Caitlyn Welch

• Utilized TLO to research and update patient information when records were unavailable on the Jan-Care profile.
• Promoted to handle Medicare HMO accounts for Jan-Care's WV, NC, focusing on comprehensive billing and insurance coordination.
• Managed all interactions with insurance companies, including obtaining claim statuses, resolving denials, and identifying reasons for HMO claim rejections, followed by submission of corrected claims (Form 1500).
• Coordinated the appeals process for Medicare HMOs, ensuring the correct documentation was compiled and submitted for timely resolution.
• Verified accuracy of coding for Medicare standards in partnership with dispatch, confirmation, and coding teams, before sending claims electronically or by mail.
• Managed Physician Certification Statements (PCS) from hospitals, nursing homes, and VA facilities, ensuring accurate documentation for billing compliance.

• Answered incoming calls, scheduled hearings, communicated with attorneys daily through phone and email, work on Courts Plus to locate case files and print off important legal documents for the Judge
• Ensure the Judge is on schedule and has everything he needs for hearings
• Making sure Orders and Motions are filed promptly
• Creating Criminal term dockets and revising and editing as criminal cases plea or file motion to continue
• Creating official court documents for the Judge to review and sign
• Also, being trained by Judge Blake’s Court Reporter Robin Cole, to become a Digital Court Reporter, to be prepared to take my National and State Certification

Collections Department (March 2023 – August 2023)

• Managed inbound and outbound calls with patients regarding billing inquiries and payment arrangements, utilizing Waystar to verify payment history and process payments over the phone.
• Utilized TLO to research and update patient information when records were unavailable on the Jan-Care profile.
• Communicated with internal departments to process claims for deceased patients or Veterans Affairs (VA) patients, ensuring proper routing to relevant teams.
• Coordinated with insurance providers (Blue Cross Blue Shield, Medicaid, Medicare, etc.) to submit and follow up on claims, ensuring accuracy and timely resolution.

Medicare HMO Specialist (August 2023 – September 2024)

• Promoted to handle Medicare HMO accounts for Jan-Care's WV, NC, and Volunteer Medical Services in PA, focusing on comprehensive billing and insurance coordination.
• Managed all interactions with insurance companies, including obtaining claim statuses, resolving denials, and identifying reasons for HMO claim rejections, followed by submission of corrected claims (Form 1500).
• Coordinated the appeals process for Medicare HMOs, ensuring the correct documentation was compiled and submitted for timely resolution.
• Oversaw preauthorization processes for all commercial insurance, Medicare, and HMO plans, ensuring compliance with insurance requirements and submission of necessary paperwork.
• Verified accuracy of coding for Medicare standards in partnership with dispatch, confirmation, and coding teams, before sending claims electronically or by mail.
• Managed Physician Certification Statements (PCS) from hospitals, nursing homes, and VA facilities, ensuring accurate documentation for billing compliance.

Additional Roles

• Operated as an EMT driver, assisting with patient transport while supporting partner EMT during field operations.
• Conducted cleaning and maintenance of two corporate offices every Monday, Wednesday, and Friday to ensure a clean and safe working environment.

• Interviewing potential employees, sending new hires paperwork and background checks through email, training new hires with our scanner machines and how an inventory works, and having meetings with higher management on how the application flow is going
• Worked with different states hiring for their districts including Oregon, Washington State, North & South Dakotas, and Minnesota
• Hosted hiring events for our company
• Developed training programs, improving team performance and ensuring compliance with company standards.

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• Performing pedicures, manicures, waxing, making appointments, answering phone calls, checking out customers, creating a peaceful atmosphere for clients to relax and unwind
• Maintained up-to-date knowledge of beauty trends and techniques through ongoing education and product training sessions.
• Provided personalized skincare consultations, recommending appropriate treatments and products to enhance client satisfaction.

• Scheduling appointments, answering phones, checking out clients, cleaning the salon sweeping, mopping wiping down windows, folding laundry, and organizing products and chemical products

• Cleaning the dining room, greeting customers, seating guests, serving food, taking to-go orders, packing up Togo orders, and checking customers out

• Answering phones, faxing, sending mail through a postal stamp machine, scheduling appointments for consults to help with getting the client's business started and working with the manager to organize events for the center