1. Alejandra (Alex) Vilchis
knightleoivey@gmail.com
602-486-5107
CAREER SUMMARY
• Bilingual in English and Spanish, with energetic, dependable, and self-motivation. Strong work
ethic with integrity.
• Proven diverse leadership and training skills for individual and group co-workers, with effective
communication and interpersonal skills.
• Proven ability to effectively multi-task at various levels of executive and administrative
responsibility with a solid time management, analytical, and independent organizational skills.
• Ability to easily grasp new ideas, concepts, methods and technologies as wells as knowledgeable in
Arizona Revise Statutes policies and procedures.
• Extensive excellent investigative, analytical skills in areas of public services and behavioral health
services.
WORK EXPERIANCE
Health Choice Arizona
November-Present
(Aerotek)
• Supervisor of Medical Prior Authorizations managing technicians, and nurses (total of 76 people)
• Resolve concerns from providers (doctors, hospitals, clinics etc)
• Create productivity reports for senior management on daily bases
• Responsible for assigning daily PA work to all teams averaging 11,000 per month.
• Assist with the processing of Prior Authorizations to identify the proper request
• Research the medical criteria to ensure accurate approval
• Answer inbound calls and resolve any issue regarding prior authorizations at supervisor level
• Mentor co-workers on proper use of medical criteria for each of the five lines of business.
• Coach or prepare needed disciplinary action for employees
Aerotek
(Cenpatico of Arizona)
June 2015 October 2015
• Conduct background check on credential and all re-credential providers including physicians,
healthcare delivery organizations, pharmacies to applicable statute specifications
• Maintain and update the credentialing database for accuracy
• Process, track and file credentialing applications within established standards
• Prepare reports for the credentialing program to ensure compliance
• Maintain the Passport Error System for all incoming errors
Phillips Law Group
July 2014-October 2014
Social Security Disability
• Responsible for scheduling all hearings for clients with pending appeals thru SSA
• Maintain a case load for all pending hearings
• Contact Social Security on daily bases to update medical records
• Communicate with clients on regular bases about the status of their hearing
• Review and update all fee agreements and any contracts of pending cases

2. Magellan of Arizona
December 2013-June 2014
(Aerotek)
Generalist & Screening Coordinator
• Review all incoming grievances and appeals for assigning to coordinators and investigators.
• QC for supporting documents
• Create research reports reflecting percentage of open and close investigations.
• Approve or deny continuation of services after review of appeal request and Notice of Action
• Conduct extensive research on all incoming grievances and appeals and analyze what is the proper
procedure and request clinical records.
• Conduct investigations and write reports on grievances.
• Communication with clinical staff for screening disposition on all incoming cases.
• Prepare expedited appeal request
• Analyze and render final decisions in consultation with operational, medical and clinical staff
according to procedure, and communicate final determination to the appellant and provider.
• Responsible for maintaining the integrity of Magellan’s relationship with client customers by
researching, resolving and responding to customers and account inquiries involving adverse
determinations.
• Review all cases set on the Fair Hearing calendar.
H&R Block
December 2013- Present
• Prepare income tax forms for individuals, IRS, Schedule C, retirement, 401K, itemized
deductions, capital assets, cancellation of debt income, Sole proprietorship, small business, rental
real estate, etc.
Arizona Supreme Court State of Arizona
April 2000 to June 2012
Investigator
• Conducts and coordinates investigator research; develops recommendations based on findings,
• Prepares and presents written and oral reports to the applicable boards, committees and
subcommittees.
• Identifies issues and potential problems; projects consequences of the recommended actions;
proposes possible solutions.
• Conduct review and analysis of certification process and licensure renewals and initial
applications for the court reporter, fiduciary, defensive driving, and confidential intermediary
programs.
• Performs background and evaluate the authenticity of all supporting documents for compliance.
• Provide recommendations and findings to the regulatory boards of each of the four programs
regarding the application of initial and/or renewal applications.
• Assisted team with the training of new Unit members, preparing reports, documents and evidence
pertaining to the disciplinary process.
• Compiling statistics and/or tracking 750 pending matters before probable cause panelist
• Maintained complaint/discipline database and documentation and responsible for quality control
of database.

3. Behavioral Health Services
Specialist III
Duties:
• Facilitated and provided training to other support staff members for the Office of Human Rights
and Grievance and Appeals departments. Maintained Bureau Chiefs calendar, files and
coordinated training/meetings.
• Provided Customer Relations by Assisting PGBHA RBHA & the seven HR Committees
throughout the state with admin support.
• Screened phone calls for advocates to investigate possible civil rights violations against people
with a mental illness.
• Helped advocates presented and provide training to behavioral health providers in regards to the
functions of the Bureau for Consumer Rights.
• Bilingual with translation abilities with both English and Spanish. Translated documents and
conversations with consumers.
• Maintained time keeping for employees within OHR.
• Ensured compliance with rules for consumers’ confidential information in different databases.
• Monitored expenditures for the office supplies on line and off line and handled mail.
Behavioral Health Licensing
Administrative Assistant
Duties:
• Processed all incoming and outgoing mail.
• Created the credentialing files for all agencies seeking licensure for facilities proving Behavioral
Health Services.
• Routed all calls using a fifteen line system
• Monitored expenditures for the office supplies on line and off line and handled mail.
Action Peformance
Supervisor (1995-2000)
• Responsible for supervising 25 people working in the warehouse
• Support and maintain the staff working in the shipping and receiving area of the warehouse
• Keep track of the inventory off all diecast cars to ensure full inventory
• Suppervice and assign work for the assembly line crew
• Drive the forklif do download the classic wooden pallets coming from China
• Ensure all sales were shipped to the customers within 24 hours of order received
• Conduct quarterly reviews and disciplinary action for employees
• Ensure assemply line is equipped with needed resources to complete the job
• Ensure timecards are correct, and deliver paychecks to employees
EDUCATION
• BBS with a major in Marketing, January 2007
• A.A.S. Paralegal Degree May 2005
TECHNICAL SKILLS
• Microsoft Word (1997-2003, and 2007) Group Wise, Outlook, Power Point,
• Jewerly making tools

4. • Aspen/Oracle/Time/Advance PDF editor/Access
• Optum 360, ICD10, CPT Codes
• CareRadius
• Frames/Data base/ADOA HRIS system, Excel/Microsoft Publisher, Typewriter, Summations/ Trial
• Directory and Time Logger, Amisys, company’s filenet system.
PROFESSIONAL DEVELOPMENT
• I create my own jewelry since 2007
• National Certify Investigator Training (NCIT) CLEAR
• Basic Training, June 2006
• Advance Training, October 2007
• (Other yearly required training)
• You Outdid Yourself Award, March, 2007
• Defensive Driving Team of the year, June 2009
• Arizona State Notary Public, Commission Number 320436 (exp.11/30/16)
• IRS certified (PTIN #P01677517)