BELINDA LYTTLE
Greenville,NC
Summary
With over ten years of healthcare experience (both clinical and non-clinical), I am interested in a position that will enable me to utilize the skills and experience I have gained in roles that I have held. I am looking for a position that will also allow me to utilize the regulation and compliance experience that I have gained both directly and indirectly in my roles, as well as courses I have taken thus far in the Healthcare Regulation and Compliance Juris Master’s degree that I was recently awarded. Detail-oriented worker with knowledge of account management and collaborating with other departments. Talented at data entry and analysis with exceptional knowledge of healthcare and customer service.
Overview
11
11
years of professional experience
Work History
SR. CORRESPONDENCE ANALYST
US HEALTHGROUP- UNITED HEALTHCARE, UHG
01.2022 - Current
- Review health insurance policies for activation, reinstatement, cancellation, and process accordingly
- Process payments and review claims paid
- Process refunds and reimbursements for insurance policies
- Add and delete payors from insurance policies
- Ensure that any request for changes and processing policies are from the policy holder
- Communicate with supervisors and managers regarding errors on accounts
- Analyze policies to ensure HIPAA compliance and other regulatory compliance.
- Analyzed data and work orders before sending or completing tasks
- Managed and maintained efficient, well-organized digital filing system
- Gather records pertinent to specific problems, review for completeness and accuracy and attach records to correspondence as necessary
- Manage time efficiently in order to complete all tasks within deadlines
SUBJECT MATTER EXPERT
LHI
05.2021 - 01.2022
- OPTUM- united health group
- Accountable for problem resolution of MSC, Veterans and providers issues and to communicate resolution to appropriate parties and coach when applicable
- Handled and resolved escalated issues when appropriate
- Supported new team members to help make a successful transition on the floor
- Worked alongside supervisor and team to tackle performance opportunities
- Met departmental performance for production, quality and KPI focus as well as phone support.
MEDICAL SERVICES COORDINATOR
LHI- OPTUM
09.2020 - 05.2021
- United health group
- Made contacts to schedule a variety of medical and dental services in accordance with Veterans availability and contract guidelines
- Responded to a variety of inquiries and resolved issues with regards to appointments, fulfillment processing and service completion in a timely manner while maintaining sensitivity towards military culture
- Conducted customer contacts related to health assessment processing, referral follow-up, education and resource inquiries
- Identified potential behavior health situations and followed contract specific protocols to assist callers
- Maintained constant awareness of service level and queue status to meet contractual requirements
- Interacted with providers to schedule, confirm, or cancel appointments.
- Implemented cross training of [Number] new hires to provide coverage during absences
Special Projects Coordinator
SPECIAL PROJECTS, LHI
2021 - 2021
- OPTUM- United health group
- Assisted the training department with operations training of new inbound and outbound customer service representatives
- Assisted Market Relations with sending emails to practitioners and providers with outstanding exams that need to be completed
- Prior to sending those emails I had to research and analyze the orders to ensure that an email was needed and that we were not waiting for any ancillaries that would prevent the practitioners from completing the exams.
Patient Safety Attendant
Orlando Health
07.2019 - 05.2020
- Assisted in meeting personal needs and comfort care of the patient (elderly and non-elderly) in a timely manner, while ensuring their safety
- Evaluated report from RN and previous Patient Safety Attendant and give report to RN and oncoming Patient Safety Attendant
- Maintained federal, state and local standards as well as maintain compliance with all Orlando Health policies and procedures such as Baker and Marchman Acts
Staffing Manager
Rio Pinar Healthcare- Consulate Healthcare
10.2018 - 05.2019
- Created schedules for Nursing Staff through OnShift Scheduling System as well as daily staffing sheets
- Secured coverage for vacant shifts, open positions, vacations, as dictated by Director of Clinical Services
- Reviewed bi-weekly payroll for accuracy for Nursing Department/Payroll Coordinator
- Oversaw CNA and nurses interview process, including conducting CNA interviews, verified license, credentials, drug screening, onboarding as well as assisting HR with job fairs
- Collaborated with Director of Nursing reporting and collecting employee information related to Workman’s Compensation incidents
- Covered for Receptionist when on breaks, lunches, call offs and vacations
- Ran frequent audits and reports to ensure Nurses and CNAs licenses and credentials are compliant.
- Devised hiring and recruitment policies for 50+ registered nurses and certified nursing assistants.
CERTIFIED NURSE’S assistant
Athena Home Health
12.2014 - 08.2018
- Provided personal care for patient (including Alzheimer’s and Dementia), including accompanying to medical appointments, planning and preparing nutritious meals and snacks and other daily tasks
- Joined weekly meetings with patient’s conservator and doctors, sharing updates on his health
- Recorded patient’s daily progress or decline performed on company issued technology
- Supported needs of 1+ residents under long-term care
BENEFITS SPECIALIST
LifeCare Inc
01.2013 - 08.2015
- Provided counsel to employees on how to utilize benefits provided through their employers
- Provided specific consultations and advisory services via telephone by completing needs assessments with clients in a professional and thorough manner
- Communicated with Social Workers and Registered Nurses to schedule case management assessments
- Reviewed, researched and processed case management and backup care benefits, ensuring that Service Level Agreements were met
- Performed research for resources such as long-term care facilities, home health agencies, assisted living facilities etc
- Provided resources for families of Alzheimer’s and Dementia patients.
Education
Master of Science - Healthcare Regulation
Florida State University
Tallahassee, FL08.2023
B.A. - Business administration, Human Resources Management
Colorado Technical University
Colorado Springs, CO08.2012
Skills
- Microsoft Office Suite and Outlook
- CRM Tools
- People Net
- Experience working with Alzheimer’s and Dementia patients
- MedNet Application
- Medical Terminology
- AS400
- HCP
- SharePoint
- Jira Projects
- OnShift Employee Scheduling System
- Cisco phone and other ACD phone systems
- CNA and CPR certified
- Complex Problem-Solving
- Engineering Change Order
Additional Information
- 2022 to Present Member of The Society for Collegiate Leadership and Achievement Honor Society
Timeline
SR. CORRESPONDENCE ANALYST
US HEALTHGROUP- UNITED HEALTHCARE, UHG
01.2022 - Current
SUBJECT MATTER EXPERT
LHI
05.2021 - 01.2022
MEDICAL SERVICES COORDINATOR
LHI- OPTUM
09.2020 - 05.2021
Patient Safety Attendant
Orlando Health
07.2019 - 05.2020
Staffing Manager
Rio Pinar Healthcare- Consulate Healthcare
10.2018 - 05.2019
CERTIFIED NURSE’S assistant
Athena Home Health
12.2014 - 08.2018
BENEFITS SPECIALIST
LifeCare Inc
01.2013 - 08.2015
Special Projects Coordinator
SPECIAL PROJECTS, LHI
2021 - 2021
Master of Science - Healthcare Regulation
Florida State University
B.A. - Business administration, Human Resources Management
Colorado Technical University
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