Data Entry Support Coordinator
Resume:
Andre D Lagua
Honolulu HI *****
Ph: 808-***-****
Objective: To obtain a full time position where I can utilize my data entry skills, learn new processes, and be part of a team environment. Work Experience:
Jul 2018 to Dec 2024: Health Net Federal Services: Care Management Support Coordinator IV
The Disease Management Enrollment Representative contacts beneficiaries, stratifies, and refers them for enrollment into appropriate disease management programs. Duties include corresponding with beneficiaries and assessing their needs via telephone for placement into appropriate disease management programs. Additional responsibilities include managing incoming/outgoing phone calls, Scheduling appointments and tracking data.
Apr 2018 to June 2018: Logistics Health Inc- Handoff coordinator: Transferring calls to the Nurse’s or the Care coordinators Jan-2018 to April 2018: Medical Services of Los Angeles Telecommuter- Senior Medical Records Technician:
Download documents in an electronic PDF format which uploads into a centralized database.
Identify listed medical or psychological conditions, including all related conditions or triggers, and electronically index each according to their medical specialty.
Appropriately note the steps taken during file conversion within our system, and ensure accuracy by recording information pertinent to file in question.
Mar-2016- Dec-2017: United Healthcare Honolulu, HI Clinical Admin Coordinator:
Responsible for initial triage of members, administrative intake of members or managing the admission /discharge information post notification, working with hospitals and the clinical team. Extract and review fax request for medical and clinical services Receive electronic referral form request for medical and clinical services Access electronic member files using policy or id number Determine member eligibility
Follow protocols to task request appropriately
Check procedures codes against notification requirements and benefit coverage to determine next step
Determine whether authorization are required for request medical services Reference automated job aid and tools via computer research relevant rules, regulations, or procedures
Learn computer system and process changes and updates and incorporate into daily work
Follow standard procedures to complete request
Feb 2014 to 2016 Hawaii Medical Services Association Account Servicing Advocate
Resolve enrollment, eligibility and billing issues and inquires timely and accurately from members, employer groups and third party administrators by phone, email and written correspondence by: Researching and collaborating with other units or departments to find a solution Accurately updating member records
Containing external partners who provide service to HMSA’s members Providing member or group education on enrollment. Promoting electronic and bill payment options
,
Support unit in performing enrollment and billing reconciliations activities for purpose of identifying discrepancies and initiating accurate and timely correction/resolution of internal as well as external processing system. Support unit in daily enrollment functions to include processing of enrollments, dis enrollment and maintenance for members. Perform quality assurance audits of customer inquiries and member updates within constrained timeframes. Based on patterns or risk assessment, recommend improvements opportunities to provide processing efficiency and increase customer satisfaction. These can include but not limited to identifying processing or servicing issues that can be addressed by a system or a workflow solution. Training and Development
Perform other duties as assigned
JUL-1998 to 2013 HMSA Honolulu, HI Billing Clerk
Maintaining and updating Membership Service database. Reconciliation for group employer billing
Answer multi-line phone system
Education:
College for Recording Arts, San Francisco CA 1993 -1994 Certificate of Completion
Skyline College, San Bruno Ca 1991-1992
College of San Mateo, San Mateo Ca 1990 -1991
Jefferson High School Daly City, Ca 1985 to 1989 Diploma Skills: MS Word, MS Excel, Outlook, Power Point, 10 key, Customer Service, Attention to detail, ability to multi-task, well organized
Contact this candidate