Nila Baker

Direct and oversee the appeals process, ensuring compliance with federal, state, and organizational regulations. Develop, implement, and refine policies and procedures to improve accuracy, efficiency, and turnaround times for appeal reviews.

Managed all aspects of the appeal process related to the intake, triaging, coordination and documentation of all grievances, complaints and appeals within the department to promote consistency and accuracy. Maintained quality control processes to ensure all standards regarding the timely acknowledgement, resolution and documentation of process improvements when required.

Implemented, documented and maintained a coordinated legislative and regulatory expectations for building health plans. Documented department workflows and assess process to identify potential process improvements and efficiencies.

Scheduled patients for pre- and post-operative appointments with surgeon and educated patients about pre and post operative procedures. Worked directly with the physician to ensure accurate interpretation, coding and reimbursement if necessary.

Coordinated Medicaid services and applicants of SNAP benefits. Scheduled phone interviews for members who required recertifications for all government subsidies.

Structured and implemented innovative database to track, allocate, and integrate program requirements, task, and work units, leading to increased efficiency. Improved transmittal time for management to utilize timekeeping metrics.

Established and monitored staff schedules, made assignment sheets and monitored menus. Completed food and physical safety audits to verify health and well-being of staff members and patrons.

Assisted in keeping track of expenses and menu planning. Prepared patients’ meal trays per dietitian orders and delivered to designated areas.

Evaluated food production to check for portion control and health department food safety standards. Worked with dietitians to set menu options to meet patients’ dietary needs.

Pursuing a Doctor of Public Health degree, expected to continue beyond the current date.

Completed a Master of Health Administration degree from 2020 to 2023.

Earned a Bachelor of Arts in Hospitality Management from 2013 to 2017.

Earned an Associate degree in Culinary Arts from 2011 to 2013.