Summary
Overview
Work History
Education
Skills
Timeline
Generic

Nashota Newman

Birmingham

Summary

Professional with solid experience in healthcare administration & customer Service, prepared to excel in supporting clinical operations and patient care. Strong focus on team collaboration, achieving results, and adapting to changing needs. Skilled in managing patient records, scheduling, communication, and multitasking. Known for reliability, problem-solving, and proactive approach to tasks.

Overview

8
8
years of professional experience

Work History

Associate Clinical Administrative Coordinator

United Healthcare- Optum at Home
05.2023 - Current
  • Manage the intake of members or the admission/discharge information post notification
  • Work with hospitals, clinics, facilities and the clinical team to manage requests for services from members and/or providers
  • Manage the referral process, processing incoming and outgoing referrals and prior authorizations, including intake, notification and census roles
  • Provide appropriate triage and care coordination notification cases for non-clinical assessment/intervention
  • Knowledge of ICD-9 and CPT codes
  • Experience analyzing and solving problems
  • Handle resolution/inquiries from members and/ or providers
  • Must be able to type and talk at the same time and navigate through multiple screens
  • Experience working in a metric-driven work environment management
  • Clearence to handle HIPPA, Consent & Secure Documents or PPI
  • Generate, Create, & Manage Power BI Reports daily
  • Create & maintain calendared events, travel, and meetings via Teams & Outlook
  • Work with IT Department in developing dashboards for report creation & resolving Team issue
  • Notify IDT Team of patients admit & discharge from facilities
  • Navigate HIE systems
  • Audit system to ensure accuracy
  • Review & Upload data into the system
  • Experience working with Medicare and/or Medicaid Services
  • Customer Service
  • Retrieve Medical Records and Discharge Disposition from Medical Facility or SNF
  • Upload Medical Records into chart and Document chart of record received
  • Make outbound calls to facilities (patient information, utilization review, case management, medical records) to obtain information regarding patient admit & discharge, medical records request medical records via eFax or mail
  • Verify physician, or facility information
  • Create reports to send to Team regarding Patients admit, discharge or expire
  • Work with Hospice, Behavior Health, Palliative Care Team for referrals
  • Microsoft Office Suite, Microsoft Excel VLook up, Pivot tables, Power Bi, Landmark Data tool, eFax, Ubiquity, Starq, Landmark Reporting Tool, Careport, Health Gorilla, Experian, ECare, HIE, EMS, Microsoft Office Suite, Microsoft Excel, PowerPoint, Outlook, Calendar, MS Teams
  • Responded to patient inquiries via phone and email, providing accurate information and resources while maintaining a professional demeanor.

Customer Service Representative I Senior Support

Blue Cross Blue Shield of Alabama
02.2023 - 05.2023
  • Handle Blue Advantage, Blue Rx, and C Plus (Medicare and Medicaid) area supports the analysis, design and implementation of group benefits, the creation of Summary Plan Descriptions, the development of Blue Exchange records, the creation of Benefits & Billing Online and day-today involvement in the development and implementation of strategies designed to address complex processing issues through project implementation
  • Inbound/Outbound Call Center & Customer Service
  • Knowledge of coverage, claims, billing, in/out of network providers & hospitals
  • Senior Products also is involved in process improvements and maintenance on behalf of the Claims Division which supports our Divisional, Corporate, and Mandated initiatives
  • Experience interacting with customers/members, physicians/providers, hospital, and in/ out of network facilities
  • Problem solving, data research, data analysis, project resolution and communicating with members, physicians, and hospital facilities
  • HIPPA Compliance
  • Programs: procedure and diagnosis code ICD-10, HEDIS, STARS, Medicare & Medicaid, SSRS, SSIS, BOL, CIS, DORS, SaaS, Interactive Time Keep, WebEx, PingID, Secure Pass Plus, Microsoft Office Suite, Microsoft Excel, Outlook, PowerPoint, Publisher, Adobe, PDF, Ulysses, Hub, CMS, Jiva, Chrome, Bing, Intranet, Fax, Encrypted Email, PPI, HIPPA Laws, SCAT, Star Rating, & Medical Terminology
  • Resolved customer complaints with empathy, resulting in increased loyalty and repeat business.
  • Managed high-stress situations effectively, maintaining professionalism under pressure while resolving disputes or conflicts.

Route Service Representative (RSR)

Quest Diagnostics
02.2022 - 02.2023
  • Carrier of routes and functions deemed necessary by Hub or Regional Logistics Operations within a defined geography
  • Customer Service, Data Entry, and conflict resolution skills
  • Written & verbal communication skills
  • Research and troubleshoot issues
  • Strong interpersonal skills dealing with merchant, hospital s, Doctor’s offices, and clinics
  • Ability to handle challenging customers in a professional business manner
  • Ability to adapt to a dynamic work environment, learn quickly, solve problems and make decisions
  • Knowledge of supply chain & general specimen haul
  • Daily dispatch communications on start and route pickup and deliveries
  • This will include multiple shifts as well as any coverage need as scheduled or on an emergency basis and is not limited to; Routine, STAT, Weekend, Holiday or Shuttle/Relay Routes
  • Safely operates company vehicle to pick up, properly store and deliver specimens and other materials; and provides service to internal and external customers in an organized, efficient, and professional manner
  • Collect specimens, scan, label, & store at correct temperature in vehicle
  • Transport specimens to Lab or Hub for processing
  • Unpack collected specimens log and store in staged areas including freezer or refrigerator
  • Pack and ship specimens to proper testing facilities
  • Knowledge of productions goals
  • Responsible for compliance with all processes including and not limited to timekeeping, attendance and punctuality, vehicle safety and cleanliness, safety and OSHA requirements, handheld /scanning device and usage, proper handling and storage of all samples from the client office to the drop off point, proper packing of specimens for shipment, end of day vehicle checks, dress code, code of conduct and all Company / Regional / Logistics policies and procedures
  • Responsible for the safe and timely transportation of specimens, supplies, reports, equipment and materials to the appropriate destination
  • Responsible for operating company vehicles safely as well as maintaining a valid driver’s license and driving record within acceptable company guidelines
  • Ensure route is started with proper equipment tools
  • I.e., route scanner sync/paper logs, carry bag, properly prepared coolers for 3 separate thermal storage, dry ice, dry ice, cell phone, keys, door hangers, observation reports, etc
  • Train on PI, HIPPA, and CPNI regarding protection of data and information
  • Skilled in operations, and field support using Turn point, GPS, Scanner software, Microsoft Office Suite, Microsoft Excel, MS Teams, MS Outlook & devices used
  • Document and provide appropriate client satisfaction information to Logistics Management


Sales Associate I

The State of Alabama- ABC
11.2021 - 02.2022
  • The ABC Sales Associate I is a position with the Alabama Alcoholic Beverage Control Board
  • Positions are located throughout the state
  • Use sales, customer service, data entry, detail orientation & communication skills to answer content questions regarding inventory for merchants, venders, or business owners daily
  • Handle inbound and outbound calls for orders or inventory
  • Trained in sales and promotion
  • Dealing with problems or conflict resolution for a positive solution
  • Manage and organize import & incoming delivery orders with wine vineyards, merchants, sellers, and customers
  • Certified and trained in Alabama Alcohol & Beverage Law
  • Organize events with venders to giveaways and purchase rare beverages
  • These functions require employees to be capable of lifting cases of merchandise weighing up to 53 pounds ranging in height from floor level up to six (6) feet to unload trucks, organize inventory, and stock/organize sales area
  • Cash register drops, count and verification Bank Deposits and make changes when needed
  • Knowledge of time keep in SAP, Kronos, SharePoint, ADP, SaaS, State Employee Site, MS Teams, MS Office Suite, Outlook, Microsoft Excel, and PowerPoint for presentations, email communications and training
  • Organized racks and shelves to maintain store visual appeal, engage customers, and promote specific merchandise.
  • Handled cash transactions efficiently while adhering to company cash handling policies, ensuring accuracy in all financial exchanges.

PSE Mail Processing Clerk/ Rural Carrier

United States Postal Service
10.2016 - 06.2019
  • Knowledge of Logistic Operations and Software (TMS)
  • Customer service, data entry, detail orientation, & communication skills dealing with businesses, customers and within the company
  • Shipping and receiving mail and packages at USPS warehouse
  • Knowledge of supply chain and general freight (package) haul
  • Makes one or more sortation of outgoing and/or incoming mail using the appropriate sort of program or manual distribution scheme
  • On a rotation basis, performs all the following duties loads mail onto automated equipment, culling out non-processable items; enters sort plan and starts equipment; monitors flow of mail to ensure continuous feed; sweeps separated mail from bins stacker's; and stops equipment when distribution run or operation is completed
  • Runs machine reports, clears jams and contacts maintenance for assistance when required
  • Prepares work area, ensuring all necessary support equipment and materials, including labels, trays, and other containers, are in place
  • Removes sorted mail from bins or separations and places into appropriate trays or containers for further processing or dispatch based on knowledge of operating plans and dispatch schedules, or at the instruction of supervisors or expediters; may rifle or verify mail to ensure sortation accuracy as needed
  • In addition, we may perform any of the following duties: provide service at public window for non-financial transactions; maintain records of mail; examine balances in advance deposit accounts; and record and bill mail requiring special service
  • Follows established safe work methods, procedures and safety precautions while performing all duties
  • Performs other duties as assigned
  • PSE Mail Processing Clerks perform a variety of clerical duties in mail processing, retail sales, customer services & conflict resolution to support day-to-day operations
  • Software: Microsoft Office Suite, Microsoft Excel, Outlook, Teams, SharePoint, AS400, RF Smart

Education

Professional Certification - IBM Data Analysis And Visualization

EdX
On Line

Bachelor of Science - Software Engineering

Colorado Technical University
Colorado Springs, CO
10-2015

Law Certification & Credits - Law

Lorman Education Services
Birmingham, AL
12-2012

Associate of Applied Science - Communications

Jefferson State Community College
Birmingham, AL
12-1992

Skills

  • ICD-10 coding
  • Medicare/Medicaid
  • Telephone customer support
  • Clinical documentation
  • Insurance verification
  • Medical terminology
  • HIPAA compliance
  • Customer Service
  • Case management
  • Medical records management
  • Call center experience
  • Microsoft Office Suite

Timeline

Associate Clinical Administrative Coordinator

United Healthcare- Optum at Home
05.2023 - Current

Customer Service Representative I Senior Support

Blue Cross Blue Shield of Alabama
02.2023 - 05.2023

Route Service Representative (RSR)

Quest Diagnostics
02.2022 - 02.2023

Sales Associate I

The State of Alabama- ABC
11.2021 - 02.2022

PSE Mail Processing Clerk/ Rural Carrier

United States Postal Service
10.2016 - 06.2019

Professional Certification - IBM Data Analysis And Visualization

EdX

Bachelor of Science - Software Engineering

Colorado Technical University

Law Certification & Credits - Law

Lorman Education Services

Associate of Applied Science - Communications

Jefferson State Community College

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Nashota Newman