North York, Ontario, Canada
•Director General Conduct and Culture •Decision- Maker, Member •Federal Health Claims/Medical Finance •Senior Events Manager •Project Manager •Communications Strategist •Volunteer Management •Innovative Marketing Team Lead •National Coordinator Principal Strengths: I assist people in recognizing their intrinsic value and potential for personal greatness. Together, enthusiasm, excellence and passion for achieving world-class results are manifested. As an engaging and creative leader who is attentive to details, my dynamic personality cultivates authentic interpersonal relationships, while incorporating ingenuity, curiosity and a strong personal •commitment to community. I have proven success meeting changing priorities in many environments and am a highly organized self-starter with a tremendous degree of initiative. Author Awarded 2019 Commanding Officers Unit Coin for saving National Federal Health Services millions of dollars prospectively via amended hospital policy. My broad vision allows me to grasp the overall dimensions of a situation, troubleshoot and structure a roadmap for long and short-term success. Leadership and community involvement are pillars of my lifestyle, honed through sound judgment, jurisprudence, compassion, confidentiality and dedication to simplifying tasks for others. Critical thinking paves the way for me to identify areas of concern and ensure participant satisfaction through disciplined thoroughness and resourceful problem solving. Experience working within the private, non-profit and public sectors has afforded me opportunities to deliver professional presentations in culturally diverse environments; successfully imparting knowledge to many demographics of people, personalities and age ranges. My proficient interpersonal and organizational skills nurture team spirit, as I respond quickly to changing priorities and relational needs.
Restorative Services
•Processing Medavie Blue Cross Medical Claims Regular Force and Reserve Service Members. •Reviewing, authorizing and dispatching manual payment requests from medical service providers. •Liaising with Medical Clinic Base Surgeon, Primary Care Nurses, Case Managers, Medical Records, Mental Health Clinicians, Support Services Management and Clerking Staff, in consultation regarding medical service delivery and communication. •Instructing Medical Service Providers through workshops and various methods on processes for facilitating payment. •Actioning pre-authorizations and claims requests, confirming service eligibility and/or approvals. •Confirming patient and treatment/medications are covered parts of the insurance plan through database research of plan details. •Verifying insurance claims forms per submission and review sections for accuracy and completeness. •Submitting insurance claims post Section 34 verification final processing via forms system and confirm claim reception checks. •Interpreting insurance policy language in benefits overview summary explanation and apply interpretation to claims review process. •Updating policy forms and claims information per insurance coverage changes and notifying appropriate parties of necessary changes. •Maintaining knowledge of all appropriate medical insurance coverage laws in the local, state and federal jurisdiction for review of claims submissions. •Following all required medical privacy laws for discussion of private patients information with physicians, healthcare managers and/or other stakeholders. •Reporting quarterly to Ottawa HQ, Department of National Defence, Section 34 approvals, audits and claim payouts. •Attending to phone, email and person-to-person inquires regarding Medavie Blue Cross eligibility, entitlements, payments and reimbursements •Advising members on access points to timely coverage for needed top quality health care, treatments and travel preparedness. •Facilitating & creating training materials
•Conducting hearings in-person or by videoconference with participants in multiple locations. •Lead hearings with refugee claimants where information is canvassed appropriately, and procedural fairness and natural justice are respected. •Responsible for determining whether refugee protection claims made in Canada will be accepted or rejected. •Planning, and preparing for refugee claim hearings in a timely manner. •Use of effective questioning techniques in hearings - including depth, breadth, focus and neutrality of questions. Members also possess a strong ability to listen actively, respond effectively and adjust lines of questioning as the hearing progresses. •Responsible for crafting decisions in a timely manner that clearly explain to refugee claimants the reasoning for decision; including analysis of complex facts and the application of relevant law and guidelines. •Apply analytical skills to administrative tribunal principles, relevant legislation, rules and other policy instruments to understand interlocking facts and determining guidelines most appropriate to the case. •Dealing professionally and compassionately while utmost respect to all parties in the hearing room. upholding the Public Service Values and showing the •Managing voluminous files and exhibits in the form of physical or digital files.
Barrister and Solicitor Licensing Examinations
•Supervised the student social worker candidates. •Needs clarification and requests assessment, working collaboratively to support Volunteer Program and ensure resolutions in alignment with strategy and objectives. •Managed Volunteer experience: including recruitment, interviews, orientations, AODA, sector screenings, reference checks, work placements and reporting. Addressed phone, email & person-to-person inquiries. •Coordinated, lead, facilitated and evaluated Volunteer Events/programs, provided oversight to operations of special projects and activities, liaised with volunteers, key stakeholders, senior management and the public. •Copy editing; developed website content for consistency of message; collated and reviewed materials for development and refinement. •Performed administrative tasks, including investigations, research, audits, maintaining key stakeholder relations, reconciliations and volunteer consultations; ensured preparation and processing of documents in accordance with guidelines and regulations.