Ciera Giles
Woodbridge,VA
Summary
Detail-oriented professional with exceptional communication skills, and over 15 years of working knowledge in the Healthcare and Information Technology field.
Overview
20
20
years of professional experience
Work History
Sr. Program Coordinator
HSCSN
06.2019 - Current
- Review Provider invoices, EOB's, Prior Authorizations, and enrollee payments on a daily basis.
- Work in partnership with Claims Department to ensure all COB related enrollee reimbursements are processed.
- Ensure the finalize request is reviewed and signed by the Chief Medical Officer.
- Prepare notification letter to be mailed out.
- Assist with Accounts Payable with processing invoices for payout to vendors and enrollees.
- Maintain and update excel spreadsheet log for auditing.
- Provide updates on non-clinical duties.
Human Resource Generalist
Total Wine & More
04.2020 - 05.2021
- Liaised between management and employees to deliver conflict resolution, alleviate problems and interpret compensation and benefits policies.
- Provided educational and informational resources regarding policies and procedures.
- Maintained personnel records and statistical data to establish accuracy and compliance with applicable regulations.
- Administered employee leave requests in accordance with FMLA guidelines, maintaining compliance with regulations while providing necessary accommodations for staff members.
- Delivered Employee Relations expertise and support to employees to mitigate risks and to enhance the manager and employee relationship.
- Understanding of federal employment laws and compliance requirements such as FMLA, ADEA, Title VII, ADA (Rehab Act), HIPAA.
Outpatient Scheduler
VCU Health System
10.2015 - 09.2019
- Work in multiple ques/online request forums, and handle faxes from physicians, patients and outside referrals.
- Schedule appointments for all out-patient clinics including surgery appointments.
- Ensured accurate patient demographic and data entry.
- Added, updated and ran insurance to verify real time accuracy.
- Supported administrative tasks including data. entry, record maintenance, and insurance verification to ensure accurate billing and reimbursement processes.
- Complied with all HIPAA laws, regulations, policies and procedures.
- Checked appointment audit forms for new hires to ensure accuracy.
- Used IDX, Cerner, Outlook, Ecare and Amcom daily.
Technical Support Advisor
Aditya-Berla/ Apple
06.2013 - 10.2015
- Provides detailed technical support for IOS and MAC OS while exhibiting exceptional customer service skills.
- Maintained expert-level knowledge of company products to provide accurate information to clients during support calls or emails.
- Assisted customers in identifying issues and explained solutions to restore service and functionality.
- Streamlined support ticket handling process for faster response times and higher customer satisfaction levels.
- Resolved technical issues related to network interruptions.
- Troubleshot and resolved challenges in a timely manner.
- Attention to detail when consulting on-line web tool, manuals, circulars or internal resources for information on resolution procedure.
- Maintained confidentiality when dealing with sensitive customer data, adhering strictly to company policies regarding privacy protection.
Technical Support Advisor
Wells Fargo
06.2012 - 06.2015
- Navigated multiple banking systems simultaneously to access account information, process transactions, and update client records accurately.
- Helped customers complete online banking services and assisted with user access problems such as forgotten passwords.
- Completed transactions for customers and capitalized on opportunities to cross-sell products and services.
- Handled sensitive personal and financial information with discretion, ensuring the privacy of clients at all times.
- Diagnosed account problems using excellent listening skills and probing approach.
- Handled level 2 call(s) of greater complexity for problem resolution.
Medicare Enrollment Specialist
Centers for Medicare and Medicaid Services/Vangent
05.2005 - 06.2012
- Responded to customer inquiries using standard scripts and procedures.
- Researched required information using available resources.
- Handled and resolved customer complaints using questioning and listening skills.
- Processed orders, forms and applications.
- Managed a high volume of applications while maintaining attention to detail and adhering to tight deadlines.
- Researched claim information for Beneficiaries.
- Maintained up-to-date knowledge of relevant laws, regulations, and policy changes affecting Medicare eligibility determinations.
Education
Bachelor of Science - Information Technology
Northern Virginia Community College
Annandale, VA05-2027
High School Diploma -
Deep Run High School
Henrico, VA06-2007
Skills
- Claims processing
- Data management
- MS Excel Proficiency
- HR policies and procedures
- Employee relations
Timeline
Human Resource Generalist
Total Wine & More
04.2020 - 05.2021
Sr. Program Coordinator
HSCSN
06.2019 - Current
Outpatient Scheduler
VCU Health System
10.2015 - 09.2019
Technical Support Advisor
Aditya-Berla/ Apple
06.2013 - 10.2015
Technical Support Advisor
Wells Fargo
06.2012 - 06.2015
Medicare Enrollment Specialist
Centers for Medicare and Medicaid Services/Vangent
05.2005 - 06.2012
Bachelor of Science - Information Technology
Northern Virginia Community College
High School Diploma -
Deep Run High School
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