Valerie Lowe
Tampa,Florida
Summary
Qualified Claims Representative versed in investigating claims, verifying information and managing settlements. Friendly and upbeat team player with organized and disciplined approach. Offering 7 years of insurance experience.
Overview
7
7
years of professional experience
Work History
Youth Care Giver
Childrens Home Network
11.2024 - Current
- To assists in providing for the daily care, safety and welfare for a cottage program of up to 12 youth, this includes providing support and guidance with daily living skills, hygiene and self-care in a therapeutic residential setting.
- Youth Caregivers plan and implement recreational activities on a daily basis that are developmentally and culturally appropriate for children up to 17 years of age.
- Provides milieu services to teach youth life skills, to include but not limited to: goal setting, problem resolution, educational activities, daily routines, social skills development, employability skills, anger management, crisis management, hygiene skills, cleanliness, housekeeping, cooking, meal routines, and bedtime routines.
- Works collaboratively with the treatment team to facilitate therapeutic relationships for the children in group and individual settings. In collaboration with therapist, documents Behavioral Health Overlay Services. Serves as the caregiver/ advocate for the kids residing in the cottage program.
- Provides Trauma informed care and utilizes CPI and TOOLs techniques when working with youth in order to prevent potential problem behavior, promote positive behavior and de-escalate incidents.
- Responsible for working within the established cottage program, inclusive of routines and adhering to a consistent Daily Living Program. Role model expectations by assisting youth with performing daily routines and chore.
- Provides interactive supervision and monitoring of youth at all times to ensure the best care, welfare, safety, health, and security for youth.
- Works collaboratively with the campus team, youth and family, assisting in mentoring and working with families that are in transition to adaptive, foster and/ or reunification placements.
- Perform and document environmental rounds at least every 15 minutes or more frequently as needed. Report and document all abnormal or suspicious situations via the information report. Maintains documentation within guidelines for MyEvolve reports, shift accountability, medical administration records, log books, BHOS, and other documentation as applicable.
- Attends and actively participate in treatment plan reviews as needed. Assist in guiding youth in having success with their cottage goals and related plans.
- Follows CHN and professional standards regarding mandated reporting laws. Follows CHN policy and procedures for reporting critical incidents and runaways.
- Adheres to all daily cottage cleanliness programs and ensure that agency health and safety standards are consistently meet, including but not limited to, nightly cleaning/ sanitation of common area floors, cleaning/organizing the closets, kitchen, and cottage janitorial supplies cabinet.
- Assist in the coordination and completion of transportation for youth, to and from activities.
- Dispense and document all medications given to youth, and medication deficiencies in accord with established agency procedures. Coordinate with medical personnel to ensure the physical/ health needs of the child.
Claims Representative
Elevance Health
05.2021 - Current
- Responsible for keying, processing and/or adjusting health claims in accordance with claims policies and.
- Participate in claims workflow projects.
- Responds to telephone and written inquiries and initiates steps to assist callers regarding issues relating to the content or interpretation of benefits, policies and procedures, provider contracts, and adjudication of claims.
- Adjusts voids and reopens claims on-line within guidelines to ensure proper adjudication.
- May have customer/client contact. May assist with training of staff. Works without significant guidance.
Patient Access Representative
USF Health
05.2019 - 05.2021
- Accurately schedule and register patients by phone, fax, email or MyChart requests for at least 3 departments or major divisions.
- Registers new patients by obtaining all required demographic and insurance/payer information to ensure accurate registration.
- Works recall and reschedule and wait lists in Epic with accuracy and in a timely fashion.
- Secured patient information and confidential medical records in compliance with HIPAA privacy rule standards to protect patient's privacy.
Education
High School Diploma -
Cornerstone Christian Correspondence School
Townsend, GA2005
Timeline
Youth Care Giver
Childrens Home Network
11.2024 - Current
Claims Representative
Elevance Health
05.2021 - Current
Patient Access Representative
USF Health
05.2019 - 05.2021
High School Diploma -
Cornerstone Christian Correspondence School