Open To Work
Hailea Fiona
Elevance Health
Manchester,NH
Work Preference
Job Search Status:
Open to work
Work Type
Full Time
Location Preference
On-SiteRemoteHybrid
Location:
Manchester, NH
Open to relocation:
Yes
Minimum Desired Compensation
$30/hr
Important To Me
Work-life balanceHealthcare benefitsWork from home optionPaid time off
22
years of professional experience
Dedicated health insurance professional with over two decades of experience in the non-clincal side of the health insurance industry. Known for personal accountability and commitment.
Work History
Utilization Management Representative III
13 Years 4 Months- Processed high volumes of data entries with attention to detail.
- Reviewed medical documents submitted by doctors' offices to ensure all required information was present. Reached out via fax or phone to obtain missing information and ensure timely review.
- Maintained up-to-date knowledge of frequently changing processing guidelines to ensure accurate set up of authorizations per multiple state regulations.
- Followed procedures to effectively comply with HIPAA laws and prevent information breaches.
- Used a variety of internal databases and processing systems to create cases accurately and sent nurses to for review for medical necessity.
Temporary Data Entry Clerk
1 Year- Combined and indexed documents to patient authorizations in the internal database at Anthem Blue Cross and Blue Shield of the Northeast before the acquisition by Elevance Health.
- Set up authorizations for nurses to review for the state of CT.
- Processed high volumes of data entries with precision and attention to detail.
Senior Enrollment & Eligibility Rep
6 Years 5 Months- Worked in the inbound call center providing members with health benefit information and providers with verification of member coverage dates.
- Worked in the inbound call center providing guidance to insurance brokers and benefits administrators regarding the policies of employer group benefit packages. Updated the contract information in the company's database.
- Entered information provided on new member enrollment forms.
- Trained new hires in a classroom setting to process member enrollment forms. Provided support to those new hires after their training period.
Skills
Documentation accuracy
Attention to detail
Professionalism and ethics
Adaptability and flexibility
Conflict resolution techniques
HIPAA complianceee
Interests
International Travel
Creative Writing
Timeline
Utilization Management Representative III
Elevance Health
01.2013 - 05.2026Read More
Temporary Data Entry Clerk
Allegis Group Services
01.2012 - 01.2013Read More
Senior Enrollment & Eligibility Rep
UnitedHealth Group, Inc.
08.2004 - 01.2011Read More