Summary
Overview
Work History
Education
Skills
Accomplishments
Timeline
Generic

Cheree Biagui

Administrative Assistant III
Columbus,Ohio

Summary

To leverage my expertise in Microsoft Excel and problem-solving at Nationwide Children’s Hospital to enhance operational efficiency. Skilled in both medical authorizations and event coordination, I successfully supported critical healthcare delivery, achieving a 20% travel efficiency improvement for patient care initiatives. Highly efficient administrative professional offering several years of experience, including administrative support, project coordination, customer service and team leadership. Comfortable working with senior management to effectively define and achieve strategic operational and administrative objectives. Streamlines administrative processes, analyzes complex issues and develops solutions. Cultivates positive work culture focused on teamwork and idea-sharing while driving goal achievement. Skilled Administrative Support Officer with proven experience in managing office operations, improving administrative processes, and supporting executive level staff. Strengths include strong organizational skills, ability to multitask effectively and exceptional communication abilities.

Overview

16
16
years of professional experience

Work History

Administrative Support III- Heart Center Administration

Nationwide Children’s Hospital
Columbus, OH
07.2021 - Current
  • Directly supports Cardiovascular surgeon/ Director of Cardiovascular Tissue Engineering
  • Schedules appointments and meeting locations; coordinates events
  • Manages both national and international travel arrangements including air reservations, scheduling options, hotel, and car rental
  • Assists with credentialing both national and international
  • Develops travel itineraries in alignment with NCH standards
  • Responsible for completion of reimbursement requests
  • Provides excellent service to both internal and external customers by applying best practices and standard operating procedures
  • Anticipates problems and proposes solutions in advance
  • Coordinates special projects within assigned department
  • Aids in training and orientation of other administrative staff
  • Coordinates group activities within administrative team
  • Creates moderately complex correspondence, spreadsheets and visual presentations for projects
  • Schedules patients for Cardio Thoracic surgery accordingly
  • Helps manage OR scheduling calendar
  • Coordinates appointments for cardio clinic patients

Health Financial Resource Specialist

State of Ohio Bureau for Children w/Medical Handicaps
Columbus, OH
08.2018 - Current
  • Reviews and evaluates financial applications and documentation, determines financial eligibility for Bureau of Children with Medical Handicaps (BCMH) and/or other financial assistance/health services programs(s) and related 3rd party programs/resources
  • Makes referrals to other programs and other resources
  • Reviews financial applications for completeness
  • Conducts in-depth evaluation of household composition, countable income and insurance information to determine if family or applicant has met eligibility requirements
  • Reviews and initiates possible referrals to Medicaid
  • Accesses Medicaid MITS system to coordinate resources to indicate financial responsibility, reviews financial reconsideration and hearing request and makes recommendations to management
  • Collaborates with public health nurses to ensure timely submission of financial application and documentation
  • Provides assistance to parents, nurses and social workers
  • Provides information and assistance to other agencies, providers, families and other interested parties regarding BCMH or other programs (e.g eligibility requirements, cost share program, reconsideration request)
  • Generates form letters parents and physicians regarding financial eligibility and outcome of financial application
  • Attends meetings, conferences and workshops to discuss regulations and any revisions in procedures
  • Gives or receives information pertaining to unit operations

Financial Clearance Specialist

OSU, Physicians Inc.
Columbus, OH
08.2017 - 08.2018
  • Obtained accurate information including demographic, physician, insurance, employment and other miscellaneous information via EPIC
  • Used integrated health information systems and telephone technology with customer service skills to facilitate customer interactions such that the customer experiences the Medical Center and its entities as an accessible, coordinated, and seamless entity
  • Screened physician’s orders and pre-registration data for changes and compliance with payer requirements for medical necessity and pre-certification
  • Reviewed and completed changes to third party eligibility and benefits verification and coordinates with insurance carriers and 3rd party entities
  • Obtained and entered accurate and complete patient registration data into EPIC
  • Confirmed and corrected billing address, subscriber, insurance plan, coordination of benefit and missing information in EPIC
  • Assured accurate information was gathered to support clinical and financial needs including changes to insurance and other patient information
  • Assessed the patient’s financial ability to pay for services, referring patients to financial counseling staff when appropriate
  • Provided required clinical, insurance, and demographic information to payer to obtain precertification and assume benefit reimbursement
  • Pre-certified and obtained authorization numbers and enter into patient’s account obtaining medical, ICD and CPT codes
  • Submitted documentation of referrals to insurance companies as identified and contacted external companies to verify patient’s employment and insurance information for Workers compensation cases, as required
  • Provided accurate information to billing and case management to assure payment of claims
  • Interacted and maintained excellent working relationships with medical staff, referring physicians, and their designates to obtain complete, accurate, timely clinical and financial information required for payer reimbursement
  • Displayed the highest level of customer service, attentiveness, and consideration possible in all cases, keeping within the standard set by the Office of Compliance and HIPAA

Medicare Concierge Associate / Provider Service Representative

Anthem, Inc.
Columbus, OH
08.2014 - 08.2017
  • Daily outbound courtesy calls to Medicare Advantage members with new policies to explain benefits, eligibility, and all other questions regarding their Anthem Medicare Advantage policy
  • Offered financial assistance programs to help reduce cost of medication and premium payments
  • Answered incoming calls from medical providers, hospital and clinics providing information on member eligibility, claim status, utilization management status, verification of current procedural terminology (CPT) codes, contractual agreement status and a variety of other provider issues
  • Assisted providers with verification of underpaid or overpaid medical claims through manual pricing according to contracted rates
  • Provided further investigation and/or resolution of escalated issues
  • Routed incorrect priced claims for review as requested, reissued provider check payments as needed and perform stop payment on checks whenever requested
  • Performed status updates on medical authorization submitted by providers through utilization management systems

Reimbursement Specialist / Customer Care & Sales Coordinator

BioRx Home Infusion Pharmacy
Cincinnati, OH
10.2010 - 08.2014
  • Assisted with managing an infusion suite by scheduling patients for intravenous immunoglobulin (IVIG) infusions and performing billing reports
  • Worked closely with BioRx’s Patient Advocate Managed Care Team and Nursing staff to help coordinate start of care for patients
  • 20% average travel to doctor offices, clinics and hospitals with pharmacy regional sales representative
  • Provided quarterly reimbursement reporting as requested by Ohio sales representative
  • Responsible for initiating new prior authorization requests as well as check status on current authorizations for both pharmacy and medical
  • Mailed and faxed over clinical and medical documentation to insurance companies as needed for approval of home infusion medication and nursing visits
  • Successfully submitted electronic claims for payment after date of service rendered
  • Responded to various insurance verification issues, coverage determination questions, copayment complaints and general patient concerns
  • Transitioned patients to hospitals or other specialty pharmacies if mandated
  • Provided supervision to other representatives involved with insurance verification and authorization processes to ensure accuracy
  • Promoted individual client and patient centered service to achieve maximum satisfaction with BioRx Infusion pharmacy by mailing out monthly patient surveys and providing consumer reports to company marketing department as requested by regional sales representative

Enrollment and Sales Specialist / Patient Care Coordinator Representative

Humana Insurance Company
Cincinnati, OH
11.2008 - 10.2010
  • Provided excellent customer service to Humana Commercial and Medicare members via telephone
  • Coordinated delivery of medication to member’s home or doctor’s office
  • Assisted providers with obtaining medical and pharmacy prior authorizations
  • Assisted with processing payment transactions for medication delivered
  • Researched copayment assistance for eligible Humana members
  • Outbound courtesy calls to Humana members to explain RightSource Specialty process and procedures
  • Participated in various sales campaigns to help promote Humana’s Right source Specialty
  • Adhered and met department performance metrics

Education

Psychology

Southern New Hampshire University
Hooksett, NH
03-2026

Skills

  • Microsoft Word
  • Microsoft Excel
  • Budgeting
  • Mathematics
  • Public Relations
  • Data Collection
  • Medical Terminology
  • ICD-10
  • CPT Codes
  • Administration
  • Health Insurance
  • Claims Processing
  • Medical Authorizations
  • Pharmacy Authorizations
  • Written Documentation
  • Clear Communication
  • Problem-Solving
  • Organizational Skills
  • Event Coordination
  • Accountability
  • Self-Awareness
  • Learning Agility
  • Resiliency
  • Motivational Skills
  • Leadership
  • Verbal communication
  • Meeting planning
  • Budgeting support
  • Records management
  • Office administration
  • Scheduling appointments
  • Document management
  • Travel arrangements
  • Calendar management
  • Report preparation
  • File organization
  • Video conference preparation
  • Travel arrangement scheduling
  • Office record management
  • Calendar maintenance and docketing
  • Payroll and benefits administration
  • Metrics tracking
  • Patient flow management
  • Recruiting
  • Proofreading
  • Confidential document control
  • Time and labor control
  • Activity reporting
  • Scheduling
  • Account reconciliation
  • Spreadsheet creation
  • Business correspondence
  • Expense reporting
  • Registration processing
  • Project planning
  • Purchasing coordination
  • Customer relations
  • Event coordination
  • Travel coordination
  • administer training modules
  • Proficient in Outlook, Microsoft, Excel, PowerPoint
  • Order processing

Accomplishments

  • Dean's List
  • National Society of Leadership and Success (NSLS)

Timeline

Administrative Support III- Heart Center Administration

Nationwide Children’s Hospital
07.2021 - Current

Health Financial Resource Specialist

State of Ohio Bureau for Children w/Medical Handicaps
08.2018 - Current

Financial Clearance Specialist

OSU, Physicians Inc.
08.2017 - 08.2018

Medicare Concierge Associate / Provider Service Representative

Anthem, Inc.
08.2014 - 08.2017

Reimbursement Specialist / Customer Care & Sales Coordinator

BioRx Home Infusion Pharmacy
10.2010 - 08.2014

Enrollment and Sales Specialist / Patient Care Coordinator Representative

Humana Insurance Company
11.2008 - 10.2010

Psychology

Southern New Hampshire University

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Cheree BiaguiAdministrative Assistant III