Aaron_resume
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This document is a resume for Aaron E. Chavez. It summarizes his professional experience working in health insurance claims operations and management roles at EmblemHealth and as an office manager and accounts receivable specialist at Times Square Church. It lists his core competencies and education.
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- 1. AARON E. CHAVEZ 473 Thrift Street Ronkonkoma, NY 11779 • aaron.aaron69@yahoo.com • (347) 861-4903 OUT OF NETWORK NEGOTIATIONS/CLAIM OPERATIONS Challenge-driven, highly accomplished health insurance professional poised to provide outstanding leadership in management positions. Proven strategist, developing and overseeing complex projects that positively impact operations efficiency, quality and profitability. Demonstrated skill in multitasking and managing competing priorities in a fast-paced, demanding environment. History of building and motivating cohesive teams focused on achieving defined goals accurately and within defined budgetary and time parameters. Excellent analyst and creative problem-solver with a track record of efficiently engineering change to meet competitive organizational objectives. CORE COMPETENCIES • Motivational Leadership • Project Coordination • Strategic Planning • Efficiency Enhancements • Financial Administration • Technology Innovations • Processes & Procedures • Quality Initiatives • Training & Development PROFESSIONAL EXPERIENCE EMBLEMHEALTH – New York, NY Contracting Specialist, Provider Network Management 4/2014 to Present Contributed to cost containment by negotiating Single Case Agreements on claims authorized or not part of EmblemHealth's network. Responsible for claim adjustments/reprocessing which include Customer Service referrals, resolution of correspondence (may include generating letters), overpayment issues, voids and adjustments and completion of special projects. • Review and investigate Out of Network professional and facility claim, specialties, lines of business according to organizational policies and procedures. • Generated and analyze reports using Cognos, Infomaker, and Saws to contain cost Supervisor, Medical Claims Dept., (4/2011 – 04/2014) 4/2011 to 4/2014 Prioritized, assigned work and supervised 12-person union staff; served as liaison with consultant team. Planned and oversaw multiple special projects and liaised with NY State Insurance Audit Dept. Compiled information and managed regular production reporting; documented attendance and prepared payroll. • Key member of HIPAA task force assigned to craft minimum necessary disclosure rules. • Successfully managed ALGS letters for subscribers/providers TIMES SQUARE CHURCH – New York, NY 2/1998 to 3/2011 Accounts Receivable Specialist (2/2006 – 2011) Directed and performed a wide array of administrative activities to support executive leadership and overall operations of 8,000-member non-profit organization with staff of 100+. Administer full range of accounts receivables functions to ensure optimal workflow and accuracy. Lead staff of five in accounting for and coding offerings from five services valued at ~$500K per week. Reconciled domestic and foreign accounts. Itemized, deposited, and transferred funds; administered petty cash, and organized all records of A/R transactions. Liaise with donors; following through to successful resolution of all inquiries or errors while maintaining confidential information. Maintain and delegated cost for office operation. • Improved ability and speed in responding to requests for information and financial reports by recommending and gaining approval to acquire and deploy new software application. • Increased department efficiency, as well as donor relations, by creating and implementing scanning procedures for optimizing storage and retrieval of A/R data. Office Manager (6/1998 – 2/2006) Orchestrated all day-to-day administrative operations, including answering telephones and routing calls, organizing meetings, filing, mail sorting and distribution, responding to inquiries, and resolving problems. Managed and scheduled projects, planned special events, and supervised volunteers. Maintained attendance records and partnered with HR Manager/Comptroller on all employee issues. Processed A/P and A/R accounts, periodically producing spreadsheets and other financial reports. Collaborated on maintenance of facility, furnishings, and equipment, as well as room rentals, security issues, and contractor relations. EDUCATION Undergraduate coursework in Accounting, in progress
- 2. AARON E. CHAVEZ • Page 2 BOROUGH OF MANHATTAN COMMUNITY COLLEGE (BMCC), New York, NY