Rebeca Handel
Avon,NY
Summary
Detail-oriented professional with expertise in managing appeals, grievances, fair hearing, and external appeals. Proven track record in regulatory compliance and client education, ensuring timely resolutions and high satisfaction.
Overview
12
12
years of professional experience
1
1
Certification
Work History
Appeals and Grievances Coordinator
iCircle Care
Webster, New York
02.2020 - Current
- Managed the receipt, investigation, and resolution of standard and expedited complaints and appeals in a timely and highly effective manner.
- Coordinated the appeal process through the collection of clinical records, consultation with the Interdisciplinary Team, and communicates the final determination in writing.
- Followed all NYS regulations, MLTC policy and procedures to ensure compliance with all timelines and reporting.
- Prepared evidentiary packets to present to the Administrative Law Judge when a Fair Hearing is requested and scheduled.
- Attended hearings as a representative of the organization when necessary.
- Reviewed appeal requests to ensure compliance with regulations and policies.
Medicare Insurance Agent
Essential Solutions
Avon, New York
06.2017 - Current
- Educated clients about Medicare options and coverage plans.
- Assisted clients in completing enrollment applications and documentation.
- Connected members to New York State EPIC and Medicare Savings Plan as needed.
- Conducted follow-up calls to ensure client satisfaction and address concerns.
- Maintained accurate records of all customer interactions, including contact information, policy changes, payment histories.
- Built relationships with existing customers to encourage renewals and referrals.
Team Leader Manager
Wegmas
Rochester, New York
05.2018 - 02.2020
- Coordinated schedules to ensure adequate staffing for operations.
- Trained new team members on workflows and safety procedures.
- Monitored inventory levels to support efficient supply management.
- Implemented process improvements to boost team productivity.
- Collaborated with management to develop training materials and resources.
- Created and maintained a positive work environment for employees.
Administrator
Family Services of Rochester
Fairport, New York
04.2017 - 05.2018
- Managed daily operations of assisted living to ensure quality care.
- Coordinated staff schedules to meet resident needs and regulatory requirements.
- Developed and implemented resident care plans in collaboration with healthcare teams.
- Oversaw compliance with health and safety regulations for resident well-being.
- Collaborated with families to address concerns and improve resident satisfaction.
Memory Care Coordinator
Atria
Rochester, New York
05.2016 - 04.2017
- Built work schedules and staff assignments, taking workload, space and equipment availability into consideration.
- Trained staff on best practices for supporting residents with memory challenges.
- Oversaw screening and intake process for new residents.
- Organized therapeutic recreational activities that stimulated cognitive functioning in individuals with Alzheimer's disease or other forms of dementia.
- Monitored medication administration by staff members to ensure accuracy according to physician orders.
Memory Care Coordinator
Golden Living Nursing Home
Gettysburg, Pennsylvania
08.2013 - 05.2016
- Assisted families with communication and support regarding resident care.
- Coordinated daily activities for residents in memory care unit.
- Monitored resident behavior and reported changes to the care team.
- Ensured compliance with state regulations regarding documentation requirements within the facility.
Education
Bachelor of Science - Therapeutic Recreation
SUNY, Cortland
Cortland, NYSkills
- Complaint resolution
- Regulatory compliance
- Appeals management
- Evidentiary preparation
- Policy interpretation
- Customer education
Certification
- New York State Life, Accident, and Health Insurance License
References
References available upon request.
Timeline
Appeals and Grievances Coordinator
iCircle Care
02.2020 - Current
Team Leader Manager
Wegmas
05.2018 - 02.2020
Medicare Insurance Agent
Essential Solutions
06.2017 - Current
Administrator
Family Services of Rochester
04.2017 - 05.2018
Memory Care Coordinator
Atria
05.2016 - 04.2017
Memory Care Coordinator
Golden Living Nursing Home
08.2013 - 05.2016
Bachelor of Science - Therapeutic Recreation
SUNY, Cortland
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