Highly self driven and motivated, bilingual English and Spanish with over 10 years experience in administrative healthcare. Excellent customer service and multi tasking skills, with ability to interact at all levels of staff and management. Ability to perform effectively in a variety of settings with minimal supervision. Works with a great sense of Time management.
Skills
Over ten years of professional healthcare administrative and Case Management experience.
Case Management department member Care Coordination support.
Experience working with Senior and behavioral health population
Microsoft Office
Insurance form /Computer Billing Anatomy/Medical Terminology
First Aid
Bed Mobility
Gait Training
Therapeutic Exercise
Transfer Training
Administrative, Microsoft Excel
Administrative support, Mail
Anatomy, Money
Agency, Microsoft Office
Assistant Manager, Outlook
Behavioral Health, Word
Benefits, Works
Billing, Office Manager
Case Manager, Pricing
Case Management, Problem resolution
Citrix, Coding
Continuous improvement, Speaking
Credit, Quality
Clients, Reporting
Database, Risk Assessment
Documentation, Safety
Electronic Health Records, Sales
English, Scheduling
Filing, Self-motivated
Financial, Spanish
First Aid, Supervising
Forms, Teaching
Home Health, Team work
Insurance, Phone
Leadership, Tender
Machinery, Transportation
Director, Type
Clinical support
Medical Terminology
Meetings
Electronic medical records management
Medical data management
Medical terminology specialist
Customer database management
Interdepartmental activity management
Business operations management
Delivery timeline management
Administrative management abilities
Research data management
Updating medical charts
Efficient time management
Experience
12/2002 to Current
Medical Management Specialist IIAnthem, Inc. – Fayetteville, AR,
Works direclty with Deparment Manager and Director to provide non-clinical support for department operations.
Conducts initial review of files and reports to determine appropriate acion required.
Maintains and updates tracking database
Prepares reports and documents all actions.
Maintenance of team Outreach tool.
Responds to requests, calls or correspondence within scope.
Monitor and ensure compliance date by Medicare guidelines are met for Health Risk assessment outreach as necessary in a timely manner..
Analyze departmental documents for appropriate distribution and filing.
Verified data integrity and accuracy.
Collaboration with Case Management Director in reviewing State Summary of benefits member booklet and Annual Notice of Change and recommending and advising on additional changes or updates to be made as needed.
Create, revise, update department Job Aides as needed.
May review and assist with cases.
Acts as Duals Case Management department liaison between Duals Case Management operations and other departments to support ease of operations.
01/2015 to 02/2017
Health Risk Assessment Outreach AssociateLandmark Health – Dayton, OH,
Health Risk Assessment Outreach team responsibilities focused on maintaining team work baskets.
Ensuring all cases are out reached accurately and in a timely manner.
Tracking, verifying and outreaching to members with annual anniversary dates to ensure they are scheduled on time for annual health exam.
Ensuring compliance date is met by outreaching to members and completing Health Risk Assessment Questionnaire as necessary.
Provides team support on special projects as needed and required to fulfill agency needs.
Individual administrative responsibilities include providing top level administrative support to Regional manager, by working directly with Regional manager, coding department and care centers for proper update and maintenance of Patient Annual Health Assessment reports submitted by various care centers.
Reviewing Patient Annual Health Assessment forms for accurate completion.
Accurately process daily review of Hospital admittance census report and report back to appropriate team.
Verify members on census report have had annual exam and/or Health Risk Assessment questionnaire completed within calendar year.
Submit updates to case management department to follow up on all necessary members for Health Risk Assessment outreach.
12/2002 to 02/2017
Care Coordinator LeadPocatello/Chubbuck School District 25 – Pocatello, ID,
Collaboration with Registered Nurse Case Manager with Coordination of member healthcare.
Working closely with Registered Nurse Case Manager, assisting with Care coordination for member including but not limited to scheduling any necessary medical appointments and transportation as needed.
Updates all necessary case Management team members with member's Care status, medical condition, appointments and all other additional support needed.
Prepares as requested member Individual Care plans along with any other requested case Management documentation for member and mail out to corresponding member in a timely manner.
Updates and completes documentation in case Management database.
Creating, reviewing, verifying all required documentation is included with each Home Health order for proper processing in a timely manner.
Maintenance of team Outreach tool.
Tracking, verifying and outreaching to members with annual anniversary dates to ensure they are scheduled on time for annual health exam.
Monitor and ensure compliance date by Medicare guidelines are met for Health Risk assessment outreach as necessary in a timely manner.
Weekly productivity reports and reporting to Leadership Team.
Analyze departmental documents for appropriate distribution and filing.
Verified data integrity and accuracy.
Create, revise, update department Job Aides as needed.
Serves as Duals Case Management department point of contact Subject matter expert.
06/2007 to 01/2015
Program SecretaryPacific Clinics – City, STATE,
Program secretary for three different programs for Behavioral Health Outpatient clinic providing administrative support to the Adult Outpatient Program, Cal-works Homeless Program and Full Service Partnership program.
Assist consumers with appointment scheduling, follow up, and rescheduling as necessary.
Knowledge in PATS and IS county system.
Prepare intake packages with all necessary and required documents for new consumer.
Monthly medical eligibility verification accurately and in a timely manner.
Updating Payor Financial Information and all other required updated information on a monthly basis And in a timely manner.
Knowledge in Medical and Medicare eligibility.
Process checks and order summaries for clients enrolled in the Cal-works Homeless Project program.
Preparing DMH forms and paperwork for fund reimbursement and submitting in a timely manner.
Provides administrative support and coverage at other programs and locations as needed/requested including but not limited to Office Manager Coverage.
During office manager coverage, responsible for review of current open position applicants and selecting best suited candidates for position.
Responsible for scheduling and coordinating interviews.
Worked in a multicultural team sensitive to the cultural and linguistic of the clients and families served.
Attended trainings and meetings as needed and required.
Assisted with providing support to Officer Manager with daily operational functions.
Copied, logged and scanned supporting documentation.
Analyzed departmental documents for appropriate distribution and filing.
Education and Training
Expected in 2004
Technical Diploma: Physical Therapy Aide ICDC College - Huntington Park, CA GPA:
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