Nathaniel Suarez
Whittier
Summary
Detail-oriented and dependable professional with a strong background in healthcare data processing, provider data management, and information integrity. Experienced in maintaining accurate provider records, validating demographic and contract data, and ensuring compliance with healthcare regulations. Familiar using SQL, Excel, and claims-related systems to support timely and accurate claims processing and reporting. Recognized for high accuracy, organizational efficiency, and collaboration across departments.
Overview
6
6
years of professional experience
Work History
Care Review Processor
Molina Healthcare
08.2023 - Current
- Verified and updated critical provider data within claims and authorization systems, ensuring accuracy for member eligibility and benefit verification.
- Contacted providers to gather missing or incomplete data to support credentialing, contracting, and claims processing workflows.
- Maintained and synchronized data across multiple internal systems in compliance with internal business rules and data integrity standards.
- Supported medical directors and case managers by providing accurate and timely updates on provider and member records.
- Prioritized and completed high-volume data entry tasks under tight deadlines with strict attention to accuracy and HIPAA guidelines.
Sheeter Operator/Helper
Kelley Spicers
10.2022 - 07.2023
- Assisted with equipment startups and machine installation tasks.
- Analyzed and measured final products with precision tools to confirm compliance to specifications and standards.
- Performed quality assurance tasks to promote accuracy and minimize mistakes.
- Performed equipment tests, calibrations and repairs to keep machines running smoothly and prevent malfunctions.
- Operated and maintained industrial systems, with a focus on precision, measurement accuracy, and adherence to quality standards—transferable to detailed data accuracy roles.
Office Manager
ACM Global
02.2022 - 09.2022
- Managed internal databases to maintain updated vendor and provider contact information.
- Streamlined workflows and improved recordkeeping accuracy for internal communications and reporting.
- Oversaw document control systems and ensured all data met audit standards for regulatory and financial compliance.
Data Integrity Specialist
South Whittier School District
09.2019 - 01.2021
- Evaluated and cleaned large datasets to maintain data accuracy and alignment with internal system requirements.
- Worked with analysts and IT to define and apply data validation rules across systems.
- Identified and corrected data quality issues at the root level and documented fixes for future prevention.
- Contributed to reporting accuracy and system updates through detailed audits and cross-referencing records.
Education
Google IT Support Certificate -
Coursera
Associate of Science -
Rio Hondo College
Whittier, CA06-2027
Skills
- Provider Data Management
- Claims Systems & Processing
- SQL & Data Validation
- Excel & Google Sheets
- Microsoft Office Suite
- Tableau (Basic Reporting)
- HIPAA Compliance
- Auditing & Quality Assurance
- Cross-functional Collaboration
Timeline
Care Review Processor
Molina Healthcare
08.2023 - Current
Sheeter Operator/Helper
Kelley Spicers
10.2022 - 07.2023
Office Manager
ACM Global
02.2022 - 09.2022
Data Integrity Specialist
South Whittier School District
09.2019 - 01.2021
Google IT Support Certificate -
Coursera
Associate of Science -
Rio Hondo College
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