics. Support investigations concerning patients, patient families, and staff by acting as a liaison between upper management and staff to track and resolve breakdowns in processes. Educate staff on empowered ownership in addition to establishing a culture of continuous performance improvement.

40 hours a week.

Serve as a Liaison daily to Case Management resolving patient and patient family concerns.

Support with claim appeals assuring the claims move through the appeal process properly.

Update insurance plan’s information in Epic.

Support daily oversight of operation in Quality Department.

Analyze invoices submitted from third party vendors for payment.

Support staff training courses

Setup travel for leadership and manager leadership’s calendars.

Initiate reimbursement process for staff expenses via Lawson database system.

Initiate P/O process for staff members via Lawson database system.

Review vendor contracts to assure alignment of services with hospital needs and make suggestions for amendments when needed to upper management for continuous process improvements.

Daily oversight of Infection Control Department ‘s infection auditing.

Collaborate with upper management when specific rare infections are identified.

Work with CAUTI / CLABSI Task Force to create and structure policies, procedures and processes.

Work with the Continuous Survey Readiness Team in support of hospital compliance with the Joint Commission. Responsible for communication of change.

Interpret CMS regulations and communication

Interface across network to assure quality measures stay in compliance hospital wide.

Responsible for monitoring the Quality and Infection Control Departments budget and Expenses.

LAHC Metairie, Louisiana

Director of Enrollment Sept. 2013 – Sep 2020

Related Competencies: Health Insurance Specialist, Continuous process improvement, Conflict Resolution, Member / Customer Support and Satisfaction, Developed Strategic Partnerships, Data Analysis, Interpretation of regulatory standards, guidelines and instruction from CMS, and State of Louisiana. Lean Six Sigma Green Belt, 5S Methodology, Enrollment specialist, Project Management, Project Opener, Receivership Subject Matter Expert, Conflict Resolution, Clear Communicator.

45 hours a week.

Daily oversight of multi-functional areas across networks

Responsible for a seamless business operation for three call centers and managed 100+ FTE.

Investigate White House Congressional concerns attached to members.

Analyze and enter data retrieved from data warehouse uploaded to Ehealth, Bswift, and Adaira Electronic Health System.

Responsible for configuration, updates and over sight of Bswift EHR System.

Responsible for creating a testing team in addition to testing the Bswift system platform after configuration.

Educated, trained, and mentored for growth all Member Services / Customer Service Representatives.

Responsible for educating all staff of CMS Regulatory changes and created training material.

Collaborated directly with Regional CMS Representative monthly.

Led bi- monthly update meetings with stakeholders and C- level executives.

Responsible for oversight of Appeals and Grievances team to assure turnaround time (tat).

Supervised auditing of claims to assure accurate data was generated in summary reports.

Supported the Utilization Management Team attached to Quality Department with special projects.

Recommended solutions for systems, and processes when needed.

Collaborated effectively with the Department of Insurance regarding a resolution to member complaints.

Circular Consulting New Orleans, Louisiana

Executive (ASU) to Chief Engineer of New Orleans Jan 2008 –August 2013

Related Competencies: Business Specialist, Continuous process improvement, Client Base Support and Satisfaction, Developed Strategic Partnerships across city of New Orleans divisions of structure, Data Analysis of Versions by the city submitted to FEMA, Contract Procurement, Support Project Management, Clear Communicator.

45 – 50 hours a week.

Support to Disaster Recovery Project Team responsible for rebuild of city facilities, and bridges after Hurricane Katrina.

Actively led meetings with Chief Engineer and the Director of Engineers for the City of New Orleans to assure process improvement.

Collaborated day-to-day with Project Engineering Leaders pertaining to status reports, and updates on their projects to ensure progress.

Partnered across the organizations departments to streamline workflows between business units.

Ensure all projects are completed within business standards, and contractual agreements.

Provided support to City Procurement Process

Assumed key role in evaluating proposals submitted to RFP.

Created Contracts submitted to the City of New Orleans Law Department for approval.

Responsible for leading meetings with FEMA representative to review versions due signatures from FEMA Representative.

Created and executed Notice to Proceed with Projects attached to FEMA and the City of New Orleans.

Assured document integrity by tracking contractor and vendor deliverables throughout the project lifecycle

Knowledge of FEMA Compliance and Community Development Block Grant

Perform administrative functions of a confidential nature with a high level of independence, discretion, and technical skill

Maintained various data bases to support job function

Provided timely project status updates to Chief Engineer for the City of New Orleans, and FEMA Repetitive.

Budget Rent a Car Terry-Town, Louisiana

Director of Operations / Owner May 2004 – December 2007

Related Competencies: Business Specialist, Continuous process improvement, Customer Support and Satisfaction, Developed marketing and sales strategies. Strategic Partnerships across other rental car locations in the city attached to fleet and needs. Data Analysis of contracts, Clear Communicator.

50 – 60 hours a week.

Collaborated with corporate to assure seamless operation of location.

Monitored and managed Customer Service Team.

Maintained and increased revenue of location.

Customer focused

Maintained customer satisfaction

Maintained effective relationships with key stakeholders and executives

Developed employee action plans to ensure a positive, engaging, and supportive workplace

Effectively hire Customer Service Team, trained, and guided employees for growth.

Responded to customer queries and resolved.

Performed Collections on unpaid balances. (Following the Fair Debt Collection Practice and the 7 in 7 rule)

Kept inventory of fleet, in addition to maintenance of fleet.

Analyzed financial data and provided statistical reports while maintaining locations budget

The Ritz Carlton- New Orleans Hotel New Orleans, Louisiana

Guest Services Manager Sept. 2000 - May 2004

Related Competencies: Business Management, Continuous process improvement, Customer Support and Satisfaction, Developed marketing and sales strategies. Strategic Partnerships across hotels network. Clear Communicator.

50 hours a week.

Maintained seamless day-to-day operations of Guest Services while exceeding the standard of guest expectations.

Supported Human Resources as first level of contact initiating the hiring process.

Performed the Assessment test for Human Resources potential new hires.

Maintains a strong working relationship with department across networks in support of a seamless operations

Developed plans put into action to organize, and accomplish high level of service

Investigated customer disputes to administer a positive resolution.

Assured compliance with company policies, standards, and procedures

Oversight of Team of 65+ EFT’s compiled of Door Me, Bell Men, and Valet.

Supported team focus on guest satisfaction by brainstorming during departmental meetings to make improvements.

Performed other tasks as assigned by executive team

Educational Background

Batchelor of Science – Specializing in Health Care Administration / Health Care Management / Health Information Systems, BSHA / BSHM/ HIS 2014

University of Phoenix

Masters in Business Administration / Business Management, MBA 2017

University of Phoenix

;GPA 3.5

Job Related Training

Lean Six Sigma Green Belt

Epic

Lawson

White Planes

Mark View

Ehealth

Adaira

Work Day

QuickBooks

Bswift

References

Darlene Smith

817-***-**** (Circular Consulting)

adygk5@r.postjobfree.com

(Professional)

Shawn Fortune’ 504-***-**** (Budget)

adygk5@r.postjobfree.com

(Professional)

Rodney Bierra 301-***-**** (LAHC)

adygk5@r.postjobfree.com

(Professional)

Dr. Adrian Woods 504-***-****

adygk5@r.postjobfree.com

(Professional)

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