Real Estate Medi Cal
Resume:
LUCILLE YOUNG
**** ******** ******, ***** *****, California 91343-2214
adyz0n@r.postjobfree.com
LOS ANGELES VALLEY COLLEGE
**** ** **** (ongoing)
Management, Marketing, Broadcasting and Art classes ANTHEM BLUE CROSS
(Open enrollment contract, specialist in Medicare) September 2017 to May 2018. Financial Operations, Sales Compensation Auditing for proper documentation from health insurance brokers for coverage of Medicare Advantage and Medicare Supplemental Insurance members. Verify proper licensing in place for insurance currently sold by brokers. Contact with licensing and credentialing. Open enrollment contract, working with brokers
October 2016 to January 2017. Retention Department Assisted brokers for individual health coverage, customers in twelve states with insurance inquiries for completion of applications, explanation of benefits when necessary, and direct members to other departments.
UNITED CEREBRAL PALSY
April 2016 to June 2016
Program Coordinator (medical leave contract position) Assisted manager at UCP with paperwork for cerebral palsy residents, for smooth transition to specialized facilities such as long-term care and nursing homes. Proper documentation verification, including medical reports, financial statements, etc. Knowledge of California Medi-Cal rules, HIPAA, completed applications or social security paperwork for members, outbound calls to families regarding questions and missing documentation, medical plans to disenrollment members from insurance, annual redetermination paperwork. ANTHEM BLUE CROSS
(Open enrollment, contract position Medicare and Medi-Cal) October 2015 to December 2015
Casework Compliance Team (level 2, escalation)
Research and investigation related to issues for adherence to federal rules for Medicare members, individual health insurance coverage, calls and correspondence to members for benefits, enrollment issues, termination of plans, coverage, discrepancies in applications using health care data bases.
LUCILLE E. YOUNG
Page 2
HEALTHNET
(Open enrollment, contract position in Medi-Cal and claims review) December 2014 to July 2015
Customer Call Center Representative I / Claims trained / HIPAA trained Medi-Cal specialist, AEVS (California state website) Inbound and outbound calls from insurance members for assistance with provider and medical group changes, medical appointments, questions for medical redetermination paperwork of Medi-Cal, knowledge of durable medical equipment, translators and interpreters in Northern and Southern California, transportation for medical appointments, setting up schedules and chair times for dialysis patients. Keeping track of latest information for coverage and insurance guidelines. Researching information for unpaid and aged claims, review and resolve claim issues, questions for financial responsibility using DOFR, checking over medical contracts, renewed each year for coverage of claims, proper coding of medical procedures, and claim forms
(CMS 1500 and UB 4).
Litigation Secretary for various law firms in Century City and downtown Los Angeles LITIGATION SECRETARY
Legal Plus Agency (2000 to 2009)
Legal Options (Hire Authority) (2005 to 2009)
Senior litigation secretary for partners in practices for entertainment, labor, subrogation, real estate, construction defect, insurance defense coverage, business law, for firms in Century City and downtown Los Angeles. Specializing in troubleshooting complex litigation cases. E-filing using PACER system. DTE and Carpe Diem time-keeping programs. Firms included Glaser, Weil; and Iverson, Yoakum, Papiano & Hatch.
DAVIS & DAVIS
2005 to 2007
Real Estate. Litigation and corporate secretary for escrow attorneys. Notice to Consumers, all pleadings and correspondence. Procurement of office supplies, year-end file closures. Data entry for medical and legal companies, including specialized software, timesheet programs, Word, Excel, PowerPoint, Claims programs, Microsoft Operating Systems, Medi-Cal systems, Financial responsibility software such as DOFR
Associate of Arts (2022)
LOS ANGELES VALLEY COLLEGE
Management, Marketing, Real Estate, Social Science
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