BRIDGETTE BAILEY

Taught as a long-term substitute teacher and planned and delivered standards-based instruction.

Coordinated daily classroom activities to ensure smooth functioning., assessing student performance, maintaining academic records.

● communicating with families, and fostering a positive learning environment to support student achievement and growth.

● Monitored student behavior and implemented classroom management strategies to promote a focused and respectful learning atmosphere.

● Participated in faculty meetings, professional development activities, and school-wide initiatives. Oversaw students during activities to ensure safety and engagement. during classroom activities, transitions, and assigned duties.

● Fostered safe, inclusive, and supportive classroom environment that encouraged academic growth and reinforced positive behavior.

● Adjudicated complex medical claims and denials by reviewing CPT/ICD coding, UnitedHealthcare policy guidelines, and clinical documentation to ensure accurate benefit determination and regulatory compliance.

● Managed high-volume claims workload, consistently meeting turnaround time and quality standards aligned with UnitedHealthcare performance metrics.

● Collaborated with providers and internal teams to resolve claim discrepancies and obtain corrected documentation, facilitating timely approvals, reconsiderations, and appeals. ● Performed claims adjustment functions in a remote environment using secure UHC systems to maintain HIPAA compliance, data integrity, and confidentiality.

● Assisted members and healthcare professionals with prior authorizations, test claims, and prescription inquiries, ensuring high service quality through effective call handling.

● Delivered empathetic, efficient virtual support in a high-volume environment, consistently meeting turnaround time and productivity benchmarks.

● Resolved escalated member and provider issues and provided real-time assist-line support to new representatives, ensuring HIPAA compliance and first-contact resolution.

● Coordinated high-volume mail-order prescription workflows, ensuring timely shipment of refills to members in accordance with established service-level agreements (SLAs).

Assisted with patient intake by collecting personal and medical information upon arrival., vital signs, room preparation, and front-desk workflows under Registered Nurse.

● Supported patient intake, vital signs, room preparation, and front-desk workflows under Registered Nurse.

● Maintained a clean, safe, and patient-ready clinical environment in compliance with infection control standards.

Checked insurance coverage details to confirm eligibility for services and procedures. and authorizations to support appointments, procedures, and continuity of care.