Gissette Guzman
Tampa,FL
Summary
Organized and dependable candidate successful at managing multiple priorities with a positive attitude. Willingness to take on added responsibilities to meet team goals. Collaborative individual with dedication to partnering with coworkers to promote engaged, empowering work culture. Documented strengths in building and maintaining relationships with diverse range of stakeholders in dynamic, fast-paced settings.
Overview
11
11
years of professional experience
Work History
Chart Retrieval Representative
UnitedHealth Group
Tampa, FL
12.2023 - Current
- Responsible for retrieving and managing medical records from healthcare providers for auditing, claims, and quality assurance purposes.
- Established and maintained strong relationships with healthcare providers to facilitate timely and accurate submission of requested charts.
- Ensured compliance with HIPAA regulations and organizational standards when handling patient records.
- Utilized internal tracking systems to monitor the status of chart requests, ensuring deadlines were met and escalating delays when necessary.
- Maintained clear, detailed documentation of all communications and submissions for reporting and compliance purposes.
Marketing Communications Planner, Ass
WellCare
01.2019 - 10.2020
- Assists in the development of Step Actions and training tools and provide input and recommendations by testing accuracy.
- Assist with updating project plans and distributing to teams as necessary.
- Assist team with projects requiring coordination with internal and external business partners.
- Responsible with some assistance for proofing test output and first articles for static and variable content and ensuring feedback is gathered and captured timely per the department procedures.
Care Coordinator
WellCare
08.2016 - 12.2019
- Interacted with other departments including Claims, Intake, Enrollment and Member Services to resolve member and provider issues.
- Organized variety of administrative and clinical tasks and prioritizes in order of importance and impact on members and providers.
- Participate and support nursing tasks, including but not limited to: faxes, discharge preparations, request of clinical information, and creation of authorizations if necessary.
- Provided coaching and mentoring to team, and facilitated team-building activities.
- Provided technical and administrative support to clinical and behavioral staff as needed.
- Assisted, completes and submitted special projects, report or assignments to meet department needs and objectives.
- Served as liaison in corresponding and communicating with providers, vendors and WellCare contacts and/or members representative’s.
Intake Ops Coordinator
WellCare
01.2015 - 08.2016
- Facilitated development, implementation and management of new vendors and contractors, and assisted with risk management.
- Data entry of authorizations and customer contacts in EMMA system.
- Participated in Pilot program transition from EMMA to Care Central.
- Outbound telephone calls related to coordination for medical health care as needed.
- Preparing and submitting projects, reports or assignments as needed to meet organizational initiatives and/or objectives.
- Participate in cross-functional teams to help streamline wide variety of process, procedures and interdepartmental communication.
- Bilingual translation as needed.
Project Analyst
Florida Hospital Tampa Bay Division
08.2013 - 01.2015
- Two (2) years managing multiple Breast Care Center projects from start to finish.
- Coordinated all phases of the project configuration and deployment process.
- Provided administrative and patient business services support for the Breast Care Center.
- Supported communication strategies, tactics and reporting to achieve optimum results.
- Coordinated and integrated team and individual efforts and build positive professional relationships with all internal and external clients.
- Planned, scheduled and managed activities to fulfill identified objectives by applying technical, theoretical and managerial skills to satisfy project requirements.
- Function as the administrative assistant to the Manager/Navigator.
- Maintained effective communication face-to-face and over the phone with a diverse of patients, medical staff, and front desk personnel.
- Bilingual translation as needed.
Education
Bachelor of Arts - Psychology
Lehman College of The City University of New York
The Bronx, NY08.2010
Skills
- Proficient in MS Word, Excel, and outlook
- Emma
- Xcelys
- Cerner
- Bilingual in Spanish and English
- Ability to learn quickly and multi-task
Timeline
Chart Retrieval Representative
UnitedHealth Group
12.2023 - Current
Marketing Communications Planner, Ass
WellCare
01.2019 - 10.2020
Care Coordinator
WellCare
08.2016 - 12.2019
Intake Ops Coordinator
WellCare
01.2015 - 08.2016
Project Analyst
Florida Hospital Tampa Bay Division
08.2013 - 01.2015
Bachelor of Arts - Psychology
Lehman College of The City University of New York