Donna Gilbert
Soldotna,AK
Summary
Focused Navigator highly effective at uncovering problems and calmly responding to changing conditions. Excited to leverage skills gained many years to pursue challenging new position.
Overview
15
15
years of professional experience
Work History
Un'ina Navigator
Kenaitze Indian Tribe
Kenai , AK
07.2020 - 09.2024
- Work collaboratively with un'ina to explore options for financial assistance for medical services
- Assists un'ina and families with applying and renewing applications for alternate resources to pay for medical care
- Perform verification of insurance, Medicaid, Denali Kid Care, Medicare, other private insurance for scheduled appointments
- Reconcile and process vendor invoices (ANTHC, Quest, City of Kenai, North Star Medical Imaging, Kenai Peninsula Borough, Procare.)
- Be the point of contact for un'ina and families, answering questions regarding purchase/referred care, and insurance
- Participate in the purchase/referred care workgroup, with timely follow up to un'ina regarding the workgroups decision
- Communicate directly with the un'ina regarding the purchase/referred care process
- Ensures compliance with Tribal, federal, state, and local employment laws and regulations, Tribal policies and TERO ordinance
- Assist with completion of TMAC reports for Medicaid reimbursement
- Submit claims for payment after configuring Medicare Like Rates utilizing the CMS addendums
Benefits Outreach Specialist
Southcentral Foundation
Wasilla , AK
05.2017 - 08.2019
- Assist customers with application for alternate health insurance applicaitons, primarily Medicaid and Tribally Sponsored Health Insurance through Premera Blue Cross Blue Shield and the Marketplace
- Assist Purchased and Referred Care with primarily Medicaid as Purchased and Referred Care is the payor of last resort
- Assist with outreach. Informing customers about alternate resources
Eligibility Technician
State of Alaska
Wasilla , AK
05.2016 - 06.2017
- Communicating information about policies, procedures, and program requirement to the public and co-workers, in person, in writing, and over the phone.
- Making eligibility determinations and benefit authorizations for clients applying for and/or receiving public assistance under rigid time frames with a high degree of accuracy.
- Conducting interviews; identifying and obtaining required documentation; analyzing, evaluating and interpreting information obtained from the client and a variety of collateral sources and computer interfaces.
- Working in a team setting to ensure that customers receive service in an accurate and timely manner.
- Maintaining current policy and program knowledge in an environment subject to frequent change.
- Entering and retrieving information from a variety of sources including verbal, written, and electronic data bases.
Automotive Detailer
Magmum Motors
Wasilla , AK
01.2010 - 03.2013
- Inspecting vehicles' interiors and exteriors to assess their condition and cosmetic issues
- Using liquids like waxes, polishes and cleaners to add shine to the body, wheels and glass
- Shampooing and deodorizing interior seats and floors
- Operating tools like steamers, vacuums and buffers on upholstery and paint
- Removing debris from cup holders, floors and crevices in vehicle interiors
- Applying protective treatments to minimize future damage
- Adhering to company guidelines, checklists, processes and quality standards
- Monitoring supply inventory and ordering tools and cleaning supplies as necessary
Education
Certificate in Medical Billing And Coding -
Charter College
Wasilla05-2019
High School Diploma -
Arviq High School
Platinum, AK05-1985
Skills
- Strong communication abilities
- Written Communication
- Reliability
- Time Management
- Active Listening
- Self Motivation
- Excellent Communication
- Decision-Making
Timeline
Un'ina Navigator
Kenaitze Indian Tribe
07.2020 - 09.2024
Benefits Outreach Specialist
Southcentral Foundation
05.2017 - 08.2019
Eligibility Technician
State of Alaska
05.2016 - 06.2017
Automotive Detailer
Magmum Motors
01.2010 - 03.2013
Certificate in Medical Billing And Coding -
Charter College
High School Diploma -
Arviq High School
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