Faith Suazo
Reynoldsburg,OH
Summary
Comprehensive knowledge of social service programs and community resources. Skilled at identifying needs and developing effective plans of action to provide intervention and assistance. Possesses strong organizational, interpersonal and communication skills.
Overview
7
7
years of professional experience
1
1
Certification
Work History
Non-Medical Case Manager
Aids Healthcare Foundation
08.2022 - Current
- Conduct comprehensive assessments to determine clients' eligibility for Ryan White Part A and Part B services.
- Verify income, residency, and HIV status to ensure compliance with program requirements.
- Offer education on sexual health, HIV prevention, and overall wellness.
- Administer and interpret screening tools such as PHQ-9 (depression), GAD-7 (anxiety), CAGE (substance abuse), and DAST-20 (drug abuse).
- Collaboratively develop personalized care plans with clients to address their specific needs and goals.
- Facilitate referrals to various support services, including food assistance, housing (HOPWA), dental care, and mental health services.
- Maintain an organized and up-to-date case management system for efficient tracking and documentation of client progress.
- Provide ongoing support, advocacy, and crisis intervention to clients within the case load.
- Attend regular team meetings, training sessions, and workshops to stay informed about updates in HIV/AIDS care, case management best practices, and program requirements.
- Foster relationships with healthcare providers, social services agencies, and other community resources to ensure a coordinated and holistic approach to client care.
Case Coordinator
Sedgwick MCO
11.2021 - 07.2022
- Oversee a caseload of 60 or more workers' compensation claims, ensuring that each case is properly managed and resolved.
Prioritize and address claims based on their severity and complexity. - Stay updated on the Ohio BWC guidelines, regulations, and compliance requirements to ensure that all claims are processed in accordance with state regulations.
- Conduct regular meetings with clients, including injured employees, employers, and insurance representatives, to discuss the status of claims, address concerns, and provide updates on the resolution process.
- Coordinate with healthcare providers to obtain necessary medical documentation related to the workers' compensation claims.
Ensure that all medical records and reports are accurate, complete, and submitted in a timely manner. - Establish and adhere to productivity goals, ensuring that claims are processed efficiently while maintaining a high level of accuracy and compliance.
- Regularly communicate with all relevant parties involved in the workers' compensation claims, including injured workers, employers, medical providers, and insurance representatives.
Inbound/Outbound Queue Associate
Aetna
11.2020 - 05.2021
- Initiate and complete the prior authorization process for medical procedures, treatments, or medications.
- Ensure that all necessary information and documentation are submitted to insurance providers for approval.
- Collaborate with healthcare providers to obtain required medical records, test results, and other documentation necessary for processing authorizations or claims.
- Engage in effective communication with healthcare providers over the phone to clarify information, request additional documentation, or discuss authorization requirements.
- Complete and maintain accurate records of all interactions, authorizations, and relevant details.
- Address inquiries, resolve issues, and provide clear and concise information regarding authorization status and procedures.
- Prioritize tasks effectively to meet deadlines for authorization submissions and other administrative responsibilities.
Patient Financial Specialist I
Mount Carmel Health System Inc.
10.2019 - 11.2020
- Collect and update patients' insurance information during each visit.
- Verify insurance coverage, ensuring that the information is accurate and up-to-date.
- Collect copayments from patients before or at the time of their appointments.
- Address past due bills by communicating with patients about outstanding balances and facilitating payment arrangements.
- Greet and check in patients upon their arrival, ensuring that all necessary paperwork is completed.
- Provide information about available financial assistance programs or options for those facing financial difficulties.
- Reconcile payments received throughout the day and ensure that all transactions are accurately recorded.
- Prepare end-of-day reports and deposits
Care Review Processor (Position Eliminated)
Molina Healthcare
01.2018 - 09.2019
- Gathered and organized statistical data related to maternal-fetal health for reporting purposes.
- Prepared reports for the Ohio Department of Medicaid and other corporate reporting requirements.
- Conducted assessments with team members or clients, likely related to maternal-fetal health.
- Handled general office tasks, such as faxing, mailings, updating documents, and maintaining spreadsheets.
- Participated in meetings, both internal and external, to stay informed about team activities and updates.
- Communicated with clients using various channels, including phone, email, fax, and letters.
- Engaged in quarterly meetings with the Ohio Department of Medicaid (ODM) and internal team members.
- Contributed to discussions, provided updates, and ensured alignment with program goals.
Care Review Processor (Temporary Position)
Molina Healthcare
03.2017 - 10.2017
- Collaborated with case managers to identify the specific needs of members transitioning from one level of care to another.
- Conducted assessments or gathered information to understand the unique requirements of each individual.
- Ensured that both case managers and members had a clear understanding of the steps involved in the transition of care.
- Assisted in connecting them with appropriate resources and services
- Contributed to general office support tasks, including faxing and mailing
Education
Bachelor of Arts - Human Services
Ohio Christian University
Circleville, OHMaster of Social Work - Generalist
Chamberlain University
Online01.2026
Skills
- Microsoft Word/Teams
- PowerPoint
- Excel (beginner)
Certification
Mental Health First Aid USA
Timeline
Non-Medical Case Manager
Aids Healthcare Foundation
08.2022 - Current
Case Coordinator
Sedgwick MCO
11.2021 - 07.2022
Inbound/Outbound Queue Associate
Aetna
11.2020 - 05.2021
Patient Financial Specialist I
Mount Carmel Health System Inc.
10.2019 - 11.2020
Care Review Processor (Position Eliminated)
Molina Healthcare
01.2018 - 09.2019
Care Review Processor (Temporary Position)
Molina Healthcare
03.2017 - 10.2017
Bachelor of Arts - Human Services
Ohio Christian University
Master of Social Work - Generalist
Chamberlain University
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