Adrianna Ortiz
Nashville,TN
Summary
Detail-oriented professional with extensive experience in content review and compliance. Proven ability to handle sensitive information accurately and enforce guidelines effectively. Experienced in crisis management and digital content creation, committed to maintaining safe and engaging online environments. Bilingual in English and Spanish, focused on upholding high standards and supporting user needs.
Overview
5
5
years of professional experience
Work History
Managed Care Specialist
State of TN - TennCare
Nashville, TN
10.2023 - Current
- Processed and audited applicant income and resources to ensure compliance with TennCare eligibility guidelines
- Interpreted and enforced state regulations, accurately assessing program eligibility and maintaining program integrity
- Collaborated with cross-functional teams to resolve complex cases and ensure adherence to compliance standards
- Maintained and updated records, identifying and correcting data discrepancies to ensure accuracy and completeness.
Content Creator & Influencer Marketing Specialist
Self Employed
Nashville, TN
11.2022 - Current
- Developed and executed content strategies across multiple platforms, ensuring alignment with brand guidelines and community standards
- Created and scheduled content including articles, newsletters, and social media posts, driving engagement and brand consistency
- Analyzed key performance indicators (KPIs) to optimize content for maximum user engagement and adherence to platform policies
- Monitored trends to inform content strategy, ensuring relevance and compliance with platform guidelines.
Integrated Services Specialist
Aetna, a CVS Health Company
Nashville, TN
10.2021 - 11.2022
- Processed healthcare enrollments directly through Aetna and the Healthcare Marketplace, ensuring compliance with legal requirements
- Resolved customer and broker inquiries efficiently, maintaining high levels of customer satisfaction and data integrity
- Audited enrollment processes, identifying and correcting technical errors using Salesforce, Softheon, CMS, and BAW systems
- Generated and distributed ID cards for members, ensuring accuracy and compliance with certification standards.
Intake Care Senior Representative
Cigna Behavioral Health
Nashville, TN
08.2020 - 10.2021
- Reviewed and approved behavioral health authorization requests, ensuring compliance with HIPAA and PHI regulations
- Conducted post-discharge outreach and assessments, providing customers with information on benefits and community resources
- Documented all interactions with meticulous attention to detail, ensuring accurate records for compliance purposes.
Mental Health Specialist II
Vanderbilt Psychiatric Hospital
Nashville, TN
06.2019 - 08.2020
- Provided direct patient care in crisis situations, specializing in psychological first aid and crisis intervention
- Led group therapy sessions focused on coping skills and therapeutic techniques, contributing to patient recovery and well-being
- Assisted in de-escalation and intervention during critical incidents, ensuring patient and staff safety.
Education
B.A. in Psychology -
State University of New York At New Paltz
Skills
- Content Moderation: Policy Enforcement, Community Guidelines, Content Review, Data Integrity
- Technical: Microsoft Office Suite, Google Workspace, Salesforce, Softheon, CMS, BAW
- Communication: Strong Written and Verbal Communication, Crisis Management, Privacy Compliance (HIPAA)
- Languages: Bilingual - Fluent in English & Spanish
Additional Qualifications
- Resilience & Adaptability: Proven ability to manage high-stress environments while maintaining productivity and attention to detail.
- Attention to Detail: Consistently achieved accuracy in record-keeping and compliance, contributing to overall team success.
- Familiarity with Online Platforms: Experienced in content creation and moderation with a focus on maintaining community standards and brand integrity.
Timeline
Managed Care Specialist
State of TN - TennCare
10.2023 - Current
Content Creator & Influencer Marketing Specialist
Self Employed
11.2022 - Current
Integrated Services Specialist
Aetna, a CVS Health Company
10.2021 - 11.2022
Intake Care Senior Representative
Cigna Behavioral Health
08.2020 - 10.2021
Mental Health Specialist II
Vanderbilt Psychiatric Hospital
06.2019 - 08.2020
B.A. in Psychology -
State University of New York At New Paltz
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