Patient Care Coordinator Resume Example
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PATIENT CARE COORDINATOR
Summary
IT Professional with background in Health Care. Strong technical proficiency with work history in health insurance. In-depth knowledge of Oracle coupled with trouble shooting and customer support capabilities. Proven history of strong work ethic, leadership and flexibility.
Skills
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Experience
Patient Care Coordinator06/2018 to CurrentTrihealth, Inc.Oxford , OH
- Served as advisory resource by providing patient and family care expertise in form of educational materials, videos and latest information from CDC.
- Liaised effectively with patients, doctors and staff members, assessing medical charts and promoting high level of communication and interaction.
- Submitted various medication requests electronically.
- Improved patient feedback by 60% in 2 years.
- Implemented new hire training to further develop skills and initiate discussions on task prioritization.
- Worked closely with store manager to maintain day-to-day operations.
- Ordered all supplies needed for pharmacy and kept tabs on inventory levels.
- Created and maintained facility documents and records, maintaining accuracy while managing sensitive data.
- Drove process, efficiency and quality improvements, resulting in 36% increase in patient discharge times.
- Added more than 82% in revenue between 2018 and 2019.
Provider Claim Analyst03/2015 to 06/2018Cancer Care NorthwestSpokane , WA
- Service areas of: CA, MO, KY, OH, GA, FL, IN, IL Coordination.
- Spearheaded claims negotiations up to $200K and contributed to litigation processes for unsuccessful settlements.
- Based payment or denials of medical claims upon well-established criteria for claims processing.
- Evaluated pending claims to identify and resolve problems blocking auto-adjudication.
- Tracked differences between plans to correctly determine eligibility and assess claims against benefits and data entry requirements.
- Documented file notes clearly and concisely in Oracle, Athena, and Kareo.
- Stayed current on HIPAA regulations, benefits claims processing, medical terminology, and other procedures.
- Efficiently and effectively processed a large volume of medical claims on a daily basis.
- Gathered and documented evidence to support authorization denials.
- Created master spreadsheet to record procedures, denials and approvals.
- Led training initiatives to optimize productivity.
- Worked closely with employees and managers at all levels.
- Handled and processed variety of claims, including Medical and Dental.
- Maintained 97% accuracy rate when preparing weekly spreadsheets and project reports for management based on data from various sources.
- Achieved high quality marks on quality assurance evaluations through 2018.
Health Information Specialist08/2014 to 03/2015Children's Hospital & Research CenterSan Leandro , CA
- Indiana Medicaid eligibility review via Manage Care.
- Vision, Dental, Pharmacy Benefit Coordination.
- Reimburse customers for payments made that should have been covered.
- Help with member appeals for denied claims, authorizations, and pharmacy authorizations.
- Explain coverage or denial of claim to inquiring members.
- Coordinating with Care Coordination, to schedule appointment and home visits.
- Upgraded medical record documentation system to meet federal and state regulations, continually monitored medical records and contacted physicians for deficient or delinquent data.
- Facilitated document import into electronic health records using variety of applications and workflows, executed scanning and indexing and organized patient records for quick reference.
- Addressed customer information requests promptly and courteously, maintained strict confidentiality and respect and identified potential improvements to inquiry response processes.
- Streamlined day-to-day office processes to meet long-term goals.
- Took part in meetings and committees to discuss such topics as electronic health records and communicate best ways to improve workflows.
- Entered patient insurance, demographic and health information into software and confirmed records.
- Set up patient charts and documented information in various company software.
- Pulled patient records and transferred information to appropriate parties.
- Logged all requests for medical records into spreadsheets.
- Assessed departmental operations to determine areas for customer service improvement and support.
- Drove quality customer experiences by leading retention strategy development and conflict resolution to improve overall support delivery.
- Trained new hires on relationship building, benefit-oriented sales presentations, sales processes and protocol, product knowledge, customer needs analysis and overcoming objections.
Pharmacy Technician03/2012 to 08/2014CVSCity , STATE
- Verified insurance benefits to refill medications by examining formularies and calling insurance companies for exceptions.
- Used 8-point check system to verify labeled prescriptions.
- Teamed with peers, technicians and other pharmacists to prioritize and complete orders.
- Efficiently responded to voicemails from healthcare providers and customers.
- Reviewed and monitored patient medication files and lab data in hospital setting.
- Trained new technicians to provide excellent customer service which resulted in higher customer satisfaction scores.
- Managed medication stocks, including conducting counts, labeling products and maintaining controls.
- Interpreted and processed medication orders under supervision of pharmacist.
- Improved drug inventory management procedures to reduce overhead and eliminate backorders or overstock.
- Received and verified daily incoming drug inventories, reported discrepancies and logged items into inventory system.
Education and Training
High School Diploma03/2012Pike High SchoolCity
- English/ Language Arts 8 credits Including a balance of literature, composition and speech.
- Mathematics 6 credits 2 credits: Algebra I 2 credits: Geometry 2 credits: Algebra I
- Science 6 credits 2 credits: Biology I 2 credits: Chemistry I or Physics I or Integrated Chemistry-Physics 2 credits: any Core 40 science course Social Studies 6 credits 2 credits: U.S. History 1 credit: U.S. Government 1 credit: Economics 2 credits: World History/Civilization or Geography/History of the World
- Directed Electives 5 credits World Languages
Certificate: Covid-19 Contract Tracing01/2021Johns Hopkins UniversityCity
- Bloomberg School of Health and courtesy of Bloomberg Philanthropies., the natural history of SARS-CoV-2 and case investigation: Johns Hopkins
- Coursework in Public Health, Epidemiology
- Volunteered at Julian Center
Certificate: Google IT Professional01/2021Coursera
- Course in: CompTIA A+, Network+ and Cyber Security+
- Professional Certificate is licensed under a Creative Commons Attribution 4.0 International License
- American Council on Education (ACE) ACE CREDIT®
- At&t Believe Scholarship Recipient 2020
Certificate: Network +Expected in 05/2021CompTIA
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Resume Overview
School Attended
- Pike High School
- Johns Hopkins University
- Coursera
- CompTIA
Job Titles Held:
- Patient Care Coordinator
- Provider Claim Analyst
- Health Information Specialist
- Pharmacy Technician
Degrees
- High School Diploma 03/2012
Certificate : Covid-19 Contract Tracing 01/2021
Certificate : Google IT Professional 01/2021
Certificate : Network + Expected in 05/2021
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