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Resume

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Resume

  1. 1. Kevin Florence Marcos 91-133 Nehupala Place Ewa Beach, HI 96706 Cell No.: (808) 670-7308 k_florencem@yahoo.com Education University of Hawaii West Oahu Kapolei, HI Major: Health Care Administration, degree received Spring 2013 Overall GPA: 3.0 Waipahu High School, August 2004 to June 2008 Waipahu, HI Overall GPA: 3.0 Work Experience Hawaii Medical Services Association, February 2013 to present Kapolei, HI  Electronic Servicing Representative I o Proficient in using web applications that promote member and provider education, services, and self-servicing tools by participating in test, maintenance, documentation, and other activities o Assist with member inquiries (not limited to):  Review claims to ensure bills received from providers are accurate  Quoting and researching member benefits for medical services  Serve as a member advocate by providing all possible options by utilizing appropriate resources to achieve resolution  Complete member correspondence requests for materials such as guide to benefits, explanation of benefits, ID cards, confirmation of coverage or cancellation of coverage letters, and others  Locating primary care physician and specialist providers to ensure members receive appropriate care o Assist with provider inquiries (not limited to):  Provide payment information for claims  Review claims to advise of information needed to complete processing of denied or pended claims  Quote eligibility, benefits, pre-certification requirements, and claims filing processes
  2. 2.  Guide to medical policies, online resources, and other materials to promote provider education o Consistent in documenting member and provider interactions in an accurate manner o Able to determine urgent cases and knowledgeable of processes to expedite for members and providers o Communicate with other departments to complete tasks; route members and providers to appropriate departments regarding inquiries o Complete assignments related to project work as directed by management o Cooperate with superiors and peers in activities that support and accomplish the company’s core values o Familiar with ICD9, CPT, and HCPCS codes o Knowledge in CMS 1500 and UB04 claimforms o Versed in preferred provider (PPO) plans and health maintenance organization (HMO) plans o Participate in community events and engage with members on a personal level (AskHMSA) Banana Republic, November 2008 to November 2013 Waipahu, HI  Sales Associate o Provide excellent customer service o Perform tasks and duties in a timely manner o Cooperate and communicate well with other team members o Adhere to all company policy in terms of policy and procedure, dress code, etc. o Able to multitask in a busy store setting o Knowledgeable in most area duties of the store o Upkeep visual representation of store o Up-sell and suggest items to drive store traffic o Always ready to answer any work-related questions on the floor  Cashier Specialist o Able to perform cashier duties efficiently o Knowledgeable in cash wrap functions o Able to perform cash wrap opening and closing duties o Assists teammembers by being open to teaching cash wrap duties o Support management team o Aware of daily sales budgets and motivate all associates to reach goals  Trainer o Train new employees about the store and expected duties
  3. 3. o Able to communicate on a personal level to promote a team-oriented work environment o Support management team with ability to answer team members questions o Up-to-date with company policies and procedures to ensure correct information is given to new employees o Communicate in an efficient and effective way to use on-the-clock time wisely Volunteer Experience State of Hawaii Department of Health – Adult Mental Health Division, August 2012 to December 2012 Pearl City, HI  Student Assistant o Opening and closing office duties o Place and answer phone calls o Directly work with care home providers o Ability to operate office equipment: fax, copiers, printers o Communicate with supervisors on daily duties o Efficiently complete tasks assigned by supervisors o Narrative entries on Microsoft Word o Created a power point presentation for caregivers meeting o Responsible for RSVP lists and travel documents for Tobacco Treatment Workshop o Provided support to supervisors on tasks Jesus Cares Ministries, November 2004 to Present Waipahu, HI  Youth Ministry Leader, June 2008-February 2015 o Coordinate events and activities targeted for young people (ages 12-17) o Act as spokesperson for entire ministry with the elders of the church and other leaders outside of the organization o Advocate role on behalf of the well-being of the youth o Responsible for group’s safety in organization’s premises and at away events o Supervises volunteer kid’s ministry teachers’ lessons and schedules o Collaborates with other ministry leaders of the church for church-wide events o Work with other youth leaders on a weekly basis o Give council when approached by anyone in the youth group
  4. 4. o Report to pastors and other leaders o Coordinate fundraisers o Responsible for annual Easter shirt fundraiser o Delegate tasks and responsibilities to encourage the talents of others o Be the mediator when conflict arises  Youth Ministry Treasurer, June 2007 to January 2010 o Report funds on a monthly basis o Balance account books on a weekly basis o Coordinate fundraisers o Raise money in a timely manner for any upcoming events o Responsible for training new person(s) for the position  Daily Vacation Bible School Director, July 2010 o Responsible for entire lesson plan o Gathered all teaching materials needed o Prepared important forms and notices for parents o Completed all tasks in a timely manner prior to start date of event o Responsible for o Appointed responsible, caring, and motivated individuals for teacher positions o Coordinated graduation ceremony o Planned off-site activities related to content o Supported treasurer to raise funds for supplies and food o Worked closely with senior pastor and adult pastor during entire session Additional Skills  Knowledgeable in Microsoft Office: o Microsoft Word o Microsoft Excel o Microsoft PowerPoint o Microsoft Outlook  Ability to speak English and Filipino (Ilocano) fluently  Communicate effectively with others  Organized behavior  Detail-oriented

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