Ada Jez

Ada Jez Objective: To secure a position with a well-established organization that will enable me to use my strong organizational skills, educational background, and ability to work well with people, leading to a lasting relationship. EXPERIENCE Company: Freedom Health Tampa,FL From: JAN 2016 to May 30 2025 Job Title: Senior Utilization Management Coordinator III (Team Lead): Medicare HMO-Medicaid • Effectively handles authorization/referral requests and inquiry phone calls from providers, balancing excellent customer service with efficiency. • Inputs review data into systems with minimal errors. • Based on authorization rules and urgency, either approves the authorization request, or sends to nurse for review. • Enter all referral/authorization request including DME, prosthetics and orthotics, home health and J codes. • Assists managers in preparing and submitting projects, reports or assignments as needed to meet department initiatives and/or objectives. • QA Audits. Review, develop and perform internal audit procedures and prepare internal audit reports reflecting the results of the work performed. • Responsible for processing phone and fax authorization requests for medical services from physicians and hospitals (providers) in an efficient, accurate and customer-focused manner. • Monitor coordinators performance and phone coverage • Assist coordinators with any questions/concerns they may have • Assist/resolve complains and/or issues that may occur • Assign works and task to coordinators • Train new coordinators • Assure HIPPA compliance is applied and follow CMS guidelines. Company: Freedom Health Tampa,FL From: May 20, 2013 to 2015 Job Title: Senior Concierge specialist: • Receive, investigate and respond to all member inquiries and resolve member problems and/or complaints in a timely and accurate manner. • Answer all telephone calls within established department standards • Track all existing member calls within the Health Axis database ensuring that documentation is concise and factual. • Responsible for fully understanding all lines of business benefits, medical management process, demographic change process, and process for change in Primary Care Physician (PCP). • Answers claims inquiries. • Understand and process enrollment and disenrollment procedures. • Maintains appropriate current source documents and reference documents. • Performs quality work within deadlines. • Participate in projects. • Provide excellent customer service • Answer member’s questions, address complaints or concerns. Company: America ll Electronics St. Petersburg, Florida From May 2010 to July 2012 Job Title Sales assistant: Company is a distributor of electronic components. Work with customers from South America and Europe. • Assist a top sales manager with paperwork and sales to customers. • Track customer purchase orders. • Create sales orders • Develop new customers through outbound prospecting. • Build customer relationship by providing superior follow through and follow up on orders and product requests. • Search for electronic components to fulfill customer orders. • Work with spreadsheet to truck customer usage. • Handle inbound inquiries. • Handle shipment issues or return material authorizations. • Proactively ensure orders are on time and/or ship as planned. Company: Porto di Ancona-maritime customs Ancona, Italy From Feb 2007 to Sep 2008 Job Title: Data entry • Update and maintain information on the system and archives • Create orders, files and documentation for travelers • Import traveler’s information on the system • Process and investigate personal information stated on traveler’s passport or ID • Once all the information are imported and verified, send all to the investigation dep for review Additional side jobs • Translator: Translating documents for Courts and Immigration • Language Tutor: Helping kids and adults learning languages EDUCATION • AAPC – CDEO/CDI (Clinical Documentation Improvement Expert Outpatient) - 2023 • Universita di interpretazioni e traduzioni - Some college – Italy • Panzini - High school Diploma - Italy SKILLS • Computer skills, knowledge of Microsoft, Excel, Word , MS Office and others. • Knowledge of Medical Terminology, anatomy, ICD, HCPC and CPT codes. • Speak and write fluently Bosnian, Croatian, Italian, Spanish and English. • Did some translations for the Court and patients from English to Spanish or English to Italian. RECONGNITIONS Reoccurring compliments and recognitions for my job for attendance, persistence in helping people, paying attention to details and excellent work ethics.. I will always do my best and my goal is to always be the best in what I do. I do not settle for less. My motto – Positive minds looks for ways it can be done!.