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, CA06.2014
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