Summary
Overview
Work History
Education
Skills
Timeline
Generic

Nicholas Caudillo

San Dimas,CA

Summary

  • Nicholas has 2 years experience processing claim adjustments
  • He has two years of experience in claim adjudication
  • He is familiar with HMO, PPO and Medi-Cal Claims
  • He is bilingual in English and Spanish
  • Interview availability Monday - Friday 10:00 am - 2:00 pm
  • Vaccination Status: vaccinated

Overview

8
8
years of professional experience

Work History

Third Party Adjudicator

Polaris RX Pharmacy
06.2022 - Current
  • Responsible for resolving all rejected insurance claims in a timely manner
  • Processed HMO, PPO and Medi-Cal claims.
  • Communicate any issues and necessary information with the long term care facilities and insurance companies we are contracted with
  • Continuously updated personal knowledge on relevant laws, regulations, and policies affecting the adjudication process within the jurisdiction served.
  • Interpret provider contract reimbursement terms desirable.
  • Identify non-contracted providers for Letter of Agreement consideration.

Pet Ambassador

Premium Retail Services - Royal Canin/Eukanuba
12.2019 - Current
  • Ensured planograms are correct.
  • Trained both managers and employees of these retailers.
  • Ensured pet safety and comfort by adhering to established protocols and guidelines in all interactions.
  • Coordinated efforts with animal rescue organizations to facilitate successful placement of homeless pets into loving homes.

Lenovo Sales Representative

Premium Retail Services
05.2018 - 01.2020
  • In charge of three Best Buy locations
  • Enhanced client satisfaction by addressing concerns promptly and providing exceptional service.
  • Consistently met or exceeded quotas by implementing strategic sales plans and effective time management.
  • Conducted product demonstrations to educate customers on features, benefits, and competitive advantages.

Merchandising Representative

Premium Retail Services
08.2017 - 06.2019
  • Traveled to various retail stores and installed displays for many clients.
  • Increased brand awareness through effective visual merchandising techniques and engaging promotional materials.

Oculus/Facebook Representative

Premium Retail Services
01.2017 - 01.2019
  • In charge of conducting demos in Best Buy locations
  • Took part in installing Oculus and Facebook portal displays in Best Buy locations.

Education

High school Diploma -

Ramon C. Cortinez
Los Angeles, CA
06.2014

Skills

  • Data Entry
  • DocuTrack
  • Knowledge of HMO, PPO and Medi-Cal Claims
  • Customer Service
  • Computer knowledge
  • Time Management
  • Attention to Detail
  • Relationship building experience

Timeline

Third Party Adjudicator

Polaris RX Pharmacy
06.2022 - Current

Pet Ambassador

Premium Retail Services - Royal Canin/Eukanuba
12.2019 - Current

Lenovo Sales Representative

Premium Retail Services
05.2018 - 01.2020

Merchandising Representative

Premium Retail Services
08.2017 - 06.2019

Oculus/Facebook Representative

Premium Retail Services
01.2017 - 01.2019

High school Diploma -

Ramon C. Cortinez

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Nicholas Caudillo