MELISSA DIANE NELSON
Pensacola,FL
Summary
Versatile professional experienced in providing support for various IRMAC tasks across the MTF. Skilled in referral processing, DHA systems, and maintaining quality SOP. Skilled at efficiently managing PAS while ensuring confidentiality of PHI in a timely completion.
Overview
27
27
years of professional experience
1
1
Certification
Work History
General Clerk II
Cyber Synergy LLC
Pensacola, FL
08.2024 - Current
- Knowledge: MHS Genesis, PAS, SOP, DHA, Tricare, Tips, Decern, SARS Table, Word, Excel programs.
- Trustworthy: Follow DHA, HIPAA, and PHI guidelines and regulations, including confidentiality, privacy, and access to personal information.
- Accountable: is efficiently organized with priorities and time management considered. Approachability for superior command and coworkers to assist in training or problem-solving.
- Communication skills: Communicate verbally and electronically to patients, staff, and beneficiaries. Communication involves an explanation of policies and updated changes in standards, policies, critical thinking, or analysis of performances.
- Continued responsibilities of previous title and employer.
Referral Management Clerk / ROFR Coordinator
BG Consulting LLC
Pensacola, FL
10.2023 - 08.2024
- Referral / ROFR Coordinator: Working side by side with UM nurses and verifying referral information with physicians, insurance companies, and other medical facilities. Ensure that we meet disposition deadlines for 5 states and 13 branches, for approximately 5,500 processed referrals a month under established policies and procedures.
- Multiple Specialty Clinic Call List: Coordinated the scheduling of appointments between referring providers and receiving providers. Communicate effectively with internal staff members regarding referral status updates.
- Review and Closing the loop: Per DHA guidelines, we review and close all 'Not Utilized' or 'Claim received; no results received' monthly.
- Copy, Fax, and Mail: Follow all ROFR appointments and fax results, mail health insurance letters, and unable to contact letters while updating demographics.
Central Appointment Clerk
BG Consulting LLC
Pensacola, FL
02.2023 - 10.2023
- Scheduled appointments: managed calendars and ensured the accuracy of appointment times.
- Answered incoming calls: from patients regarding scheduling or rescheduling appointments, and medication rewrites.
- Updated patient contact information: as necessary, updated demographics and network appointment dates.
- Provided clerical support: filing, copying, faxing, and scanning documents.
- Communicated: effectively with other staff members to ensure smooth operations.
Family Manager / Student
Self-employed
Pensacola, FL
05.2013 - 11.2022
- Budgets: expenses across the family, including tracking income and investments. Developed systems to streamline daily routines such as meal planning and grocery shopping.
- Communication: Channels between all members of the family should be established to ensure that any issues or concerns are addressed promptly. Assisted during difficult times, such as illness or bereavement.
- Organized: family schedules and activities, ensuring everyone was on time for appointments and events. Assisted with event planning for special occasions such as weddings or anniversaries. Creative and fun activities enhance children's physical, emotional, and social well-being. Engaged with children on an individual basis to build positive, trusting relationships.
- Provided support: to family members in areas such as education, healthcare, financial management, and legal advice. Handled complex tasks related to travel arrangements, including visas, passports, and tickets. Engaged in after-school activities by assisting with sports practice and homework assignments.
Office Service Technician
Kern County Mental Health KLP-Green Gardens
Bakersfield, CA
06.2006 - 05.2013
- Safety officer: policy training, HIPAA and OSHA training, fire extinguisher maintenance monitoring, fire marshal inspections, and all accident and death reports for patients and staff.
- Knowledge: Anasazi, Chart Tracker, Gismo, Word, and Excel Programs.
- Chart room: reports, chart audits for in-house and Medi-Cal, alphabetical and numerical filing, building hard copies and EMRs, checking charts in and out for staff and doctors' appointments, transporting PHI from one facility to the next.
- Staff Tracking: responsible for the whereabouts of 90+ staff in the office and out in the field, staff training requirements for annual assessments.
- Other duties: quarterly surveys, purchase orders, and monthly patient tracking sheets for group activities.
- Continued responsibilities from the previous position.
Office Services Assistant
Kern County Mental Health KLP
Bakersfield, CA
06.2005 - 04.2006
- Created and maintained the doctor's schedule at the front desk, while answering and directing phone calls.
- Maintained in/out board for 90+ staff.
- Processed incoming and outgoing mail, including courier services.
- Pulled charts for doctors' and nurses' daily appointments.
Buyer
Memorial Hospital - Apple One
Bakersfield , CA
06.2003 - 02.2004
- Reviewed purchase orders, contracts, and invoices to ensure accuracy.
- Resolved any discrepancies between purchase orders and actual receipts of goods or services.
- Monitored inventory levels to ensure the availability of products for customers.
Buyer Assistant
Memorial Hospital - KHSD
Bakersfield, CA
02.2003 - 06.2003
- Answered phones.
- Filled purchase orders.
- Training to complete department orders.
Cashier
Big Lots!
Bakersfield, CA
11.2001 - 11.2002
- Operated cash register efficiently and accurately, and processed payments by cash, check, credit card, gift card, or automatic debit.
- Stocked shelves with merchandise when needed.
- Ensured compliance with all safety regulations within the store environment.
Counter Girl
Captain D's Seafood
Pensacola, FL
06.2000 - 09.2000
- Operated cash register accurately and efficiently.
- Monitored dining room area frequently for cleanliness and organization.
- Performed opening and closing duties such as cleaning counters and setting up displays.
Sandwich Artist
SUBWAY®Restaurants
Pensacola, FL
07.1999 - 06.2000
- Kept customer and food preparation areas clean and well-organized.
- Prepared sandwiches and salads using quality ingredients and tailored to customer requests.
- Completed opening, closing, and shift change tasks by following company guidelines.
- Organized food preparation stations and regularly replenished supplies.
- Restocked kitchen supplies by rotating food according to dates and health guidelines.
Counter Girl
Godfather's Pizza
Pensacola, FL
08.1997 - 01.1999
- Operated cash register accurately and efficiently.
- Stocked and maintained salad bar and Lunch buffet.
- Provided excellent customer service to ensure repeat business.
- Performed opening and closing duties such as cleaning counters and setting up displays.
- Replenished condiments, napkins, straws, cups, and other supplies as needed.
- Monitored dining room area frequently for cleanliness and organization.
Education
Bachelor of Science - Health Administration
University of Phoenix
Phoenix, AZ06-2022
Certification - Clerical
Mexican American Opportunity Foundation (MAOF)
Bakersfield, CA02-2003
High School Diploma -
Bakersfield Adult Schools
Bakersfield, CA06-2001
Associate of Science - Human Services Management
University of Phoenix
PhoenixAssociate of Arts - Business
Bakersfield Junior College
Bakersfield, CASkills
- 27 years of customer service or relations
- Knowledge of HIPAA, PHI, IRMAC, SOP, PAS, DHA, Tri-care, MHS Genesis, Microsoft Office
- Critical thinking, analyze, problem resolution and collaboration abilities
- Organized, Time Management, and self-directed
- Communication skills are oral, written, and visual
- Team player, approachable, trainer and trainee
Certification
- Basic Life Support: 06/02/2023-06/2025
- HIPAA and Privacy Act Training: 03/05/2024
- Department of Defense (DOD) Cyber Awareness: 03/04/2024
- FEMA: 02/06/2023
References
References available upon request.
Timeline
General Clerk II
Cyber Synergy LLC
08.2024 - Current
Referral Management Clerk / ROFR Coordinator
BG Consulting LLC
10.2023 - 08.2024
Central Appointment Clerk
BG Consulting LLC
02.2023 - 10.2023
Family Manager / Student
Self-employed
05.2013 - 11.2022
Office Service Technician
Kern County Mental Health KLP-Green Gardens
06.2006 - 05.2013
Office Services Assistant
Kern County Mental Health KLP
06.2005 - 04.2006
Buyer
Memorial Hospital - Apple One
06.2003 - 02.2004
Buyer Assistant
Memorial Hospital - KHSD
02.2003 - 06.2003
Cashier
Big Lots!
11.2001 - 11.2002
Counter Girl
Captain D's Seafood
06.2000 - 09.2000
Sandwich Artist
SUBWAY®Restaurants
07.1999 - 06.2000
Counter Girl
Godfather's Pizza
08.1997 - 01.1999
Bachelor of Science - Health Administration
University of Phoenix
Certification - Clerical
Mexican American Opportunity Foundation (MAOF)
High School Diploma -
Bakersfield Adult Schools
Associate of Science - Human Services Management
University of Phoenix
Associate of Arts - Business
Bakersfield Junior College
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