An organized and motivated individual, eager to utilize time management and organizational skills across diverse settings. Seeking entry-level opportunities to enhance abilities while contributing to company growth.
Overview
11
11
years of professional experience
Work History
Payroll Specialist
Prime Flight Aviation Services
Sugarland, TX
04.2023 - 07.2024
Responsible for the timely preparation and submission of weekly, biweekly, and semi-monthly payrolls, and answering employees’ payroll questions
Works with co-workers and Payroll Supervisor on audits and reporting requests as needed
Continuously exhibits and upholds Core Values of Integrity, Accountability, Communication, Teamwork, Innovation and Customer Service
Handle Data Entry, salary changes, direct deposit, terminations, and other payroll issues
Audits information and data flows into UltiPro by HR team members that may include salary changes, new hires, and terminations
Calculates retro pay and gross ups, as needed; sets up wage garnishment and child support deductions; imports pay data files
Work closely with Unions (Local 1877, SEIU Texas, and 32BJ) setting up member deductions into UKG, adding information to Union website, uploading reports, and paying Union fees
Prepares weekly, bi-weekly, and semi-monthly payroll reports for the Payroll Supervisor’s review based on payroll schedule
Once payrolls are approved, submit files to payroll provider (UKG) for processing and downloading final reports
Review and enter timesheets for calculations and research discrepancies
Distributes paychecks and funds pay cards as necessary in ADP
Answers employee inquiries regarding payroll via email, phone, and the ticket system
Computer proficiency and technical aptitude with the ability to utilize Microsoft Office with emphasis on Excel using VLOOKUP and Pivot Tables
Working with the payroll supervisor reconciles accounts as necessary.
Prepared quarterly reports for government agencies such as 941s, W-2s, 1099s.
Coordinated with Human Resources staff on employee leaves of absence or termination paperwork.
Created and maintained employee records, including new hires, terminations, salary changes, and tax withholding forms.
Researched discrepancies in payroll data and provided corrective action when needed.
Network Operation Specialist I
Blue Cross Blue Shield of Louisiana
Baton Rouge, La
04.2020 - 03.2023
Accurately setups providers in provider systems of record to ensure appropriate claims payment in accordance with contractual language
Compiles, analyzes, and verifies the required information for provider credentialing, enrollment, contracts, and maintenance for completeness and accuracy, and enter it into the systems of record
Communicates, orally and in writing, directly with providers and/or external credentialing verification representatives to resolve questions and issues regarding updates and changes in the systems of record
Researches, responds to, analyzes, and resolves complex claims and/or provider credentialing issues related to provider setup and provider eligibility daily
Creates resolution documents to address provider issues and increase provider satisfaction
Utilizes probing and problem-solving methods to resolve all inquiries/requests
Identifies, understands, and anticipates providers unexpressed needs and concerns
Provides cross functional support and serves as subject matter resource or second tier resolution to internal and external provider teams (i.e., Contracting, Provider Relations, etc.)
Manages timely responses to external provider inquiries and requests
Evaluates new service and/or provider credentialing requests from providers to determine appropriate actions for recording into the systems of record.
Enrollment and Billing Specialist III (M&B)
Blue Cross Blue Shield of Louisiana
Baton Rouge, La
01.2016 - 09.2019
Providing positive attitude, organizational cultural beliefs, company values, accuracy, and confidential information
Knowledge of Facets, IPD, Benefit Focus Exceptions, EEnrollment, Common Query,834, GET, CMOD, ICD/10, Doc Creation application
Knowledge of company guidelines, procedure, laws, ensure information is current and accurate
Processes and maintains eligibility, delinquency, and reinstatement information to ensure complete, accurate and timely enrollment and billing transactions
Processing and researched claims
Process new enrollments and changes to existing contracts, completing customer service tasks, and processing letters.
Enrollment and Billing Specialist, I (BBS)
Blue Cross Blue Shield of Louisiana
Baton Rouge, La
10.2013 - 01.2016
Utilize Facets, IPD, Common Query, Benefit Focus, Oracle, and Blue on a day-to-day basis
Process new applications, benefit changes, and personal changes to existing applications (Medical, Dental, Life and Pharmacy)
Communicate with group leaders, and account managers by phone and email
Maintaining and updating accurate information on members
Ensure production and quality standards are being met
Order ID cards, send invoices to group leaders, Batching, and providing customer service to the group leaders, account managers, and customers daily
Facets Testing, Update new groups and benefit changes
Ensure production and quality standards are being met
Maintaining and updating accurate information on members.
Education
BS Psychology -
University of Maryland
College Park, MD
01.2002
A.A General Studies -
Montgomery College
Rockville, MD
01.2001
Skills
Knowledge of working in UKG, UltiPro, and ADP
Experience with UKG formally Ultimate Software
Detail-Oriented and able to prioritize responsibilities
Knowledge of VLOOKUP and Pivot Tables
Demonstrated knowledge of insurance services and operations
Basic knowledge and understanding of the credentialing and provider enrollment process is preferred