Demonstrates strong analytical, communication, and organizational skills. Proven ability to work autonomously while also eager to contribute to team success. All while bringing a positive attitude and commitment to continuous learning.
Work History
Member Auth Management- Case Team
3 Years 9 Months
Progyny | 11.2022 - Current
Assessed and verified authorization requests to maintain compliance and operational integrity.
Analyzed patient eligibility coverage information and assessed benefit levels.
Facilitated timely processing of prior authorization requests to ensure compliance with departmental standards.
Utilized electronic databases and manual filing systems to systematically track and manage authorization statuses.
Financial Advocate Supervisor
1 Year 2 Months
IVFMD | 07.2021 - 09.2022
Crafted tailored financial plans for clients, enhancing their long-term financial stability.
Assisted clients in navigating financial documents, improving their understanding of loan agreements and insurance policies.
Developed and implemented operational policies and procedures to ensure efficiency and accuracy of workflows.
Monitored project progress and offered constructive feedback to staff, fostering professional development.
Front Desk Receptionist
3 Months
Spine And Wellness Centers Of America | 04.2021 - 07.2021
Coordinated appointments for clients and visitors to optimize front desk operations.
Answered incoming calls, redirected callers to the appropriate personnel and took messages.
Executed data entry into computer systems, ensuring accuracy of customer information records.
Server
4 Years 2 Months
Olive Garden | 01.2017 - 03.2021
Developed in-depth knowledge of menu items, garnishes, ingredients, and preparation methods to enhance customer experience.
Recorded customer orders accurately and in a timely manner.
Ensured dining room cleanliness and proper set-up, contributing to a positive dining atmosphere.
Education
High School Diploma
Miami Coral Park Sr High School | Miami, FL | 05-2019
Bachelor of Science - Biology
Florida International University | Miami, FL | 08-2028
Skills
Time Management
Attention to detail
Adaptable
Verbal and written communication
Self-motivation
Teamwork and collaboration
Problem-solving
Accomplishments
Assisted in resolving provider visibility issue in Progyny portal by suggesting we implement a template which led to optimization of work flow for timely case resolution.
Surpassed QA benchmark consistently by embracing Progyny's white glove service standards.
Officially recognized by my supervisor and Associate Provider Account Manager for providing timely case resolution and white glove service to my assigned clinics.
<ul><li>Lead a high performing team of Case Managers, Injury Management Advisor and Technical Specialist. Acting as a Third Party Administrator and responsible for the management of the portfolio of Youi CTP Claims.</li><li>My role was to oversee and supervise the day to day operation of the claims team and to ensure that both our Statutory Benefits and Common Law claims portfolio are being managed at a high level and in line with the legislation.</li><li>I am responsible for design and implementation of framework for effective claims strategies to uplift Customer Experience including Business and Regulator deliverables.</li><li>Established and developed strong working relationships with our client Youi to ensure that regular business performance updates are provided, improve reporting and claims governance including risk oversight are being identified.</li><li>Develop new initiatives and ideas to assist with the continuous improvement of claims processes and procedure including the rolling out of such plan to the business.</li></ul> at Employers Mutual Limited<ul><li>Lead a high performing team of Case Managers, Injury Management Advisor and Technical Specialist. Acting as a Third Party Administrator and responsible for the management of the portfolio of Youi CTP Claims.</li><li>My role was to oversee and supervise the day to day operation of the claims team and to ensure that both our Statutory Benefits and Common Law claims portfolio are being managed at a high level and in line with the legislation.</li><li>I am responsible for design and implementation of framework for effective claims strategies to uplift Customer Experience including Business and Regulator deliverables.</li><li>Established and developed strong working relationships with our client Youi to ensure that regular business performance updates are provided, improve reporting and claims governance including risk oversight are being identified.</li><li>Develop new initiatives and ideas to assist with the continuous improvement of claims processes and procedure including the rolling out of such plan to the business.</li></ul> at Employers Mutual Limited
<ul><li>Manage three separate teams for which their scope includes middle office support for the client relations community including known population remediations, complex reporting as well as a business manager team executing on efficiencies and development opportunities (eleven individuals both domestic and overseas contingent workers). 13 years of Institutional Relationship experience, 7 of those involving people management</li><li>Currently own and assist with facilitating the client relation pieces of various Management Action Plans (MAP) and internal audits within Revenue Credit Account (RCA) and Service Level Agreement (SLA) areas</li><li>In February 2024 released the first Salesforce Intake system at TIAA after five years of development and advocacy. This build has been noted as the blue print for all future case management intake systems within Salesforce at TIAA providing efficiency and ease for the user while reducing risk for the company</li><li>Worked on advancements and efficiencies within the Service Level Agreement process including salesforce automation. Implemented continuous improvement projects which reduced specific quarterly reporting tasks from days to minutes as well as the inception of a single budget code to pull penalties from rather than dozens of different budget codes</li><li>Through partnership with operations, updated the standard operating procedures for Client Service Managers concerning non bulk Lost Earning Calculations in 2021 to be submitted primary through plan focus unless through special exception. This reduced volumes for my team around lost earning calculations by 22% compared to the year prior while providing a more seamless and straight through process for the external clients</li><li>Continue working through obstacles, avoid duplication of efforts between client relations and other support team within different departments while creating synergy towards “working as one”</li><li>Advanced public speaking skills presenting both in person and virtually to groups as small as senior leadership to hundreds of employees on various forums</li></ul> at TIAA<ul><li>Manage three separate teams for which their scope includes middle office support for the client relations community including known population remediations, complex reporting as well as a business manager team executing on efficiencies and development opportunities (eleven individuals both domestic and overseas contingent workers). 13 years of Institutional Relationship experience, 7 of those involving people management</li><li>Currently own and assist with facilitating the client relation pieces of various Management Action Plans (MAP) and internal audits within Revenue Credit Account (RCA) and Service Level Agreement (SLA) areas</li><li>In February 2024 released the first Salesforce Intake system at TIAA after five years of development and advocacy. This build has been noted as the blue print for all future case management intake systems within Salesforce at TIAA providing efficiency and ease for the user while reducing risk for the company</li><li>Worked on advancements and efficiencies within the Service Level Agreement process including salesforce automation. Implemented continuous improvement projects which reduced specific quarterly reporting tasks from days to minutes as well as the inception of a single budget code to pull penalties from rather than dozens of different budget codes</li><li>Through partnership with operations, updated the standard operating procedures for Client Service Managers concerning non bulk Lost Earning Calculations in 2021 to be submitted primary through plan focus unless through special exception. This reduced volumes for my team around lost earning calculations by 22% compared to the year prior while providing a more seamless and straight through process for the external clients</li><li>Continue working through obstacles, avoid duplication of efforts between client relations and other support team within different departments while creating synergy towards “working as one”</li><li>Advanced public speaking skills presenting both in person and virtually to groups as small as senior leadership to hundreds of employees on various forums</li></ul> at TIAA