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Work Background
Precision Tune Auto CareAdministrative Manager
Nov. 2019United States
NateraAppeals and Clinical Medical Management, A/R Analyst Management
Jun. 2017Austin, Texas Area
MedtronicAccountant Level II
Mar. 2012 - Sep. 2015San Antonio, Texas AreaPrepares work to be accomplished by gathering and sorting documents and related information. Pays invoices by verifying transaction information; scheduling and preparing disbursements; obtaining authorization of payment. Obtains revenue by verifying transaction information; computing charges and refunds; preparing and mailing invoices; identifying delinquent accounts and insufficient payments. Collects revenue by reminding delinquent accounts; notifying customers of insufficient payments. Prepares financial reports by collecting, analyzing, and summarizing account information and trends. Maintains accounting ledgers by posting account transactions. Verifies accounts by reconciling statements and transactions. Resolves account discrepancies by investigating documentation; issuing stop payments, payments, or adjustments. Maintains financial security by following internal accounting controls. Secures financial information by completing data base backups. Maintains financial historical records by filing accounting documents. Contributes to team effort by accomplishing related results as needed.
United Healthcare Medicare SolutionsAccountant
Mar. 2000 - Jan. 2012Resolve customer complaints via phone, email, mail, or social media. Use telephones to reach out to customers and verify account information. Greet customers warmly and ascertain problem or reason for calling. Cancel or upgrade accounts. Advise on company information. Act as the company gatekeeper. Attempt to persuade customer to reconsider cancellation. Utilize computer technology to handle high call volumes. Work with customer service manager to ensure proper customer service is being delivered. Close out or open call records. Compile reports on overall customer satisfaction
United Healthcare InsuranceAppeals Coordinator, Medical Management
Responds to member and practitioner grievances/appeals with minimal direction; while assisting members, via phone or face to face, further/support quality related goals. Investigates and resolves member and practitioner grievances/appeals within plan, regulatory and accreditation timeframes Prepares, attends and presents grievances/appeals documentation for plan, regulatory hearings and/or during audits, as needed Prepares all grievances/appeals written documentation Documents all grievances/appeals in an accurate and timely manner per policy, related follow-up activities and final outcomes in designated systems while concurrently maintaining secure, comprehensive and clearly defined files Provides timely assistance to members and practitioners in filing a formal grievance/ appeal and ensures that members and practitioners are advised of their appeal rights Works collaboratively, coordinates, communicates and integrates recommendations from impacted organizational departments and/or Senior Level Executives and other designated staff, as approved and required Generates reports with trend analysis and recommendations for quality improvement to Manager, as required Communicates detailed account of risk management issues to the Manager within the specified timeframe Assists with training, in-services and quality audits as a result of plan, regulatory or accreditation requirements Assists with any/other project management duties, as needed Assists with accreditation related duties, as needed Attend MAC and PAC meetings, as needed Maintains strict confidentiality
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