Tammy Merette
Meriden,CT
Summary
. Collaborative leader with dedication to partnering with coworkers to promote engaged, empowering work culture. Documented strengths in building and maintaining relationships with diverse range of stakeholders in dynamic, fast-paced settings.
Overview
32
32
years of professional experience
Work History
Personal Assistant
SIBA Corp.
05.1992 - 05.2001
- Mediated communications with Property Managers and the Diamond District
- Arranged domestic and international travel plans and itineraries.
- Monitored household expenditures and budgeted for groceries and household utility payments.
- Processed accounts payable and receivable for the CEO personal accounts and staff
- Revised and advised market values and statistics
Claims Manager
Yale Surgical Orthotics And Prosthetics
01.2022 - Current
- Determined proper course of action for claims processing.
- Examined claims forms and other records to determine insurance coverage.
- Organized and supervise prior authorization guidelines with the staff
- Post payments and maintain the accounting system
- Created and implemented process documents
- Gathered sensitive information to update customer profiles and help with appeals process.
Manager
JCC & Joanie Petty
01.2017 - 01.2020
- Provided office and financial management
- Organized all business relations
- Prepared budgets
- Processed accounts receivable and payable
- Managed emails and social media content
Senior Non-Clinical Intake Coordinator
Community Health Network of Connecticut
01.2007 - 01.2017
- Supervised the Call Center and Non-clinical Prior Authorization Intake team, insured that the policies, procedures, and performance were followed by staff both in office and telecommute
- Participated on the submission and implementation team that acquired the ASO contract with the State of Connecticut Dept
- Of Social Services (CTDSS)
- Administered daily operations and reports to ensure policies and metrics were adhered conforming with CTDSS ASO contractual agreement
- Collaborated with the medical reviewers and medical directors with complex cases
- Serviced as a Member Services, Provider Relations, Claims Process, and
- Escalation Unit team lead
- Created, and implemented process documents utilized by the UM
- Department
Administrative Assistant
Community Health Center
01.2006 - 01.2007
- Provided non-clinical administration and assisted the medical doctors
- Processed claims
- Scheduled and triaged appointment requests
- Balanced and closed payment batches
Ticket Sales Airport Agent
American Airlines
01.1993 - 01.2001
Education
Bachelor of Science - Development Economics And International Development
Skills
- Project Management
- Medical Programs Implementation
- Utilization Management
- Administrative Staff Supervision
- Claim Validity Determination
- MS Office Suite
- Medicare and Medicaid Eligibility
- Claims Analysis
- Business Planning
- Verbal and Written Communication
- Contract Development and Management
Languages
English
Native or Bilingual
Spanish
Native or Bilingual
French
Limited Working
Timeline
Claims Manager - Yale Surgical Orthotics And Prosthetics
01.2022 - Current
Manager - JCC & Joanie Petty
01.2017 - 01.2020
Senior Non-Clinical Intake Coordinator - Community Health Network of Connecticut
01.2007 - 01.2017
Administrative Assistant - Community Health Center
01.2006 - 01.2007
Ticket Sales Airport Agent - American Airlines
01.1993 - 01.2001
Personal Assistant - SIBA Corp.
05.1992 - 05.2001
CUNY - Bachelor of Science, Development Economics And International Development