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patient advocate eligibility and enrollment special resume example with 20+ years of experience

Jessica Claire
  • Montgomery Street, San Francisco, CA 94105 609 Johnson Ave., 49204, Tulsa, OK
  • H: (555) 432-1000
  • C:
  • resumesample@example.com
  • Date of Birth:
  • India:
  • :
  • single:
  • :
Professional Summary

Multi-talented patient advocate consistently rewarded for success in planning and operational improvements. Experience in policy development and staff management procedures positively impacting overall morale and productivity. Experienced Patient Advocate adept at conflict resolution, time management and relationship building. Resourceful Patient Advocate offering 5 years of hospital experience. Versed in collaborating with insurance companies and completing paperwork. Passionate about patient care.

Work History
Patient Advocate/Eligibility and Enrollment Special, 03/2020 - Current
Klamath County Oregon Klamath Falls, OR,

Responsible for screening self-pay patients at hospital bedside for eligibility in various government and non governmental programs. Responsible for identifying all sources of potential payors including auto insurance, workers compensation, commercial insurance, private insurance, private insurance, private insurance, TPL, etc. to route account appropriately in the Patient Accounting environment. Also responsible for obtaining and and completing the Confidential Financial Statement form and assisting patients in the process of applying for any benefits for which they may be eligible.

Conducts interviews with patients and/or family members, records and maintains complete documentation of activities performed on account while in-house and during the patient accounting cycle. Performs financial clearance function including collections. Cancels accounts that have not had any patient cooperation and are not eligible for any other programs that prepares accounts for Financial Assistance review. Follows up on MECS assigned accounts to ensure follow-through on Government application submitted. Develops a working relationship with patients, based on good communication skills, enabling accounts to be processed quickly with government program eligibility. Conducts field visits to patient homes for skiptracing and or assisting patient with documents.

Conducts field visits to patient homes for skipracing and or assisting patient with documents. Notifies hospital case management, social services and admissions staff of case screening determinations and outcomes via verbal and written communication.

Work as a community Partner assistor with the Oregon Health Plan, applying for and filing an application on the ONE Portal. Licensed and trained yearly to navigate the healthcare market place.

Act as outreach coordinator working with medical providers, facilities, drug and alcohol program facilities, teen crisis homes, battered persons, clinics and medical providers to provide OHP applicant assistance.

Assist patients with completing and filing facility financial assistance program.

Equipment and Fire Watch, 05/2014 - 10/2020
Grayback Forestry City, STATE,
  • Remained flexible in rapidly changing environments and adapted to developing situations.
  • Answered alarms, investigated disturbances and contacted law enforcement personnel to escalate crises.
  • Worked independently and collaboratively to resolve urgent issues to protect lives and property.
  • Prepared regular written logs and incident report at close of each shift for distribution to Private mill companies .
  • Recorded observations and occurrences and interviewed witnesses to complete and submit incident report.
  • Secured premises and personnel by patrolling property and monitoring surveillance equipment.
  • Provided basic first aid and CPR to individuals in need of medical care until arrival of emergency medical personnel.
  • Remained calm, assertive and mindful to think critically and problem solve during stressful situations.
  • Responded quickly to emergency situations to assess and deflect issues.
  • Placed necessary outgoing calls to verify alarms, dispatch proper authorities and notify proper parties.
  • Drafted reports of property damage, theft, accidents and unusual occurrences to document daily activities and irregularities.
  • Greeted guests professionally and courteously to cultivate welcoming atmosphere while making safety top priority.
  • Reported irregularities such as fire and safety hazards to maintenance.
Case Manager, 01/1997 - 10/2011
State Of Oregon Self Sufficiency (DHS) City, STATE,

Participated in the development of the Medical assessment program, long and short range plans to meet the state and federal program goals for JOBS program goals for the JOBS program and in integrated team meetings to assist TANF program clients. Interpreting state rules and policy manuals for all programs, Cash assistance(TANF), Food stamps, Oregon Health Plan, MAA/MAF- Welfare assisted medical, OFSET/Jobs programs. Determine all program eligibility for listed programs. Determine eligibility for the State family Pre-SSI/SSDI program, which included working with the Douglas County Health Department Nurse in order to obtain and analyze medical,psychological,social,vocational and other data as part of this process. Employment related child care program, case development and direction through TANF program. This included but not limited to, developing case plans, case plan narration, budgeting, to assist clients in meeting short and long term goals. Issuance of TANF payments through the State of Oregon's JASR system. Coordinate services with other DHS staff, community sources and contracted staff to develop a plan to meet the clients financial, medical and other service needs. work with a multiple of clients with physical/emotional needs, while keeping a stress free environment. I have responded to applicants and client concerns and any grievances they may have. I have been responsible for responding to community complaints, fraud reports by making home visits, completing forms for over-payments, working with the fraud investigator and reporting the outcome to ou local branch manager. I have met with several community partners to enhance human service programs through providing additional access to clients

Skills
  • Patient and family interaction
  • Reading and writing specialist
  • Patient assistance and service
  • Patient care standards
  • Patient education and advocacy
  • Special needs understanding
  • Patient education and counseling
  • Maintaining standards
  • Enrollment requirements
  • Special event promotion
  • Medicare and Medicaid eligibility
  • Following up with patients
  • Policy compliance understanding
  • Patient assessment and diagnosis
  • Hospital inpatient and outpatient records
  • Patient and family education
  • Special instructions understanding
  • Patient support and advocacy
  • Family and patient education
  • Enrollment and claims procedures
  • Contracting policies and regulations
  • Patient-focused quality service
  • Budget and records management
  • Open enrollment procedures
  • Business requirements understanding
  • Quality Standards
Education
High School Diploma: , Expected in 06/1983
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South Umpqua High School - Myrtle Creek, Oregon,
GPA:
Status -
Associate of Arts: Accounting, Expected in
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Colorado State University - Englewood, CO
GPA:
Status -
Associate of Arts: Business Management, Expected in
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Umpqua Community College - Winchester,
GPA:
Status -

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Resume Overview

School Attended

  • South Umpqua High School
  • Colorado State University
  • Umpqua Community College

Job Titles Held:

  • Patient Advocate/Eligibility and Enrollment Special
  • Equipment and Fire Watch
  • Case Manager

Degrees

  • High School Diploma
  • Associate of Arts
  • Associate of Arts

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