Enthusiastic Claims Specialist examines claims, negotiates and processes
settlements and verifies insurance coverage. Attentive team player consistently
treats clients fairly and equitably. Motivated to succeed in fast-paced and
deadline-driven professional environment

Kerlene Azor

Seffner, FL

kerleneazor@vahoo.com

+1 813 312 6375

 

 

 

Work Experience

 

Staffing Coordinator

Carrollwood Care Center - Tampa, FL

March 2023 to Present

  • Recruits, interviews, and hires direct reports. Includes full-time, part-time, and part-time on-call employees. Establishes clear performance expectations with direct reports.
  • Ensures new hires receive new hire (on-boarding) training and completes performance evaluations.
  • Develops, monitors, and manages the master staffing schedule for direct reports. Updates weekly and/ or daily to meet staffing needs.
  • Participates in the staff grievance process to a satisfactory resolution.
  • Tracks and maintains records of absentee reports, time-off requests, or other areas affecting the status of the schedule. Completes overtime report for each pay period to reflect use of overtime and corrective plan of action as needed.
  • Regularly monitors time-clock punches of direct reports and corrects as needed. completes payroll.

for direct reports.

  • Participates in 24-hour on-call to address scheduling needs.
  • Works with Direct Support Professionals each shift (1st and 2nd) at least once monthly when needed or schedules to work these shifts.
  • Works in partnership with QIDP to ensure clients receive continuous Active Treatment
  • Works in partnership with DON and nursing staff to ensure excellence in the delivery of health care.

Devices

Oversees risk management activities to ensure a safe environment to decrease staff injuries, client.

inquires, and decrease first aid and workers compensation claims.

  • Reports to work during inclement weather (hurricanes) to ensure staff-client ratios are met

Scheduler

 

 

 

 

Staffing Coordinator

North Tampa Behavioral Health - Wesley Chapel, FL

May 2021 to March 2023

  • Recruits, interviews, and hires direct reports. Includes full-time, part-time, and part-time on-call employees. Establishes clear performance expectations with direct reports.
  • Ensures new hires receive new hire (on-boarding) training and completes performance evaluations.
  • Develops, monitors, and manages the master staffing schedule for direct reports. Updates weekly and/ or daily to meet staffing needs.
  • Participates in the staff grievance process to a satisfactory resolution.
  • Tracks and maintains records of absentee reports, time-off requests, or other areas affecting the status of the schedule. Completes overtime report for each pay period to reflect use of overtime and corrective plan of action as needed.
  • Regularly monitors time-clock punches of direct reports and corrects as needed. completes payroll.

for direct reports.

  • Participates in 24-hour on-call to address scheduling needs.
  • Works with Direct Support Professionals each shift (1st and 2nd) at least once monthly when needed or schedules to work these shifts.
  • Works in partnership with QIDP to ensure clients receive continuous Active Treatment
  • Works in partnership with DON and nursing staff to ensure excellence in the delivery of health care.

Devices

Oversees risk management activities to ensure a safe environment to decrease staff injuries, client.

inquires, and decrease first aid and workers compensation claims.

  • Reports to work during inclement weather (hurricanes) to ensure staff-client ratios are met

Scheduler

 

Trilogy Home Healthcare - Clearwater, FL

March 2021 to Present

  • Coordinates the scheduling of clinical visits for care team in compliance with physician approved orders and clinician plotted visits approved by clinical Services Manager. Ensures compliance with the schedule Communicates any requests to change the schedule to the Clinical Services Manager and, once approved, reschedules missed or declined visits.
  • Assists clinicians with assuring all visits are properly assigned and scheduled on Electronic Medical

Record (EMR) devices.

  • Maintains on-call schedule for assigned care team. Responsible for contacting PR associates according

co established protocol to ensure adequate scheduling or services to meet patient needs.

  • Responsible for monitoring and scheduling home health therapy reassessment visits to meet home health reassessment requirements.
  • Facilitates compliance in the electronic medical record for notices provided to the patient or responsible party (e.g. Notices of Medicare Non-Coverage) in a timely manner.
  • Assures compliance with, and facilitates completion of, service agreements from patients) and/or power of attorney(ies) receiving services from the agency.
  • Fields all calls related to the assigned team patients and routes to appropriate care team members.
  • Keeps the Clinical Services Manager informed on aspects within the care team specific to EMR scheduling workflow.
  • Prepares reports for scheduling tracking and participates in agency meetings to ensure patient and associate scheduling needs are met.
  • Maintains positive relationships and rapport with co-workers, associates, patients, and their family members and community personnel.
  • Adheres to communication and accountability guidelines established by local and regional administration.
  • Maintains a safe and clean work area and adheres to agency safety standards.
  • Adheres to established confidentiality standards as required by Brookdale and HIPAA concerning community and patient information.

Nurse On Call

Central Services

February 2021 to Present

Administrative Coordinator

Pre-Claim Review Specialist

  • Coordinates communication of agency referrals to appropriate associates of the agency.
  • Communicates with Central Services to address needs at the agency regarding referral management.
  • Responsible for reviewing and directing Curator documentation platform, together with other EMR information to the correct associate in the agency and in collaboration with Centralized Services.
  • Serves as a coordinator between Centralized Services and the Agency.
  • Facilitates compliance in the electronic medical record for notices provided to the patient or responsible party (e.g. Notices of Medicare Non-Coverage, DOA documentation) in a timely manner.
  • Tracks documentation management activities that are managed by the agency.
  • Assures compliance with, and facilitates completion of, service agreements from patients) and/or power of attorney(s) receiving services from the agency.
  • Keeps the Clinical Service Manager informed on aspects within the care team specific to documentation and referral management.
  • Keeps the sales team informed on referral management.
  • Prepares reports for scheduling tracking and participates in agency meetings to ensure patient and associate scheduling needs are met.

Maintains positive relationships and rapport with co-workers, associates, patient's/family members and community personnel.

Adheres to communication and accountability guidelines established by local and regional administration.

Maintains a safe and clean work area and adheres to agency safety standards.

Adheres to established confidentiality standards as required by Brookdale and HIPAA concerning community and patient information.

Assists with coordination of scheduling for timely initiation of care.

 

Provides support with scheduling as needed.

Performs other duties as assigned.

The Pre-Claim Review (PR) Specialist organizes, prepares and execute all pre-claim review workflow in order to achieve claim affirmation to approve billing through Medicare.

The PCR Specialist will review each patient case prior to and after PC submission to ensure all necessary components are present and coordinate with other HRS team members and departments in order to resolve any concerns that could lead to or have led to non-affirmation, claim rejection, or claim ADR. This position will be accountable to the Pre-Bill Supervisor and will provide guidance for process or quality improvements by department and individual.

Benefits Account Representative

MetLife

June 2019 to November 2019

  • Performs functions that are critical to the accuracy of billing for the group program for all assigned accounts; (annually updating account billing schedules, daily analysis of reports that document missed or incorrect deductions, audit the accuracy of the content of administrative systems, etc.) in order to prevent serious administrative problems and implement proactive practices to avoid escalation.
  • Monitors the billing, transmission and payment processes for assigned group customers.

Accounts Receivables Specialist

Coca-Cola Refreshments

May 2015 to December 2018

  • Process accounts and incoming payments in compliance with financial policies and procedures
  • Perform day to day financial transactions, including verifying, classifying, computing, posting and recording accounts receivables' data.
  • Prepare bills, invoices and bank deposits.
  • Reconcile the accounts receivable ledger to ensure that all payments are accounted for and properly posted.
  • Verify discrepancies by and resolve clients' billing issues.
  • Facilitate payment of invoices due by sending bill reminders and contacting clients
  • Generate financial statements and reports detailing accounts receivable status.
  • Payment Posting

Receptionist

Coca-Cola Refreshments

September 2016 to May 2018

  • Welcomes visitors by greeting them, in person or on the telephone, answering or referring to inquiries.
  • Directs visitors by maintaining employee and department directories, giving instructions.
  • Maintains security by following procedures; monitoring logbook; issuing visitor badges.

SR Intake

EQ Health Solutions - Tampa, FL

September 2013 to September 2016

Claims Processer

  • Obtain and input initial demographics for inpatient and outpatient precertification.
  • Accurate documentation of information obtained.
  • Responsible for professional interactions telephonically. Includes accurate communication of services requested.
  • Screen calls appropriately and work with clinicians to ensure optimal turnaround times. Responsible for completing callbacks in an efficient manner.
  • Print correct and forward reports requested to nurses or supervisor.
  • Responsible for managing all clinical faxes and ensuring all regulatory timelines are met.
  • Demonstrates appropriate customer-care skills such as empathy, active listening, courtesy, politeness, helpfulness and other skills as identified.
  • Look through clients' insurance files to determine the type of policies that they are covered under.
  • Verify the type and tenure of policies from insurance companies by indulging in conversation with representatives over the telephone, through email, and in-person.
  • Determine clients' eligibility for medical insurance payouts by coordinating with hospitals, police staff, and other people involved in an accident, illness, and hospitalization.
  • Review claim forms in detail to ensure that all provided information is complete and accurate.
  • Provide clients with information on incomplete form entries and assist them in locating avenues to obtain them.
  • Identify process improvements and offer solutions to claim denials and resubmissions.
  • Assist clients by resubmitting their claims for second approvals and communicate with insurance companies to provide them with heads ups.
  • Enter information in the company's internal database for future or further reference.
  • Prepare materials for claims audits and provide assistance to auditors during the procedure.
  • Perform follow-up services to ensure that all unpaid and selective denied claims are paid in an accurate and timely fashion.
  • Obtain necessary documentation from various individuals and groups to provide credence to filed claims.

 

 

 

 

Education

High school diploma

Database fundamentals Centers for technology & Training

Cybersecurity-Google

Skills

  • Proficient in Microsoft (Word, Excel, PowerPoint, Outlook)
    Proficient in SAP
  • CONA
  • Corporate Billing System
  • Salesforce
  • Homecare Homebase
  • Forcura
  • Medical Records
  • Medical Scheduling
  • Accounts Receivable
  • Employee Orientation
  • Human Resources
  • Recruiting
  • HIPAA
  • SQL

 

 

Last Resume Update March 5, 2024
Address seffner, United States of America
E-mail Locked
Phone Number Locked

Experience

carrollwood care center
staffing coordinator
Mar 2024 - Current

o Recruits, interviews, and hires direct reports. Includes full-time, part-time, and part-time on-call employees. Establishes clear performance expectations with direct reports.
o Ensures new hires receive new hire (on-boarding) training and completes performance evaluations.
o Develops, monitors, and manages the master staffing schedule for direct reports. Updates weekly and/ or daily to meet staffing needs.
o Participates in the staff grievance process to a satisfactory resolution.
o Tracks and maintains records of absentee reports, time-off requests, or other areas affecting the status of the schedule. Completes overtime report for each pay period to reflect use of overtime and corrective plan of action as needed.
o Regularly monitors time-clock punches of direct reports and corrects as needed. completes payroll.
for direct reports.
o Participates in 24-hour on-call to address scheduling needs.
o Works with Direct Support Professionals each shift (1st and 2nd) at least once monthly when needed or schedules to work these shifts.
o Works in partnership with QIDP to ensure clients receive continuous Active Treatment
o Works in partnership with DON and nursing staff to ensure excellence in the delivery of health care.
Devices
Oversees risk management activities to ensure a safe environment to decrease staff injuries, client.
inquires, and decrease first aid and workers compensation claims.
• Reports to work during inclement weather (hurricanes) to ensure staff-client ratios are met
Scheduler

north tampa behavioral health hospital
staffing coordinator
May 2021 - Mar 2023

o Recruits, interviews, and hires direct reports. Includes full-time, part-time, and part-time on-call employees. Establishes clear performance expectations with direct reports.
o Ensures new hires receive new hire (on-boarding) training and completes performance evaluations.
o Develops, monitors, and manages the master staffing schedule for direct reports. Updates weekly and/ or daily to meet staffing needs.
o Participates in the staff grievance process to a satisfactory resolution.
o Tracks and maintains records of absentee reports, time-off requests, or other areas affecting the status of the schedule. Completes overtime report for each pay period to reflect use of overtime and corrective plan of action as needed.
o Regularly monitors time-clock punches of direct reports and corrects as needed. completes payroll.
for direct reports.
o Participates in 24-hour on-call to address scheduling needs.
o Works with Direct Support Professionals each shift (1st and 2nd) at least once monthly when needed or schedules to work these shifts.
o Works in partnership with QIDP to ensure clients receive continuous Active Treatment
o Works in partnership with DON and nursing staff to ensure excellence in the delivery of health care.
Devices
Oversees risk management activities to ensure a safe environment to decrease staff injuries, client.
inquires, and decrease first aid and workers compensation claims.
• Reports to work during inclement weather (hurricanes) to ensure staff-client ratios are met
Scheduler

Education

GOOGLE
CYBERSECURITY ANALYST
Jan 2024 - Current

Coursera Career Certificate
Professional Certificate - 9 course series
Learners who complete this program will receive a 50% discount voucher to take the SC-900 Certification Exam.

Organizations rely on cybersecurity experts to protect themselves from threats, but nearly 60% report security talent shortages.1 Prepare for a new career in this high-demand field with professional training from Microsoft — an industry-recognized leader in cybersecurity.

The role of a cybersecurity analyst includes monitoring networks for vulnerabilities or potential threats, mitigating attacks on the network infrastructures, and implementing strategies for data protection. With 95% of fortune 500 companies using Azure, it’s critical for cybersecurity professionals to learn to protect data within an Azure environment.2

Through a mix of videos, assessments, and hands-on activities, you’ll learn cybersecurity concepts and how they apply to a business environment, discuss threat mitigation strategies from an enterprise perspective, apply effective cybersecurity policy measures within an Azure environment, & practice on tools like MS defender, Azure Active Directory & more.

When you graduate, you’ll have tangible examples to talk about in job interviews and you’ll also be prepared to take the Microsoft SC-900 Certification Exam.

1McKinsey & Company, Securing your organization to reduce cyber risk (June 2022)

2Microsoft Azure, Microsoft Azure:The only consistent, comprehensive hybrid cloud (Sept 2018)

Applied Learning Project

This program has been uniquely mapped to key job skills required in cybersecurity analyst roles. In each course, you’ll be able to consolidate what you have learned by completing a capstone project that simulates real-world cybersecurity scenarios. You’ll also complete a final capstone project where you’ll create your own cybersecurity proposal for the creation and protection of a business network and infrastructure. The projects will include practicing on:

A real-world scenario focused on penetration testing, building configuration, and testing strategy for white box testing of a penetration test on virtual networks.

A real-world capstone project that enables you to demonstrate your cybersecurity analyst skills.

To round off your learning, you’ll take a mock exam that has been set up in a similar style to the industry-recognized Microsoft Exam SC-900: Microsoft Security, Compliance, and Identity Fundamentals.

Read more
Introduction to Computers and Operating Systems and Security

Introduction to Networking and Cloud Computing

Cybersecurity Threat Vectors and Mitigation

Cybersecurity Identity and Access Solutions using Azure AD
Course 4

21 hours

4.3(61 ratings)

Cybersecurity Solutions and Microsoft Defender
Course 5

23 hours

4.6(42 ratings)

Cybersecurity Tools and Technologies
Course 6

20 hours

4.7(44 ratings)

Cybersecurity Management and Compliance

Advanced Cybersecurity Concepts and Capstone Project

Microsoft SC-900 Exam Preparation and Practice

centers for technology and training
certificate
Mar 2019 - Apr 2024

database fundamentals
SQL

CC High School
high school diploma
Aug 1999 - May 2002

Contact Candidate

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