Beatriz Andrade
Oxnard
Summary
A detail oriented professional with customer service experience, equipped with strong problem-solving abilities, willingness to learn, and excellent communication skills. Ready to tackle new challenges and advance organizational objectives with dedication and enthusiasm.
Overview
14
14
years of professional experience
Work History
Utilization Management Representative III
Elevance Health
03.2017 - Current
- Manage and process incoming telephone and written inquiries from members, providers, and internal departments.
- Verify prior authorization requirements based on members benefits and plan criteria.
- Create and submit cases that require medical review.
- Followed all personal and health data procedures to effectively comply with HIPAA laws and prevent information breaches.
- Knowledge in systems/ programs: Aspen, ACMS (AUMI) and ACMP.
Utilization Management Representative
Temp Agency- Elevance Health
11.2016 - 03.2017
- Training on Utilization Management process.
- Educated on Medical data procedures and HIPPA laws and prevention.
Office Manager/Administrative Assistant
SAGE Services
07.2013 - 11.2016
- Assisted in bi-weekly payroll and billing for 100+ employees.
- Maintained good communication and relations with regional centers, parents, care providers, and staff.
- Worked collaboratively with other employees and management.
- Oversaw office inventory activities by ordering, stocking and shipment receiving.
- Improved office operations by automating correspondence, record tracking and data communications.
- Answered and routed phone calls.
- Handled incoming and outgoing mail and faxes.
- Filed and updated paper and electronic participant files.
Sales Advisor
H&M
06.2011 - 08.2013
- Customer Service.
- Maintained store cleanliness.
- Maintained stock levels of daily business.
- Worked as part of a team.
Office Clerk I
VCPH Communicable Disease Office
08.2011 - 04.2012
- Answered and managed incoming and outgoing calls.
- Filed and organized cases and paperwork.
- Fax, copying and scanning.
- Distributed incoming paperwork and separated based on prioritization.
- Input data into spreadsheets and databases.
- Maintained communication with providers.
Education
No Degree - General Ed.
Oxnard College
Oxnard, CAHigh School Diploma -
Hueneme High School
Oxnard, CA06-2005
Skills
- Multi-task and prioritize workload efficiently
- Strong organizational and time management skills
- Ability to learn quickly and retain information
- Medical terminology proficiency
- Documentation accuracy
- Communication
- Interpersonal and written communication
Languages
Spanish
Native or Bilingual
Timeline
Utilization Management Representative III
Elevance Health
03.2017 - Current
Utilization Management Representative
Temp Agency- Elevance Health
11.2016 - 03.2017
Office Manager/Administrative Assistant
SAGE Services
07.2013 - 11.2016
Office Clerk I
VCPH Communicable Disease Office
08.2011 - 04.2012
Sales Advisor
H&M
06.2011 - 08.2013
No Degree - General Ed.
Oxnard College
High School Diploma -
Hueneme High School