Mauricio Melinu

  • Miami FL

Seasoned communications professional with 5+ years of interpersonal skills, research experience and extensive knowledge of organizational and management abilities obtained from positions in media publishing, system administration, non-profit finance and healthcare management. Offering a unique combination of creativity and analytical skills with the ability to work confidently under pressure, assess effective solutions for employer, employees and client.

Work History

Work History
Jul 2012 - Feb 2014

Business Manager

Miami Jewish Health Systems CSD (Community Service Division)

Position of Business Manager is to ensure smooth back office operations and maintain the business aspects of the non-for profit agency successful. Roles being accomplished are a combination of System Administrator/IT, MIS/Data director, Vendor relations representative and Finance manager positions.

  • Selected as one of 5 Task Force members for data migration and transition to new case management software representing more than 80 users and all department functions.
  • Refine and maintain software application (GO! Systems- IBM Lotus Notes) functionality and database integrity for over 80 users across five databases.
  • Collaborated with software vendor to develop, test, and implement software enhancement projects saving ongoing staff hours with minimal programming costs.
  • Created more than 5 specialized views for purposes of reporting and data validation saving 40 hrs and $5,000 in software programming charges.
  • Provide technical assistance and serve as In-House tech support for staff of more than 80 people.
  • Assess business and clinical processes within software system. Made successful recommendations for system and process refinement decreasing task completion times.
  • Coordinate monthly schedule for seven adjudication staff and processing of bills for 600
  • Supervise staff of 3 adjudicators processing bi-weekly claims of over $1.3 Million
  • Review all vendor check requests and backup for accuracy; approve check requests for payment.
  • Perform weekly maintenance of views containing data exceptions. Review data for accuracy.
  • Use GO! Systems-IBM Lotus Notes, ACCESS, and Crystal reports to gather revenue and expense information for programs with yearly budgets over $24 million.
  • Prepare and submit monthly and/or quarterly reports for Department of Elder Affairs (DOEA), CSD Staff, and MJHS Accounting Department as required by state contracts.
  • Revenue procurement exceeding $24 million for three Medicaid related programs in one year. Review payments worth $2.2 million a month for three grant programs.
  • Ensure accurate monthly capitation reimbursement for more than 1900 program enrollees, prepare monthly reconciliation report of claims paid and submit report to Dept. of Elder Affairs. Generate/submit monthly enrollment and disenrollment files (834 format) to Dept of Elder affairs for more than 900 enrolled clients. Create/submit 837P files for 3 programs (Channeling, Project Independence, Douglas Gardens Comm. Care) for capitation and fee-for-service reimbursements from DOEA and grant programs.
  • Review, research and correct denials on monthly Remittance Advice, decreasing denials from $282k denials monthly to $17k of denials.
  • Maintain Aging Report for open AR; discussed status and recommended course of action with Supervisor to decrease $3 Million owed for two programs to less than current open AR of $245,000, collecting in total more than $2.75 million. 
Dec 2011 - Jul 2012

Communications Coordinator

United HomeCare
  • Website Administrator in charge of maintenance and routine error checking, updated content, and managed overall access to the website averaging 100+ hits daily.
  • Created more than 20 different marketing materials including design, layout, creation printing, proofreading and article writing saving the company more than 200 hours of outsourced work
  • Posted for, monitored and maintained company’s social media presence.
  • Supported development of company intranet
  • Contributed to research, writing, proofreading and producing publications in more than 15 different outlets (some including, Constant Contact Emails, So Fla Hosp. News, Miami Today, Miami Dade Parks Flyer, LightHouse for the Blind Fundraising Program, Claude Pepper Program)
  • Monitored and made recommendations on analytical reports (website traffic, hits)
  • Designed more than 40 advertisements and coordinated adherence to exact advertisement specifications with more than 10 publishers and editors
  • Developed promotional materials for special functions and events including the Annual Claude Pepper Dinner fundraising event that brought over $60,000 in donations.
  • Completed product research for websites and domain names, strategic sponsorships and advertising, acquiring stock images and creating templates for internal & external marketing
  • Routinely updated PowerPoint presentations and media on four flat panel screens at office site
  • Coordinated writing, editing, production and distribution of monthly newsletter to over 80 employees
  • Managed over 300 contacts, internal electronic folders and files for agency partners, vendors, donors, and community sponsors.
Jan 2007 - Dec 2011

Claims Adjudication/QA

United HomeCare
  • Responsible for vendor billing and payment of approximately $800,000/month
  • Ensured that all billing from subcontracted providers was accurate, followed authorized plan of care for over 1500 clients and eliminated possible fraudulent charges.
  • Maintained information in agency database for over 700 vendors including pay-rates, service provider listing and contact information, billing codes, services and insurances.
  • Reviewed, coded and processed more than 150 hospital claims for allowable payment
  • Processed and printed Explanation of Benefits for subcontractor payments bi-weekly
  • Created, updated and trained more than 300 vendors on the billing requirement forms and processes.
  • Attended to at least 35 daily calls for claim status and worked with providers to resolve billing issues.
  • Participated as member of the 15 person implementation and testing team for new agency-wide software for more than 80 daily users; successfully deployed software in 12 months.
Jan 2008 - Dec 2008

Miami Herald

City Desk Clerk
  • Worked on candidate background, candidate platforms, community impacts coverage for the 2008 Presidential Primaries, Local Elections & Presidential Election
  • Wrote more than 10 breaking news updates and briefs for the Miami Herald online
  • Assisted staff of over 30 General Assignment and night reporters in research and collecting quotes
  • Monitored evening newscasts across all local broadcast networks (English and Spanish) and five additional emergency services websites for local breaking stories
  • Wrote featured obituaries for the Metro Section
  • Responded to over 20 daily phone calls for potential story tips
  • Distributed press releases to appropriate staff of over 100 beat reporters and editors


Apr 2008

Bachelor of Science in Communications

Florida International University

Primary Concentration in Print Journalism, Minor in History

Dec 2005

Associate in Arts

Miami Dade College

Primary Concentration in Communications