Summary
Overview
Work History
Education
Skills
Timeline
Generic

Wendy Simmons

Florissant

Summary

Diligent administrative coordinator with a solid background in coordinating administrative tasks and supporting executive teams. Successfully managed office operations, ensuring efficient workflow and facilitating project completion. Demonstrated exceptional organizational skills, communication proficiency, and problem-solving abilities. Dynamic administrative professional and leader with over 17 years of experience contributing to daily objectives and long-term goals across diverse office platforms. Excels in timely and accurate processing of accounts payable and receivable, utilizing advanced analytical acumen. Committed to raising productivity and service quality through strategic planning, resource allocation, and process improvements. Skilled receptionist and liaison with superior communication, computer, support, and organizational skills.

Overview

13
13
years of professional experience

Work History

Care Coordinator- Foster Care

Centene
06.2023 - Current
  • Coordinated discharge planning, ensuring a smooth transition from hospital to home or other facilities.
  • Built strong relationships with clients to deliver emotional support and companionship.
  • Determined need for special assessment activities for complex cases, effectively handling care plans.
  • Used company software and databases to maintain records of services performed and patient conditions.
  • Monitored, tracked, and conveyed important patient information to healthcare staff to help optimize treatment planning and care delivery.
  • Managed patient caseloads effectively, ensuring timely follow-up and appropriate interventions.
  • Enhanced patient care by developing and implementing comprehensive care plans.
  • Implemented evidence-based interventions that improved overall patient satisfaction with the care process.

Referral Specialist

Centene
06.2022 - 06.2024
  • Called insurance companies to get precertification and other benefits information on behalf of patients.
  • Coordinated with medical staff and patients to find cost-effective options for services.
  • Maintained accurate records on in-progress and completed referrals, ensuring full data integrity throughout process.
  • Linked families to relevant community support to meet non-medical needs.
  • Acted as a liaison between referring physicians and specialists, establishing trust and rapport through professionalism.
  • Collaborated with healthcare providers to ensure accurate and complete referral information, improving patient care coordination.
  • Contributed to the development of referral policies and procedures, enhancing departmental operations.
  • Provided ongoing training for new Referral Specialist staff members, ensuring consistent quality service delivery across the team.
  • Identified opportunities for process improvements within the referral department, leading to increased efficiency and accuracy.

Clinical Administrative Coordinator

UnitedHealth Group
03.2019 - 06.2022
  • Liaised between departments to facilitate communication and keep appropriate parties updated on project developments.
  • Kept projects on schedule by managing deadlines and adjusting workflows.
  • Kept corporate and client information confidential, adhering to data safety measures.
  • Identified potential risks and developed mitigation strategies to minimize disruptions to project timelines.
  • Played an active role in brainstorming sessions held for the purpose of generating innovative ideas/solutions which could potentially be incorporated into existing/new projects being undertaken by the company.
  • Assisted with onboarding newly hired staff members and coached on task prioritization.
  • Implemented change management processes that minimized disruptions while maintaining forward momentum on projects.
  • Improved client satisfaction with timely updates and transparent communication throughout the project lifecycle.
  • Managed competing demands and professionally adapted to frequent change, delays and unexpected events.
  • Enhanced team collaboration through regular meetings, fostering a positive work environment for increased productivity.

Senior Customer Service Representative

Centene
09.2014 - 07.2018
  • Resolved customer service issues using company processes and policies and provided updates to customers.
  • Escalated issues to proper supervisors when standard processes were not effective.
  • Trained and directed new employees in call script use, conflict resolution, and data entry practices to boost customer satisfaction ratings.
  • Engaged clients in person and over phone to answer questions and address complaints.
  • Assisted in creating departmental policies, protocols, and guidelines that improved overall effectiveness of the customer service team.
  • Demonstrated excellent multitasking abilities by managing multiple concurrent tasks while ensuring timely completion.
  • Processed, scheduled and executed customer orders for new and established customers.
  • Enhanced customer satisfaction by promptly addressing and resolving complex inquiries and complaints.

Behavioral Health Customer Service

Aetna Healthcare
04.2014 - 08.2014
  • Assist members with locating network providers
  • Schedule therapist appointments via phone, fax, etc
  • Setup case management files for members
  • Successfully handle crisis call
  • Coordinate administrative intake and manage service requests with hospitals, clinics, and facilities
  • Process referrals and prior authorizations, ensuring timely notifications and accurate census roles
  • Support clinical staff by organizing documents and triaging cases for Clinical Coverage Review
  • Resolve inquiries from members and providers, ensuring high satisfaction and efficient issue resolution
  • Optimized member intake process, reducing processing time by 18% and enhancing overall member satisfaction
  • Mentored call center staff, enhancing team performance and customer satisfaction
  • Developed and refined call center workflows, improving operational efficiency
  • Processed pre-certifications and authorizations, ensuring compliance with member plans
  • Handled claims processing, consistently meeting production and quality standards
  • Resolved member inquiries and complaints, ensuring clarity on benefits and billing

Business Analyst

SSM Healthcare
04.2013 - 04.2014
  • Collaborated closely with stakeholders to identify opportunities for process improvements and drive continuous innovation in the organization.
  • Improved business processes by analyzing current practices and recommending optimization strategies.
  • Optimized workflow processes to enhance overall productivity and achieve operational excellence.
  • Developed high-quality documentation to support training efforts, helping employees fully understand new systems and procedures.
  • Conducted market research studies to provide valuable insights for strategic planning initiatives.
  • Actively participated in team meetings to share knowledge, exchange ideas, address challenges, and collaborate on potential solutions.
  • Implemented best-practice methodologies that improved overall project delivery timelines while maintaining quality standards.

Customer Service Representative

Cigna
10.2011 - 04.2013
  • Receive inbound calls for pre-certification of medical services
  • Perform clinical reviews under direction of medical director
  • Complete insurance and benefits verification

Education

Bachelor of Science - Health Care Administration

Grand Canyon University
Phoenix, AZ

GED -

Maine Department Of Education
Augusta, Maine
08.2024

Skills

  • Attention to Detail
  • Time Management
  • Data Entry
  • Team Collaboration
  • Office Administration
  • Document Management
  • Critical Thinking
  • Project Scheduling
  • Decision-Making
  • Administrative Support
  • Computer Proficiency
  • Scheduling
  • Professional Communication

Timeline

Care Coordinator- Foster Care

Centene
06.2023 - Current

Referral Specialist

Centene
06.2022 - 06.2024

Clinical Administrative Coordinator

UnitedHealth Group
03.2019 - 06.2022

Senior Customer Service Representative

Centene
09.2014 - 07.2018

Behavioral Health Customer Service

Aetna Healthcare
04.2014 - 08.2014

Business Analyst

SSM Healthcare
04.2013 - 04.2014

Customer Service Representative

Cigna
10.2011 - 04.2013

Bachelor of Science - Health Care Administration

Grand Canyon University

GED -

Maine Department Of Education
Wendy Simmons