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ASSISTING MEMBERS
Core Qualifications
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Experience
Assisting members
January 2014 to CurrentCuesta College － San Luis Obispo , CAChicago, IL Health Resource Navigator Serving as part of pediatric care coordination team. Providing outreach to participants and families with regard to program parameters. Advocating for members through ensuring access to necessary services and supports. Resolving member concerns, complaints and grievances. Assisting members/guardians in the successfully mastering of skills needed for self management of condition(s).
January 2014 to CurrentCuesta College － San Luis Obispo , CAChicago, IL Health Resource Navigator Serving as part of pediatric care coordination team. Providing outreach to participants and families with regard to program parameters. Advocating for members through ensuring access to necessary services and supports. Resolving member concerns, complaints and grievances. Assisting members/guardians in the successfully mastering of skills needed for self management of condition(s).
Patient Accounts Liaison/Administrative Assistant/PT Assistant
January 2010 to January 2014Amerihealth Caritas Health Plan － Southfield , MI*Hybrid position for the Department of Occupational and Physical Therapy* Patient Accounts Liaison Developing and implementing systems to review and analyze denied claims Identifying and tracking key reasons for denials Serving as a resource to department staff and patients/families to address complex financial or insurance circumstances Acting as corporate liaison to health benefits organizations on behalf of the department to resolve insurance issues Identifying patients needing financial counseling and referring to Business Associates Ensures all Medicaid, EI and DSCC applications for clinicians are completed and processed. Reviewing coding and billing questions and requesting rebilling as appropriate to assist with customer satisfaction. Using computer systems reports to monitor and maintain accuracy of billing documentation and referral module documentation Administrative Assistant Provided clerical and administrative support to the Director of PT/OT Assisted in preparation of operating and capital budgets, and monitored expenses Worked closely with Information Management as liaison land technical support for leadership staff Performed human resource functions including job requisitions, new hire and existing staff documentation, performance appraisal submission Performed other duties as assigned Physical Therapy Assistant Assisted physical therapist in multidisciplinary Juvenile Dermatomyositis clinic in evaluating new and existing patients Performed intake of patient prior to being seen by PT and prepared instruments for use Assisted in muscle strength and endurance tests, and served as scribe for inputting information into the patients medical record
January 2010 to January 2014Amerihealth Caritas Health Plan － Southfield , MI*Hybrid position for the Department of Occupational and Physical Therapy* Patient Accounts Liaison Developing and implementing systems to review and analyze denied claims Identifying and tracking key reasons for denials Serving as a resource to department staff and patients/families to address complex financial or insurance circumstances Acting as corporate liaison to health benefits organizations on behalf of the department to resolve insurance issues Identifying patients needing financial counseling and referring to Business Associates Ensures all Medicaid, EI and DSCC applications for clinicians are completed and processed. Reviewing coding and billing questions and requesting rebilling as appropriate to assist with customer satisfaction. Using computer systems reports to monitor and maintain accuracy of billing documentation and referral module documentation Administrative Assistant Provided clerical and administrative support to the Director of PT/OT Assisted in preparation of operating and capital budgets, and monitored expenses Worked closely with Information Management as liaison land technical support for leadership staff Performed human resource functions including job requisitions, new hire and existing staff documentation, performance appraisal submission Performed other duties as assigned Physical Therapy Assistant Assisted physical therapist in multidisciplinary Juvenile Dermatomyositis clinic in evaluating new and existing patients Performed intake of patient prior to being seen by PT and prepared instruments for use Assisted in muscle strength and endurance tests, and served as scribe for inputting information into the patients medical record
Coordinator/Educator
January 2008 to January 2010Children's Memorial Hospital － City , STATECoordinating the scheduling of patients within the various hospital departments and clinics Interviewing patients and families to obtain insurance, demographical and other information prior to office visits, surgical procedures and admission, etc. Interfacing with representatives for the various health insurance agencies and third party billers to maintain current information on policies and regulations Providing high-quality, compassionate "front-line" customer service and assistance to patients, patient families, employees, vendors and other visitors to the hospital Confirming scheduled outpatient appointments, as well as appointments for departments that are receiving outside guests Screening incoming phone calls and transferring them appropriately Screening employees and ensuring that they have appropriate identification badges Collaborating with Security Services and other departments to maintain the safety of those in and around the hospital campus Maintaining appropriate levels of supplies Staff training, as needed Performed continuous quality improvement of injury prevention programs Provided trainings and seminars with a focus on safety and injury prevention Partnered with the Chicago Park District, the Chicago Public Schools, the Chicago Police Department and other civic groups to facilitate access underserved populations Tracked appropriate legislation through ongoing communication with state agencies Designed and developed marketing and public information materials addressing various injury prevention initiatives Served as a community liaison for Children's Memorial Hospital Implemented training course for new recruits
January 2008 to January 2010Children's Memorial Hospital － City , STATECoordinating the scheduling of patients within the various hospital departments and clinics Interviewing patients and families to obtain insurance, demographical and other information prior to office visits, surgical procedures and admission, etc. Interfacing with representatives for the various health insurance agencies and third party billers to maintain current information on policies and regulations Providing high-quality, compassionate "front-line" customer service and assistance to patients, patient families, employees, vendors and other visitors to the hospital Confirming scheduled outpatient appointments, as well as appointments for departments that are receiving outside guests Screening incoming phone calls and transferring them appropriately Screening employees and ensuring that they have appropriate identification badges Collaborating with Security Services and other departments to maintain the safety of those in and around the hospital campus Maintaining appropriate levels of supplies Staff training, as needed Performed continuous quality improvement of injury prevention programs Provided trainings and seminars with a focus on safety and injury prevention Partnered with the Chicago Park District, the Chicago Public Schools, the Chicago Police Department and other civic groups to facilitate access underserved populations Tracked appropriate legislation through ongoing communication with state agencies Designed and developed marketing and public information materials addressing various injury prevention initiatives Served as a community liaison for Children's Memorial Hospital Implemented training course for new recruits
Program Coordinator
January 2007 to January 2007The University Of Chicago － City , STATEOversight of the day-to-day operations of the Pediatric Immunization Program Managed a staff of two outreach workers Assisted with submissions to pediatric medicine and infectious disease publications Maintained relationships with the Chicago Department of Public Health and other funders, and identified other agencies with whom collaborations could be made Drafted potential program expansion budget Program development
January 2007 to January 2007The University Of Chicago － City , STATEOversight of the day-to-day operations of the Pediatric Immunization Program Managed a staff of two outreach workers Assisted with submissions to pediatric medicine and infectious disease publications Maintained relationships with the Chicago Department of Public Health and other funders, and identified other agencies with whom collaborations could be made Drafted potential program expansion budget Program development
Community Educator
January 2003 to January 2006Rehabilitation Institute Of Chicago － City , STATEPlanned and implemented injury prevention outreach to underserved populations Recruited and trained personnel to further the scope of outreach Collaborated with local and national agencies and groups to address the major causes of death and disability in the United States
January 2003 to January 2006Rehabilitation Institute Of Chicago － City , STATEPlanned and implemented injury prevention outreach to underserved populations Recruited and trained personnel to further the scope of outreach Collaborated with local and national agencies and groups to address the major causes of death and disability in the United States
Licensing and Recruitment Specialist
January 1997 to January 2000Catholic Charities － City , STATEDesigned and executed recruitment and public information campaigns Ensured adherence to the policies and procedures of the pertinent state authorities Made specific recommendations regarding suitability and placement of candidates and new recruits Coordinated staff of 5 workers for various campaigns
January 1997 to January 2000Catholic Charities － City , STATEDesigned and executed recruitment and public information campaigns Ensured adherence to the policies and procedures of the pertinent state authorities Made specific recommendations regarding suitability and placement of candidates and new recruits Coordinated staff of 5 workers for various campaigns
Certified Family Educator
January 1993 to January 1997Maryville Academy － City , STATEDesigned and implemented early childhood education, activity, treatment and occupational therapy plans for children ages birth through five years of age Provided training and support for recovering substance-addicted mothers Served as Weekend Assistant Program Manager Coordinated volunteer services training
January 1993 to January 1997Maryville Academy － City , STATEDesigned and implemented early childhood education, activity, treatment and occupational therapy plans for children ages birth through five years of age Provided training and support for recovering substance-addicted mothers Served as Weekend Assistant Program Manager Coordinated volunteer services training
Education
B.A. : EnglishLoyola University － City, State, USB.A., English, January 1993 Loyola University Chicago, IL
Masters : level courseworkUIC School of Public HealthMasters level coursework, UIC School of Public Health (non-degreed)
Certifications
Physical Therapy Assistant Certified Family Educator
Skills
Therapy, Training, Liaison, Access, Administrative Assistant, Administrative Support, Appraisal, Benefits, Billing, Budgets, Claims, Clerical, Coding, Documentation, Health Benefits, Medicaid, Performance Appraisal, Satisfaction, Scribe, Technical Support, Disability, Program Manager, Marketing, Recruitment, Pediatric, Interviewing, Scheduling, Customer Service, Outpatient, Receptionist, Retail Sales, Security, Staff Training, Budget, Infectious Disease, Operations, Public Health, Epic, Excel, Microsoft Access, Microsoft Excel, Microsoft Powerpoint, Microsoft Word, Ms Access, Powerpoint, Word
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Resume Overview
School Attended
- Loyola University
- UIC School of Public Health
Job Titles Held:
- Assisting members
- Patient Accounts Liaison/Administrative Assistant/PT Assistant
- Coordinator/Educator
- Program Coordinator
- Community Educator
- Licensing and Recruitment Specialist
- Certified Family Educator
Degrees
- B.A. : English
Masters : level coursework
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