Samantha Bistel
North Las Vegas,NV
Summary
Dedicated professional in Medicare and Medical Customer Support with a focus on HMO eligibility management. Expertise in data analysis and cross-functional collaboration to drive service quality and operational improvements. Supervised case management for disadvantaged communities, ensuring comprehensive medical and psychological care. Engaged with social security and Medicaid to facilitate accurate benefits and eligibility processes for long-term services.
Overview
2026
2026
years of professional experience
Work History
Medical Eligibility HMO Support CA/WV/SC
Anthem Blue Cross // Las Vegas
02.2023 - Current
- Ensured precision in member data management through effective HMO eligibility support.
- Streamlined processes to minimize errors and boost member satisfaction.
- Drove collaboration with cross-functional teams, enhancing operational efficiency.
- Implemented innovative data-driven solutions for complex eligibility cases, increasing accuracy.
- Refined procedures across CA, WV, and SC by engaging diverse team partnerships.
- Optimized workflows by creatively resolving complex eligibility challenges.
- Led projects that promoted team collaboration and achieved significant outcomes.
- Improved service delivery metrics and data precision significantly.
SLA/ISLA Case Manager & Assistant to Qmba State Ma
Pennicle Community Services
2013 - 2025
- Coordinated individualized care plans ensuring alignment with client goals and needs.
- Enhanced multidisciplinary team communication to improve service delivery and resource use.
- Conducted detailed assessments for identifying client issues and developing intervention strategies.
- Mentored junior case managers, promoting best practices and professional growth.
- Implemented efficiencies in processes that increased service delivery effectiveness.
- Created training materials to enhance staff knowledge of compliance and best practices.
- Led outreach initiatives, significantly boosting community awareness of services offered.
- Educated clients about available programs, enabling informed choices regarding care.
Education
High School Diploma - Nursing Management
CCSN
Las Vegas, NVSkills
- Collaborative teamwork
- Innovative problem-solving
- Analytical data interpretation
- Efficiency optimization
- Critical analysis
- Effective time management
- Flexible adaptability
- Negotiation techniques
- Exceptional customer service
- Detail-oriented approach
- Conflict mediation skills
- Strategic development planning
- Quality control
Custom section
- Previous Employment
- Available on request
- Have been in the work field since I was 15. I stated working in medical professional fields since 1996 and have been concurrent with employment until 2019. I became a stay home mother, grandmother and in the process of opening my own business medically related. - business sold and now im back in the work force.
Timeline
Medical Eligibility HMO Support CA/WV/SC
Anthem Blue Cross // Las Vegas
02.2023 - Current
SLA/ISLA Case Manager & Assistant to Qmba State Ma
Pennicle Community Services
2013 - 2025
High School Diploma - Nursing Management
CCSN