Jan2016resume
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This document is a resume for Renee L. Hays, a healthcare professional seeking an opportunity to continue their career where they can maximize their work ethic, healthcare experience, and member service skills. Renee has over 15 years of experience working for healthcare organizations, including as a Medicare Risk Member Service Representative and Enrollment Coordinator at Inter Valley Health Plan from 1997 to 2012. Most recently, Renee earned a Bachelor's degree in Healthcare Administration from the University of Phoenix in 2016.
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- 1. RENEE L. HAYS H ea lth c a r e P r o f ession al 602 W. Granada Court,Ontario,CA 91762 (909) 984-4857 – (909) 821-5639 – reneflorea@aol.com C A R E E R O B J E C T I V E Ambitious,personable,andhighlyorganized healthcare professional withexcellentcommunication skillsseekinganopportunitytocontinuemy healthcare profession whereIcan maximize myresilient workethic,Healthcare experience,andMemberService skills. Q U A L I F I CA T IO NS ProficientinMicrosoftWord/Works programs,Medicare Marx systems,Facets Excellentcommunication/telephoneskills/people oriented Work well underpressure/able tocompleteprojectsbyassigneddeadlines Excellentknowledge of Medicare andMedi-Cal guidelinesandbenefits HIPAA Certification E X P E R I E N C E S p e c t a t o r s S p o r t s B a r 2 0 0 5 - 2 0 1 6 I n t e r V a l l e y H e a l t h P l a n 1997 – 2012 O w n e r / M a n a ge r All aspectsof operatingandrunningan S-Corpbusiness,includingpayroll, accounts payable,accountsreceivable,scheduling,vendorrelationships, stocking, ordering,maintenance andcustomerservice M E D I C A R E R I S K M E M B E R S E R V I C E R E P R E S E N T A TI VE Responsibilitiesincludeinformingmembersandeducatingthemontheir benefits and healthcare options,processingandfollowinguponclaims, authorizations, responsible forrecordingandenteringall member information,includingchange inname,address,change inprimarycare physician,correctdate of birth,and lost ID cards, makingsure that all memberconcerns,problems,andgrievances,are understood andexpeditiouslyresolved,usingdirectcontactwiththe physician offices,and medical groups,answeringtelephone linesinatimelyand professionalmanner,informsmembersof,anddocumentsresearchoutcomes, eitherby telephone orwrittendocumentation,responsibleformonthlyphysician and medical groupterminations,contactingmembersandgoingover optionsto insure changesare done withinHCFA guidelines,along withmembersatisfaction ss E N R O L L M E N T C O O R D I NA T OR All enrollmentanddisenrollmentprocesses,includingprocessing andinputof newapplications,andverifyingeligibility. O U T B O U N D V E R F I CA T IO N R E P R E S E N T AT I VE Responsible forconductingtelephoneinterviewswiththe beneficiariestoensure marketingwasdone incompliance withMIPPA regulations,identifyingany potential marketingallegations,confirmingintenttoenroll andassistingthe beneficiarieswithanyfinal questionstheymayhave priortothe enrollment E D U C A T I O N U n i v e r si t y o f P h o e n i x 2013 – 2016 B A C H E L O R O F S C I E N C E I N H E A L T H C A R E A D M I N I S T R AT I ON The Bachelorof Science inHealthAdministration(BSHA) addressesthe basicbody of knowledge,understanding,andskillsidentifiedasrelevanttoanever
- 2. expandinganddiversehealthcare arena.Mycourseworkincluded contentin some of the followingareas- management,finance,legalandethical parameters, riskand qualitymanagement,humanresources,andinformationsystems.