Dedicated and highly motivated employee known for punctuality, pursuing employment options where great customer service and positive attitude will make a difference. Case Manager well-versed in performing diverse administrative functions and great business acumen. Positive and upbeat team player with good communication and time management abilities. Demonstrated extreme attention to detail with accuracy. Meticulous in adhering to policies and protocols, handling confidential information, with quality driven skills. Strong worth ethic, adaptability and exceptional interpersonal skills. Adept at working effectively unsupervised and quickly mastering new skills. Seeking opportunities to expand skills while facilitating company growth.
Skills
Recording histories
Medical filing
Patient interviewing skills
Medical billing
Appointment scheduling
Insurance company knowledgeable
Solution implementation
Medical terminology expertise
Authorization verification
Insurance information collection
Reimbursement Services
HIPAA compliance
Analytical decision-making skills
Case/Account Management.
Program Development
Documentation and Reporting
Data Entry and Analysis
MS Office, Excel, Teams, and SharePoint
Calm Under Pressure
Organization and Multitasking
Operational Support.
Utilization Management
Verbal and Written Communication
Email and Telephone Etiquette
Experience
01/2023 to Current
Case Manager (Remote)Children's Memorial Hospital – Westchester, IL,
Maintained up-to-date case records with case activity status.
Provided case management services including intake, assessment, crisis intervention, advocacy, referral and monitoring of families.
Maintained logs and electronic client records following department and agency policies for effective monitoring.
Assisted individuals with eligibility for available benefits.
Adhered to ethical principles and standards to protect clients' confidential information.
Participated in regular team meetings and in-house training sessions to boost group effectiveness.
Applies HIPAA privacy and security regulations while handling patient information.
Applies all company policies and procedures to provide resolution to issues.
Verifies demographics and insurance information for registration in computer system.
Organizes and maintains records by updating and obtaining both personal and financial information from patients and providers
Obtains necessary signatures for privacy laws and consent for treatment.
Applies knowledge of payer requirements and utilized on-line eligibility systems to verify patient coverage and policy limitations.
Calls insurance companies and verifies patient coverage.
Updates reference materials with Medicare, Medicaid and third-party payer requirements, guidelines, policies and list of accepted insurance plans.
Initiated application processes to add patients to assistance programs and followed through until completion.
Received patient or provider inquiries or complaints and directed to appropriate staff members.
Assists with Prior Authorization Processes and Appeal Coordination.
Intake reports of Adverse Events
Processes any new or aged correspondence.
Billing and Coding support.
Assists with coordination of internal and external services to ensure all services are performed within program policy and within service level agreements.
12/2021 to 01/2023
Patient Access Specialist (Remote)Capital Health – Columbus, NJ,
Applies HIPAA privacy and security regulations while handling patient information.
Applies all company policies and procedures to provide resolution to issues.
Verifies demographics and insurance information for registration in computer system.
Organizes and maintains records by updating and obtaining both personal and financial information from patients and providers
Obtains necessary signatures for privacy laws and consent for treatment.
Applies knowledge of payer requirements and utilized on-line eligibility systems to verify patient coverage and policy limitations.
Calls insurance companies and verifies patient coverage.
Updates reference materials with Medicare, Medicaid and third-party payer requirements, guidelines, policies and list of accepted insurance plans.
Initiated application processes to add patients to assistance programs and followed through until completion.
Received patient or provider inquiries or complaints and directed to appropriate staff members.
Assists with Prior Authorization Processes and Appeal Coordination.
Intake reports of Adverse Events
Processes any new or aged correspondence.
Billing and Coding support.
Assists with coordination of internal and external services to ensure all services are performed within program policy and within service level agreements.
09/2020 to 12/2021
Medical Assistant IISpectrum Health – Wayland, MI,
Served as lead Medical Assistant for team about day-to-day workflow issues or office procedures.
Administration of injectable medications and immunizations by applying aseptic techniques.
Collection of patient specimens, adhering to proper handling of specimens to ensure quality and correct laboratory results.
Relayed messages from patients to physicians about concerns, condition updates or refill requests to facilitate treatment.
Interviewed and engaged patients to obtain medical history, chief complaints and vital signs.
Maintained inventory, vaccination and product expiration logs to record updated documentation for tracking purposes.
Completed lab requisitions using ICD coding.
Trained new team members.
09/2016 to 09/2020
Advanced Patient Care TechnicianDepartment Of Defense – Little Rock Air Force Base, AR,
Point of Care Testing and Glucose Monitoring
Knowledgeable of Basic Arrhythmias andConducted EKG testing
IV Insertion & Phlebotomy
Knowledgeable of Power Chart, First Net, Epic softwares.
Documented patient intake and dietary requirements and aided with feeding and monitoring.
Obtained patient vital signs and reported results to staff nurse or physician to identify changes from prior measurements.
Delivered outstanding patient care based on physical, psychological, educational and related criteria.
Trained new team members.
Worked closely with Clinical Directors regarding various projects Involving improving Patient and Employee experience.
Served as Co-Chair for the UPMC East Nursing Support Staff Council.
02/2016 to 07/2016
Sales AssociateCompany Name – City, State,
Helped customers find specific products, answered questions and offered product advice.
Trained new team members in cash register operation, stock procedures and customer services.
Arranged new merchandise with signage and appealing displays to encourage customer sales and move overstock items.
Built and maintained relationships with peers and upper management to drive team success.
Engaged customers in friendly, professional dialogue to determine needs.
Education and Training
Expected in 01/2015
High School Diploma: Pennsylvania Cyber Charter School - , GPA:
Honor Roll 2015
Expected in
: Health Management And Clinical Assistance CCAC (Community College of Allegheny County) - , GPA:
Completed coursework in Microbiology, Algebra, English Literature, Anatomy and Physiology I and II.
Expected in
: UPMC Schools of Nursing - , GPA:
Completed coursework in Clinical Studies, Pharmacology, and Ethics.
Any information uploaded, such as a resume, or input by the user is owned solely by the user, not LiveCareer. For further information, please visit our Terms of Use.