Personable, dedicated and highly motivated staff member with extensive experience in the healthcare industry. Positive attitude and proven skill in establishing rapport with patients. Very organized with a strong work ethic, adaptability and exceptional interpersonal skills. Strong leadership and planning abilities.
Skills
Work Planning and Prioritization
Training and Development
Documentation and Reporting
Managing Operations and Efficiency
Team Leadership
Scheduling and Coordinating
Professional and Courteous
Demonstrated ability to manage projects and work independently to develop creative solutions to ongoing complex issues/challenges
Strong computer skills in Microsoft systems, including Word, Excel and Power Point
Ability to complete thorough research.
Organization.
Teamwork.
Database management.
Understanding of laws, regulations and procedures.
Computer proficiency.
Familiarity with medical terminology
HIPAA Guidelines
Insurance Billing
Patient Data Coding
ICD-10 Coding
Experience
04/2019 to Current
Credentialing ManagerE Cancercare – El Centro, CA,
Perform ongoing research to correct data so it does not create duplicate provider, locations, payees, and participation
Keep up to date provider enrollment process and records and track provider participation levels
Maintains Provider enrollment files, applications, contracts and all updates.
Performs primary source verifications such as Medical License, DEA License, Malpractice Insurance, APRN Protocol, NPI license and Board Certifications.
Processes incoming provider applications and maintains existing contract and credentialing documents to ensure records and documents are complete, accurate and compliant with regulatory agency and corporate requirements.
Establishes productive relationships with medical providers and office staff to facilitate prompt integration into company network.
Communicated with patients with compassion while keeping medical information private.
Directed, supervised and evaluated medical, clerical or maintenance personnel.
Built work schedules and staff assignments, taking workload, space and equipment availability into consideration.
Planned and led team meetings to review business results and communicate new and ongoing priorities.
Resolved customer inquiries and complaints requiring management-level escalation.
04/2019 to Current
Quality SpecialistAaipharma – Saint Louis, MO,
Established solid relations with leadership and staff by attending board meetings and coordinating interdepartmental information exchanges.
Maintain records management system to process personnel information and produce reports.
Maintain awareness of government regulations, health insurance changes and financing options.
Communicate with patients with compassion while keeping medical information private.
Track and report clients' progress based on observations and conversations.
Communicate with patients' family members and friends to answer questions and explain care tasks.
Monitor individuals to identify and address specific care needs.
Record vital signs, weight and patient information in electronic health records system.
Coordinate care with physicians and other healthcare professionals.
Compiles quality data to capture metrics
Attends Quality meetings and seminars
Uses quality monitoring data management systems to compile and track performance at team and individual levels.
10/2001 to 04/2019
Front Office Manager/Referral CoordinatorRafael J. Aguila, M.D. – City, STATE,
Answered phones to respond to patient inquiries and transferred calls to appropriate staff members.
Reviewed completed work to verify consistency, quality and conformance.
Recruited and trained new employees to meet job requirements.
Reviewed safety, health and sanitation processes throughout areas and enforced rules to promote security and safety.
Remained calm and professional in stressful circumstances and effectively diffused tense situations.
Monitored office inventory to maintain supply levels.
Mediated conflicts between employees and facilitated effective resolutions to disputes.
Responded proactively to concerns and questions by acting on patient feedback.
Coordinated care with physicians and other healthcare professionals.
Corresponded with patients through phone, fax, email and in person to schedule appointments and answer inquiries.
Transmitted medical records and other correspondence by mail, e-mail, or fax.
Prepared reports, invoices, letters, or medical records using word processing, spreadsheet, or other software applications.
Arranged hospital admissions for patients as required.
Scheduled tests, lab work or x-rays for patients based on physician orders.
Compiled and coded patient information or data in appropriate computer system.
Managed front office staff members, appointment management, billing and administration tasks to streamline workflow.
Scheduled evaluations and procedures for patients.
Education and Training
Expected in 07/2010 to to
: Medical Billing And Coding Health Tech of Georgia - Warner Robins, GA, GPA:
Expected in 2000 to to
High School Diploma: James Madison High School - Atlanta, GA, GPA:
Expected in to to
: Health Administration Georgia Military College - Milledgeville - Warner Robins, GA, GPA:
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