Summary
Overview
Work History
Education
Skills
Accomplishments
Timeline
Generic

TREMESA DRAINE

INDIANAPOLIS,IN

Summary

Motivated and creative event planner with over 15 years of experience. Seeking a career as a professional Event Planner to leverage positive attitude, adaptability, and effective communication skills in support of team goals. Aims to drive increased registrations and revenue annually, expand social reach, and enhance the desirability of events within our community.

Overview

15
15
years of professional experience

Work History

Provider Reimbursement Admin Sr.

Elevance Health
09.2023 - Current
  • Conducts research of claims systems and system edits to identify adjudication issues and to audit claims adjudication for accuracy
  • Prepare and format itemized bills and claims for nurse's review in various platforms such as Excel, CAVO, Abby Fine Reader for final auditing
  • Works on large scale initiatives with high dollar cost savings opportunities, current savings for iNO Denials over $400,000.

Event Planner

Williams Executive Realty & Associates, LLC
04.2016 - Current
  • Responsible for planning open house visits in person and by registering and scheduling potential clients
  • Answering emails and managing over 30 incoming calls, filing paperwork, preparing name badges for events, preparing attendee lists, and organizing meetings
  • Defines marketing environment through development of key criteria, identification of desirable community partners, availability of local programs and opportunities for marketing programs and services
  • Designs and produces open house event collaterals for staging properties for viewings by managing inventories, identifying inefficiencies, developing solutions
  • Increased event attendance by developing strategic marketing campaigns and engaging promotional materials.
  • Coordinated schedules and timelines for events.

Medical Management Specialist II-Prior Authorization

Anthem Inc.
12.2021 - 09.2023
  • Assisted multiple states with Elevance Health Commercial Contractual policies
  • Assisted with out-of-network benefit checks/research
  • Verified PAR/ NON-PAR contracts via system verification or provider inquiries procedure code
  • Proficiency in Microsoft Word, Excel, and SharePoint

Medical Management Specialist-High Risk OB

Anthem Inc.
12.2017 - 12.2021
  • Planned, hosted, and assisted in member registration for events such as baby showers, car seat giveaways
  • Prepared census hospital report and document all actions to identify high risk obstetrics patients by maintaining and updating databases
  • Mentored junior staff members, helping them develop their skills as Medical Management Specialists while also fostering a positive work environment.
  • Enhanced patient care by implementing efficient medical management processes and protocols.
  • Improved patient satisfaction scores by addressing concerns promptly and providing personalized attention.
  • Evaluated the effectiveness of various intervention programs, making recommendations for changes based on data-driven insights.
  • Implemented innovative case management strategies that resulted in reduced lengths of stay for patients receiving complex treatments.
  • Maintained accuracy, completeness, and security for medical records and health information.

Indiana Medicaid Concierge Multi-Representative II

Anthem Inc.
12.2016 - 12.2017
  • Assisted members with coordinating internal and external resources for housing, food, and other needs
  • Ensured superior client experience by addressing client concerns and issues efficiently
  • Always demonstrated professionalism and courtesy with clients
  • Establishes positive relationships with community-based organizations and other key partners to gain understanding of the cultural and linguistic needs of members
  • Maintained industry knowledge through continuing education, training, and monitoring of state guidelines
  • Collaborated closely with team members to deliver project requirements, develop solutions, and meet deadlines
  • Provided exceptional customer service to diverse clientele, fostering an atmosphere of inclusivity and respect.
  • Remedied issues quickly and effectively through active listening, conflict resolution, and dynamic communication skills.
  • Managed a variety of tasks simultaneously, maintaining professionalism and efficiency under pressure.
  • Supported event planning efforts, contributing to the successful execution of memorable occasions.
  • Coordinated transportation arrangements for guests, leading to seamless travel experiences.
  • Arranged language translation services as needed, easing communication barriers for international guests.

Event Planner/ Coordinator

Lucille's How Bout That BBQ
01.2010 - 04.2016
  • Managed all aspects of event planning including client interviews, vendor negotiating, and event promotions
  • Executed plans as clients envisioned by communicating effectively to develop strong strategies to meet quotas and expectations
  • Developed creative themes for events and created related activities to engage attendees.
  • Improved team productivity with regular communication and progress updates, fostering a collaborative work environment.
  • Supported successful project completion by meticulously reviewing and updating project plans to reflect changing needs and objectives.
  • Oversaw appointment scheduling and itinerary coordination for both clients and personnel.
  • Managed logistics for successful events, including venue selection, contract negotiation, and coordinating with vendors.
  • Streamlined event registration processes, enhancing attendee experience and improving overall efficiency.

Education

Medical Assisting -

Olympia College
Merrillville, IN
05.2003

Skills

  • Scheduling
  • Budgeting
  • Planning
  • Attention to detail
  • Trends Knowledge
  • Communication
  • Event Logistics
  • Multitasking ability

Accomplishments

  • Elevance IMPACT recognition awards March 2023- Manager
  • Anthem IMPACT recognition award December 2020- Team Lead
  • Anthem IMPACT recognition award December 2020- HROB Nurse
  • Anthem IMPACT recognition February 2020- HROB Nurse

Timeline

Provider Reimbursement Admin Sr.

Elevance Health
09.2023 - Current

Medical Management Specialist II-Prior Authorization

Anthem Inc.
12.2021 - 09.2023

Medical Management Specialist-High Risk OB

Anthem Inc.
12.2017 - 12.2021

Indiana Medicaid Concierge Multi-Representative II

Anthem Inc.
12.2016 - 12.2017

Event Planner

Williams Executive Realty & Associates, LLC
04.2016 - Current

Event Planner/ Coordinator

Lucille's How Bout That BBQ
01.2010 - 04.2016

Medical Assisting -

Olympia College

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TREMESA DRAINE