Highly successful Program Specialist proficient at executing financial administration, reporting and scheduling functions. Strong leadership and interpersonal communication abilities with expertise in working with teams of professionals in high-volume settings.
Skills
Group and individual instruction
Performance assessments
Skill Development
Data management familiarity
Financial administration
Client records management
Persuasive communication style
Vendor management
Generating schedules
Education
Delta CollegeBay City, MIExpected in ā ā: - GPA:
Davenport UniversitySaginaw, MI, Expected in ā ā: - GPA:
South Side High SchoolFort Wayne, INExpected in 06/1990 ā āHigh School Diploma: - GPA:
Work History
Temple University - Program Specialist Philadelphia, PA, 04/2003 - Current
Acts as a liaison between our hospital and at least five different VA facilities, as well as private facilities to coordinate treatment requests for up to 150 consults weekly
Ensures eligibility for VA medical care is met and accompanies each consult/fee basis request. If eligibility is not met, or if information submitted is insufficient to make this determination, so informs the appropriate party
Serves as primary contact with medical staff in advising them of eligibility determinations, to include the concept of medical versus legal eligibility and advising them of alternative resources such as fee basis or community referrals
Receives numerous telephone inquiries. Uses proper telephone etiquette, being courteous at all times, for a wide array of questions and problems. Screens calls for physicians , initiates Reports of Contact, when necessary, and completes follow-up action. Frequently receives unclear inquiries, determines the nature of the call and responds appropriately
Submits consults from Saginaw to other VA facilities to include eligibility and necessary medical information, when required
Reviews the medical content of each consult and ensures the referral is appropriate as addressed, then either schedules to correct clinic, arranges admission, or sends for review by clinic directors, according to established guidelines
Obtains information on changes in laws and regulations which impact basic veterans' medical benefits entitlement
Is constantly alert to medical content of consults and physicians' orders so that appropriate action is taken concerning urgency, and follows through by coordinating correct action and notifying veteran. Reviews each referral for geographic location of veteran's primary residence and coordinates final referral to nearest appropriate VA medical facility
Incumbent manages and coordinates fund control point activities for the fee-basis services, contract hospitalization, homemaker/health aid, beneficiary travel, and CBOC activities
Maintains a current knowledge of policies and procedures, and is available for questions and problems which arise daily
Follows-up on problems, looking for and presenting solutions to the supervisor. Coordinates the needs of the Clinical Services and prepares recommendations for hospital management's coordination
Is well versed in all VISTA functions and performs satisfactorily as required by the position
Assists in orienting and advising physicians in VA regulations, policies, and procedures on patient care in regard to administrative matters
Responsible for quality, accuracy, and timely submission of all assigned reports. Reports are recurring and nonrecurring and require manual tracking methods to ensure validity. Assists in preparation of congressional correspondence and other reports, as requested
May be delegated to perform special duties or tasks by the Supervisor. Must have a thorough knowledge of current and amended regulations and be able to apply this knowledge to available records.
Thorough knowledge of VA procedures as well as technical knowledge of the purpose and functions of all services within the hospital and satellite clinics
Knowledge of the organization of the patient's medical records necessary to assemble and disassemble records, file test results, retrieve needed information, and to review records for completeness and accuracy by other members of the patient care team
Knowledge of a wide variety of forms is required
Knowledge of medical terminology pertaining to various tests and procedures and specialty consultants in order to interpret doctors orders. Doctor's orders are frequently illegibly written, abbreviated, or incomplete and usually deciphered independently by the incumbent in their absence. Therefore, a functional knowledge will enable incumbent to skillfully interpret and transcribe intent
Must have knowledge of geographic location of cities/town within Michigan in order to accept/submit referrals to nearest appropriate VAMC and to coordinate appointments more efficiently
Incumbent must be a qualified typist and become intricately familiar with the use of computers with knowledge/skill in all functions required in the performance of duties
In the performance of official duties, employees have regular access to printed and electronic files containing sensitive data, which must be protected under the provisions of the Privacy Act of 1974 and other applicable laws, federal regulations, VA statutes and policy, and VHA policy. The employee is responsible for (1) Protecting the data from unauthorized release or from loss, alteration, or unauthorized deletion and (2) following applicable regulations and instructions regarding access to computerized files, release of access codes, etc., as set out in the computer access agreement which the employee signs
Must have strong interpersonal skills, as specialized skills are required for maintaining customer relations and monitoring timeliness of service. Interacts with peers and/or internal and external customers in a manner that portrays a positive image of Service and facility. Tact and professionalism will be maintained at all times
Worked alongside other professionals to outline and implement program plans and objectives
Department Of Veterans Affairs - Patient Services Assistant Billings, MT, 06/2002 - Current
Reviewing first party receivables
Collecting, compiling and/or tracking of data and program information in support of revenue
Preparing, executing and/or tracking revenue program specific information
Organizing and retrieving computerized data, generating reports of data, reviewing data for inconsistencies and referring to appropriate area for completion
Entering information into tracking system and maintaining accurate program specific data for maximum reimbursement
Conducting proactive accounts receivable follow up and analysis on various account receivables
Responsible for the coordination of billing of worker's compensation or tort cases
Providing patient education and assistance concerning Medical Care Cost Fund Program
Providing answers to customer service inquiries regarding accounts receivable, means and co-payment testing and health insurance related issues
Reviewed and corrected claim errors to facilitate smooth processing
Performed duties in accordance with all applicable standards, policies and regulatory guidelines to promote safe working environment
Aleda E Lutz VAMC - Release of Information Clerk/Switchboard Operator City, STATE, 01/2001 - Current
Obtained veteran permission and signatures to release information to the veteran or send results or medical records to outside facilities or providers
Ensured we had the proper authorization to release information to outside entities to include lawyers or insurance companies
Reproduced protected health information by using variety of technologies, including, data extraction and file management techniques
Navigated within patient records to locate requested documentation, successfully completing over 50 requests per day
Accurately pulled patient records for upcoming appointments and procedures, typically within 8-hour period
Handled variety of phone calls from attorneys, insurance companies and patients, including medical/dental and auto insurance inquiries
Date stamped requests and highlighted pertinent data to facilitate processing
Communicated effectively with staff, patients and insurance companies by email and telephone
Kept accurate log of all requests for medical information and records
Interacted and communicated easily with department personnel and public
Maintained accuracy, completeness and security for medical records and health information
Connected callers with appropriate professional, department or business
Performed clerical work such as sorting mail, restocking supplies and typing documents
Created and maintained company phone directory with current extensions and staff information
Answered calls on first ring and engaged customers with friendly, professional demeanor
Managed multi-line switchboard system for busy hospital
Announced important information and emergency notifications over PA system
Directed incoming calls to internal personnel and departments, routing to best-qualified department
Managed telephone switchboard of 500 personnel and routed internal and external calls to provide quick connection
Operated digital paging system to notify recipients of incoming calls
Maintained up-to-date knowledge of emergency call procedures
Attended safety training meetings to learn procedures for handling medical and fire emergency calls
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