Summary
Overview
Work History
Education
Skills
Accomplishments
Certification
Work Availability
Software
Timeline
8d

Traci Riccio Rice

Des Moines,IA

Summary

Dedicated professional with a passion for continuous growth and embracing challenges. Skilled in leasing and billing principles to efficiently manage diverse tasks in different roles. Committed to contributing to both individual and team success through diligence, meticulousness, and strong organizational abilities. Motivated by a drive for ongoing personal and professional development in every role undertaken.

Overview

38
38
years of professional experience
1
1
Certification

Work History

Pharmacy Benefits Manager

Sagility Health / Prime Therapeutics
10.2022 - 04.2025
  • Developed and maintained a comprehensive understanding of evolving industry regulations, guidelines, and best practices in pharmacy benefits management.
  • Implemented data-driven strategies to enhance operational efficiency in the processing of prescription claims.
  • Ensured seamless transitions during client onboarding processes by effectively communicating expectations and managing timelines for deliverables.
  • Collaborated with healthcare providers to optimize patient care and promote appropriate medication use.
  • Provided expert guidance on complex issues related to formulary management, drug pricing, rebate negotiations, and clinical program development.
  • Educated members about their prescription drug coverage options, empowering them to make informed decisions about their healthcare needs.
  • Assessed client requirements and developed targeted benefits solutions.
  • Kept programs in line with plan structure, company policy and legal requirements.

Billing Revenue Specialist

Pur Foods / Moms Meals
03.2019 - 04.2023
  • Reviewing clients eligibility, authorizations, authorizations dates for clients to receive meals.
  • Billing for all State of PA DHS Medicaid clients, UPMC/Medicaid, Keystone/Amerihealth, and Pace agencies.
  • Process pre-work to insure proper billing is submitted, work through eligibility issues if needed. Request documentation if needed to show authorization confirmation and/or eligibility.
  • Process claim rejections, denials. Keep communication open with contacts at agencies to insure problems or questions are dealt with on timely matter.
  • Communicate either by phone or email to agencies requesting verification of coverage
  • Track aging for agencies and insure it is current and payments are being received on time.
  • Conducted call audits to assess interaction quality, accuracy and service success.
  • Conducted research, gathered information from multiple sources and presented results.
  • Verified completeness of provided details when processing Medicaid coverages available to clients
  • Dependable, team player, lead person that worked independently with a Denial Specialist and PA Team/Agencies.
  • Improved financial reporting by conducting thorough account reconciliations and resolving discrepancies.
  • Increased revenue by streamlining billing processes and implementing effective collection strategies.

Leasing Assistant

National Management Group
06.2013 - 02.2019
  • Collected, completed, and processed lease applications.
  • Assisted tenants with HUD, low income/income restricted applicatins, renewals and rent adjustments
  • Developed marketing strategies to attract new tenants, ultimately improving occupancy rates.
  • Managed move-in/move-out processes efficiently by conducting inspections, coordinating cleaning services, and completing necessary paperwork in a timely manner.
  • Maintained accurate records of all lease agreements, rent payments, and tenant information for easy retrieval when needed.
  • Responded to messages and inquiries from various parties and used well-developed active listening and open-ended questioning skills to promote quick issue resolution.
  • Collected rent and tracked resident payments and information in computer system.
  • Established key relationships with potential leasers and renters.
  • Managed daily and weekly marketing and leasing plans.
  • Managed lease agreements from inception to termination, ensuring legal compliance and minimizing potential disputes between parties.
  • Collaborated with maintenance teams to address property upkeep, enhancing overall appearance and functionality of units.
  • Created and submitted daily reports on leasing activities.
  • Streamlined lease renewal processes, significantly reducing tenant turnover rates.

Fixed Annuity Specialist

Voya / ING Financial
02.2010 - 08.2015
  • Assisted members via phone or email with questions, instructions, changes to their accounts.
  • Processed withdrawal requests to be sent out.
  • Discussed with customers to provide information about available products and policies.
  • Conducted annual reviews of existing policies to update information. Determined financial needs by assessing existing coverage and aligning new products and services with long-term goals.
  • Worked to accommodate new and different insurance requests and explored new value opportunities to optimize clients experiences.
  • Conducted annual reviews of existing policies to update information.
  • Assisted clients in understanding complex annuity concepts, helping them make informed decisions about their investments.
  • Trained staff for 5 weeks in Manila, the Phillapines, for 25% of the customer service load - when we came back, the whole customer service call center was transferred

Barista, Assistant Manager, Trainer

Starbucks/Starbucks Hyvee
04.2005 - 05.2015
  • The last 4 years this was an on call as needed position that allowed to watch my grandchildren most of the time and help out family.
  • Continued to train/on call when needed as I worked regular job.
  • In this position I would go into stores / new locations and teach the Baristas how to : Customized training strategies based
  • Taught new drinks and procedures first, and instructed all team members on how to properly complete each.
  • Created wide variety of hot and cold drinks in average shifts with consistently positive customer satisfaction scores.
  • Pleasantly interacted with customers during hectic periods to promote fun, positive environment.
  • Trained new team members with positive reinforcement and respectful, encouraging coaching.
  • Assisted in inventory management to maintain adequate stock levels and reduce wastage.
  • Increased repeat business by providing exceptional customer service and building rapport with patrons.
  • Optimized scheduling to ensure adequate staffing during peak hours, improving service efficiency.
  • Led weekly team meetings to discuss goals and review performance, fostering culture of continuous improvement.
  • Engaged with customers to gather feedback, using insights to improve service and product offerings.
  • Facilitated team-building activities, enhancing team cohesion and morale.

Provider Services Specialist

BCBS OF IA / Wellmark
07.2001 - 04.2009
  • Took high number of incoming calls from Drs offices or members verifying benefits, coverages, correct way to file claims re: CPT or ICD coding.
  • Assisted Delta Dental with Claims, and benefits/coverages.
  • Developed and sustained daily tracking spreadsheets of calls and benefit questions
  • Assisted other departments when needed - verifying claims or benefits for UPMC or Medicare coverages or claims
  • Implemented and assisted with training of procedure changes
  • Kept in contact with Clients/Drs offices via phone or email and verified documentation on file
  • Assisted with training on new system when BCBS went from DOS system to Internet system
  • Conducted regular audits of provider files, ensuring compliance with established standards and regulations.
  • Managed high-volume caseloads effectively, prioritizing tasks and meeting deadlines consistently while maintaining attention to detail.
  • Established strong working relationships with external partners such as insurance companies and healthcare organizations, fostering cooperation in addressing shared challenges.
  • Assisted providers with navigating online portals, enhancing their overall experience with the organization''s services.
  • Researched and resolved disputes, billing discrepancies, and claims efficiently to maintain customer satisfaction, boosting satisfaction ratings [Number]%.
  • Met customer call guidelines for service levels, handle time and productivity.
  • Followed up with customers about resolved issues to maintain high standards of customer service.
  • Cross-trained and provided backup support for organizational leadership.

Customer Service Rep/Team Lead/Supervisor

EMSI Examination Management Services
09.1987 - 11.1999
  • Started out as Call Center Representative and moved up Team Lead in 1990 and then Supervisor in 1999
  • Assisted in developing standard operating procedures for all employees
  • Self-motivated, with a strong sense of personal responsibility.
  • Trained new team members by relaying information on company procedures and safety requirements.
  • Promoted a positive work environment by fostering teamwork, open communication, and employee recognition initiatives.
  • Served as a role model for the team by demonstrating commitment to excellence, professionalism, and adherence to company values at all times.
  • Arranged office meetings for updates and team coaching
  • Offered ongoing coaching and motivation - created incentives for team
  • Coached new hires on company processes
  • Coordinated special projects and managed schedules
  • Managed CRM training, troubleshooting, updates and reports
  • Managed schedules, accepted time off requests and found coverage for short shifts.

Education

High School Diploma -

East High School
06.1985

Skills

  • Claims processing
  • Healthcare Benefits
  • Account reconciliation
  • Vendor relationship management
  • Auditing procedures
  • HIPAA compliance
  • Medical insurance
  • Employee benefits administration
  • Document preparation
  • Property inspections & tours
  • Microsoft Excel expertise
  • Invoice processing
  • Data analytics
  • Tax compliance
  • Collections management
  • Detailed documentation
  • Researching
  • Time management abilities
  • Continuous improvement
  • Audit management
  • Fraud detection
  • Fair housing regulations
  • Property management
  • Accounting management
  • Quickbooks
  • Contract coordination
  • Lease renewals/agreements
  • Creative problem solving
  • Administrative support
  • Account Reconciliation
  • Leasing terms and specifications
  • Coaching and mentoring
  • Conflict resolution
  • Customer focus
  • Performance monitoring/improvement
  • Schedule management
  • Human resource processes
  • Employee training
  • Work assignment delegation
  • Daily workflow/Goal setting
  • Issue resolution
  • Work planning
  • Onboarding and orientation

Accomplishments

  • Achieved Medical Terminology Certification with accuracy and efficiency.
  • Achieved HIPPA Certfication
  • HCPCS / ICD / CPT Coding / Billing
  • Fair Housing Certfication by HUD & State of Iowa Fair Housing Agencies
  • Certified Occupancy Specialist (COS Certification)
  • AAPC - CPB Certified Professional Biller
  • Denials Management & Appeals
  • Project Management / Design Thinking
  • Currently completing Human Resource Associate Professional Certification (HRCI) course

Certification

  • Certified in CPT Coding / ICD Coding
  • Loma 1 & 2
  • AAHAM Certification I
  • Benefits Training
  • Hipaa Training Experience
  • Medical Terminology Certification
  • HR Basic/ Office Operations / Payroll & Benefits

Work Availability

monday
tuesday
wednesday
thursday
friday
saturday
sunday
morning
afternoon
evening
swipe to browse

Software

EMR Billing Systems

Nextgen / Promise / RX Claims / Athena Health / Nexus

Microsoft Office

Clearinghouse Claim Software

Timeline

Pharmacy Benefits Manager

Sagility Health / Prime Therapeutics
10.2022 - 04.2025

Billing Revenue Specialist

Pur Foods / Moms Meals
03.2019 - 04.2023

Leasing Assistant

National Management Group
06.2013 - 02.2019

Fixed Annuity Specialist

Voya / ING Financial
02.2010 - 08.2015

Barista, Assistant Manager, Trainer

Starbucks/Starbucks Hyvee
04.2005 - 05.2015

Provider Services Specialist

BCBS OF IA / Wellmark
07.2001 - 04.2009

Customer Service Rep/Team Lead/Supervisor

EMSI Examination Management Services
09.1987 - 11.1999

High School Diploma -

East High School

Similar Profiles

CREATE PROFILE