Adrienne Piazza
Metairie,La
Summary
Results-driven individual with a solid track record in delivering quality work. Known for excellent communication and teamwork abilities, with a commitment to achieving company goals and delivering exceptional service. Passionate about continuous learning and professional development.
Overview
27
27
years of professional experience
Work History
Patient Care Coordinator
Khoobehi Plastic Surgery
Metairie, LA
04.2024 - Current
- Assist physician by documenting patient progress and ongoing care plans in a clinic setting
- Oversee the maintenance and stocking of exam rooms
- Manages the end-to-end inventory process for high-value surgical devices, including procurement, audit, and documentation.
- Responsible for device tracking and warranty claims regarding breast implants
- Served as administrative support, managing phone correspondence, patient inquiries, and scheduling appointments
Utilization Management Administration Coordinator
Humana Inc.
Metairie, Louisiana
12.2006 - 10.2023
- Facilitate utilization management team queue by updating inpatient cases, requesting clinical information, and assigning to appropriate nurses.
- Performs various tasks including processing discharge orders, attaching faxes for chart reviews, and organizing nurses' queue daily with second clinical requests.
- Follow up with medical offices for surgery date changes.
- Manage various forms of communication including processing all incoming fax/email requests, providing telephonic customer service support, and creating and distributing necessary written correspondences.
Provider Appeals
Ochsner Health Plan / Humana Inc.
Metairie, Louisiana
10.1998 - 12.2005
- Monitors day to day compliance of appeal decision time frames.
- Reviews clinical and medical records for completeness and determines administrative appeal. Maintains
- Assigns reviews to physician advisers and medical directors for those requiring medical necessity reviews.
- Prepares reviews for cases that do not meet the required criteria
- Coordinate and deliver verbal and written information regarding patient and provider appeals, and ensure all letters are in line with all required standards
- Maintains files and logs related to all appeals
Stop Loss / Financial Recovery
Ochsner Health Plan / Humana Inc.
Metairie, Louisiana
10.1998 - 12.2005
- Facilitating stop loss accurately, timely, and professionally in accordance with stop loss policy and department guidelines
- Make notification of pertinent information to management and reinsurance carriers as defined in stop-loss policies and/or department guidelines
- Notify others as needed such as providers, account management, department manager, and client Document communication and follow up internally as required
- Follow up with clients on checks not cashed reports from carriers
- Work closely with the finance dept
Claims Adjudicator
Ochsner Health Plan / Humana Inc.
Metairie, Louisiana
10.1998 - 12.2005
- Verify and process claims in a timely manner
- Collaborate with provider, payer, employee, and employer group to ensure claims are correctly priced, per contract.
- Complete bill processing within the appropriate time frame.
- Provide exceptional customer service.
Education
High School Diploma -
Mount Carmel Academy
New Orleans, LA05.1990
Some College (No Degree) -
University of New Orleans
New Orleans, LASkills
- Detail orientation
- Effective written communication
- Strategic planning
- Time efficiency
- Collaborative teamwork
- Multitasking expertise
- Quality control
- Critical analysis
- Proficient in Microsoft Office
- Solution-oriented problem solving
- Certified in basic life support
- Customer relationship management
- Administrative support
Certification
- [Basic Life Support], American Safty and Health Institute , 10/2024 -10/2026
Timeline
Patient Care Coordinator
Khoobehi Plastic Surgery
04.2024 - Current
Utilization Management Administration Coordinator
Humana Inc.
12.2006 - 10.2023
Provider Appeals
Ochsner Health Plan / Humana Inc.
10.1998 - 12.2005
Stop Loss / Financial Recovery
Ochsner Health Plan / Humana Inc.
10.1998 - 12.2005
Claims Adjudicator
Ochsner Health Plan / Humana Inc.
10.1998 - 12.2005
High School Diploma -
Mount Carmel Academy
Some College (No Degree) -
University of New Orleans