Customer Service Data Entry

Valerie Meehan

361-***-**** ****************@*****.***

Objective: Utilize my skills and experience to benefit my future employer.

Centene Intake Authorization Specialists I/TMS

February 19, 2024- September 17, 2024

Contribute to the Utilization Management Team remotely by documenting necessary medical information to ensure authorization requests are processed within TAT (turnaround time) per state requirements and within state guidelines. Document requested services and route to appropriate facilitator to complete the clinical review. Track and document authorizations and referrals in accordance with policies and guidelines, attend and complete required training to ensure polices and procedures are followed accordingly, job requirements included being able to navigate through a variety of system that included but not limited to True Care Classic, Cloud, MS Excel, MS Word, MS Outlook, and TEAMS.

Driscoll Children’s Hospital Authorization Specialist/Customer Service

February 1, 2019- February 1, 2023

Answer continuous incoming calls to assist members with research of their Texas Medicaid/Driscoll Star Plan medical coverages. Locate and change physicians for members utilizing Epic and plan coverages to provide information and incentives for plan. Data entry required to update changes such as address, phone number, change of physician research of coverages daily. Access and review claims for providers and administrative staff for errors in billing of claim to escalate issues, when necessary, route calls based on level of care and requirements before transfer. Advancement to Authorization Specialist work in rotation to answer incoming call and complete request for medical services. Utilize guidelines to route authorizations according to clinician specialty after all required information has been collected such as single case agreement or durable medical equipment certificate of necessity. TEAMS. MS Excel, softphone, MS Word, SharePoint, Internal sites for guideline review.

LK Jordan Customer Service Representative (Covid Project)/Driscoll Hospital

February 1, 2018- January 1, 2019

Provide outbound calls to offer home loan members forbearance option during covid, calculate and draft contracts, accept payments, retrieve docu-sign signature scan documents, answer incoming calls with inquiries regarding home loans and payments. Schedule Covid vaccines during the peak of Covid ensure all recipients of the first shot were scheduled for their second required does of the vaccine. Utilize SharePoint, MS Excel Spreadsheet, soft phone and all requirements to work remotely out of office.

Skills

Typing 62 WPM, Proficiency MS Excel, MS Outlook, MS Word, EPIC, Phressa, scheduling, familiar with HIPAA Guidelines and Texas Medicaid. Experience TrueCare, Cloud, Streamline, Teams, Meditech, UHC, BCBS, CMS portals along with numerous applications to work remotely including fax and online scan systems.

Education

Del Mar College 120 Hours College Credit Associautes Social Work

MS Word, MS Excel, MS Power Point

Del Mar College Medical Terminology

Workforce Readiness Certification

References:

Anne Marie Sandoval Child Protective Services Administrator 361-***-**** (Supervisor for Internship)

June Biste Driscoll Childrens Hospital 361-***-**** (Co- Worker)

Valerie Garcia 361-***-**** (Apac Coworker/Navy Army)

Rosalinda Ramos

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