Britni Aleong
Brooklyn,NY
Summary
Dynamic, self-motivated home care Authorizations leader with achievable track-record of exceeding expectations with high productivity and quality standards. Demonstrate a high level of integrity, passion for positive customer service, and take ownership of personal and team actions. Communicate effectively, promote collaboration, nurture a positive, professional work environment, and adhere to Standard Operating Procedures.
Overview
12
12
years of professional experience
Work History
Appeals Specialist
MetroPlus Health Care
New York, New York
08.2024 - Current
- Reviewed and analyzed appeal requests for medical services.
- Collaborated with healthcare providers to gather necessary documentation.
- Communicated decisions regarding appeals to members and providers.
- Maintained accurate records of all appeal cases and outcomes.
- Participated in team meetings to discuss process improvements and strategies.
Authorizations Manager
Edison Home Care
Brooklyn, NY
01.2021 - 07.2024
- Supervise authorization department of 10 Authorization Specialists, oversee work flow, train and evaluate new employees, handle staff inquires and issues
- Run daily reports ensuring all patients profiles are up to date
- Provides superior customer service to internal and external clients, customers and patient
- Utilize various means of communication, such as fax and phone calls, for exchange of information within many complex organizations
- Maintaining email resource and internal log and working closely with Administrator
- Obtained prior authorizations from various insurance companies by submitting clinical information via fax or speaking directly to a case management representative
- Process and post insurance payments
- Contacting insurances (by phone, e-mail and regular mail) for eligibility, benefits, network status and authorization, documenting information.
Authorizations Manager
True Care Home Care
Brooklyn, NY
01.2017 - 01.2021
- Supervise authorization department of 8 Authorization Specialists
- Contact insurances for eligibility, Benefits, Demographics, Authorizations, Maintains emails, Faxes, Mail
- Provides and maintain positive consumer services
- Speaks Directly to case managers to promptly obtain authorizations
- Ensure Patient's schedules are up to date
- Mentored new hires, resulting in stronger staff development and increased productivity
- Used coordination and planning skills to achieve results according to schedule.
Administrative Assistant/ Human Resources
Heritage Home care Services Inc.
Brooklyn, NY
01.2014 - 01.2016
- Monitor HHA compliance with trackers appropriate
- HHA Exchange demographic data entry
- Upload documents to HHA Exchange
- Assist with move-in paperwork/annual paperwork as required by state regulations and Atria
- Coordinate transportation of residents to outside medical appointments
- Organize and update orientation and in-service binder, manage in-service calendar which is utilized to schedule in-services, and help DPS to prepare
- Assist DPS/Administrator with ordering supplies as needed, within budget
- Coordinate staff schedule under the direction of the DPS
- Receive fax or phone calls from physicians, pharmacies and families and take appropriate action
- Make copies and manage and update resident charts, appointment books, and patient binder
- May perform other clerical duties as needed and/or assigned.
Education
GED -
Beyond Institute & Career Center Inc
Kissimmee, FL06-2023
Skills
- Exceptional customer service
- Working knowledge of MS Office
- POS system and Microsoft Outlook
- Salesforce
- Hha exchange
- Workforce Management
- Performance Management
- Contract Management
- Record management
- Team supervision
- Problem solving
References
Available Upon Request
Timeline
Appeals Specialist
MetroPlus Health Care
08.2024 - Current
Authorizations Manager
Edison Home Care
01.2021 - 07.2024
Authorizations Manager
True Care Home Care
01.2017 - 01.2021
Administrative Assistant/ Human Resources
Heritage Home care Services Inc.
01.2014 - 01.2016
GED -
Beyond Institute & Career Center Inc