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Seasoned Utilization Review Nurse with a proven ability to enhance patient care through strategic utilization management and comprehensive clinical assessment. Recognized for excellence in collaborative teamwork, ensuring adherence to healthcare regulations while consistently achieving optimal patient outcomes. Extensive experience in developing detailed care plans and coordinating patient care across various healthcare settings, including inpatient, observation, and outpatient environments. Committed to delivering exceptional healthcare services, backed by a solid foundation in Medicare knowledge and proficiency in Microsoft Office. Actively seeking remote opportunities in Behavioral Health while remaining open to other medical roles.

Accomplished healthcare contract and project management professional with over a decade of experience in negotiating and executing complex federal and commercial agreements, including TRICARE and VA contracts. Expert in driving operational efficiencies, ensuring regulatory compliance, and leading cross-functional teams in diverse healthcare environments. Proven track record of optimizing contractual outcomes, enhancing provider networks, and fostering strategic stakeholder relationships to deliver measurable cost savings and improved service delivery.

Dynamic enrollment supervisor with extensive experience at TriWest Healthcare Alliance, excelling in data analysis and process improvement. Proven track record in leading teams to optimize performance and enhance compliance with TRICARE standards. Adept at training and developing staff, driving operational efficiency, and resolving complex issues to support organizational goals.

Bilingual customer service professional with three years of experience in high-volume, chat-based technical support. Skilled in resolving complex internet, video, and voice service issues with empathy. Trusted mentor for team training and problem-solving. Committed to clear communication in English and Spanish, focusing on timely decision-making and a customer-first approach. Seeking to leverage my skills in a leadership role to enhance team collaboration and customer satisfaction.

Dependable detention officer accomplished enforcing institution rules and supervising the daily activities of several inmates. Adept at thoroughly inspecting the premises for contraband and unsanitary conditions, performing specimen collections and processing inmates. Communicative and just with sound knowledge of inmates' rights. Preforming care, custody and control with inmates.
I have been certified by TCOLE (Texas Certification Of Law Enforcement). gone through self defense training. Certified to use OC (Oleoresin Capsicum) spray. Part of a Special Operations Response Team which deals with cell extractions and riots inside and outside of the facility.

Dynamic educator with a proven track record at Loma Linda Elementary School, excelling in classroom management and student engagement. Developed innovative lesson plans that fostered critical thinking and collaboration, while effectively communicating with parents to support individualized learning. Committed to enhancing student outcomes through tailored assessments and a supportive learning environment.

Dynamic Referral Management Specialist with a proven track record at Memorial Health System, excelling in customer relationship management and insurance pre-authorizations. Adept at prioritizing tasks and maintaining meticulous documentation, I leverage my proficiency in medical terminology to enhance patient interactions and streamline processes, ensuring optimal service delivery in fast-paced environments.

Experienced Referral Management Specialist with a strong background in insurance verification, patient eligibility, and authorization processes. Adept at managing patient information, processing claims, and ensuring compliance with healthcare regulations. Proven ability to streamline administrative processes and deliver exceptional customer service.

Detail-oriented team player with strong organizational skills. Ability to handle multiple projects simultaneously with a high degree of accuracy. To seek and maintain full-time position that offers professional challenges utilizing interpersonal skills, excellent time management and problem-solving skills. Organized and dependable candidate successful at managing multiple priorities with a positive attitude. Willingness to take on added responsibilities to meet team goals.

Certified Coding Specialist (CCS) with a background in insurance administration and healthcare documentation. Trained in ICD-10-CM, CPT coding, and HIPAA compliance. Over five years of experience handling confidential records, data entry, and client documentation. Motivated entry-level candidate seeking a medical billing or coding role.


Emylie Vargas

Summary

Overview

Work History

Referral Management Specialist

Call Center Representative- Marketplace

Cashier

Deployed Services Support

Education

No Degree - Medical Assistiant

Skills

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Referral Management Specialist

Call Center Representative- Marketplace

Cashier

Deployed Services Support

No Degree - Medical Assistiant

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