Provider Services for Horizon Blue NJ Medicaid and D-SNP programs
Results CX
Martinsville
05.2025 - Current
Insurance verification
Emevs
Facets
Knowledge of Availity
Authorization procedures and relatable information
Claims information; timely filing, review, adjustments, appeals, and all claims related information
HIPPA compliant at all times
Document the call with all the information exchanged during the call.
Routing tickets to correct department if necessary
Time management
Knowledge of the Medicaid and Medicare programs and concierge programs that go along with these state and federally run medical programs.
Caregiver
Private Duty Care
Weatherford, TX
11.2023 - 05.2025
Promote a safe, clean, and organized environment.
Provide personal care assistance to residents – personal hygiene, feeding, and mobility.
Provide mental and emotional stimulation through facilitation of engaging activities.
Observe, report, and document resident conditions and activities.
Comply with policies and procedures and abide by HIPAA guidelines to protect privacy.
Home Health Aide
Girling Homehealth
Brownwood, TX
08.2022 - 11.2023
Assisted with activities of daily living – mobility, personal hygiene, and feeding.
Documented services provided on phone app, patient condition, and changes in patient behavior.
Kept the household clean and organized, ran errands, and prepared and served meals.
Provided in-home personal care services, and maintained a safe, secure, and healthy environment.
Respected and safeguarded patient’s privacy.
Caregiver
Mercy House
Temple, TX
10.2021 - 02.2022
Assisted with activities of daily living – personal hygiene, mobility, and feeding.
Communicated and interacted effectively and tactfully with patients, visitors, families, peers, and supervisory staff.
Documented and reported observations of patient behavior, complaints, and physical symptoms via paperwork.
Maintained confidentiality standards of protected health information in accordance with HIPAA guidelines.
Collections Specialist / Customer Service – Remote Call Center
Tru Green
Weatherford, TX
03.2020 - 09.2021
Resolved delinquent accounts while providing quality customer service on inbound and outbound calls.
Made arrangements with customers to pay the balance in full or set up payment plans.
Deescalated customer conflicts while maintaining professionalism and strong customer service.
Complied with Fair Debt Collection Practices Act (FDCPA) provisions and state collection laws.
Documented collection activity in database in a concise and accurate manner.
Safeguarded private and confidential information.
Store Manager / Customer Service – Retail
Circle K
Weatherford, TX
06.2017 - 12.2019
Led team during each shift, supervised, hired, and trained team members, and reinforced safe working procedures.
Managed inbound and outbound calls, created schedules, processed payroll, prepared bank deposits, completed end of day paperwork, counted inventory, and ordered supplies.
Operated the cash register, processed transactions, scanned merchandise, and accepted payments.
Maintained a customer focused, team oriented environment by building effective relationships and providing guidance and support to employees.
Enforced policies and procedures, identified problems, initiated corrective action, and maintained quality standards.
Store Manager / Customer Service – Retail
CEFCO Convenience Store
Jarrell, TX
12.2015 - 05.2017
Supervised team members, created schedules, hired and trained new employees, and delegated tasks.
Handled inbound and outbound calls, processed payroll, prepared bank deposits, took inventory, ordered supplies, completed paperwork, and ensured adherence to policies and procedures.
Offering fast and friendly service, operated a cash register, scanned merchandise, accepted payments, and maintained the overall appearance and cleanliness of the work area.
Built relationships and stayed attentive to employees by motivating them to succeed and improve.
Addressed issues in a professional manner and resolved staff and customer service problems.
Timeline
Provider Services for Horizon Blue NJ Medicaid and D-SNP programs
Results CX
05.2025 - Current
Caregiver
Private Duty Care
11.2023 - 05.2025
Home Health Aide
Girling Homehealth
08.2022 - 11.2023
Caregiver
Mercy House
10.2021 - 02.2022
Collections Specialist / Customer Service – Remote Call Center