Independence, Louisiana, United States
Highly organized and effective professional with more than 15 years of experience in healthcare operations. Strong history of fulfillment of CNA and medical office role responsibilities. Outstanding communicator who can easily build influence and consensus with professionals of all levels and backgrounds. Adept at providing patient outreach and communications with ability to diffuse complaints and calm concerns. AREA OF EXPERTISE: *OSHA/HIPPA Compliance *Patient Care & Safety *Medical Terminology *Medication Administration *Data Entry *Claims Processing *Scheduling *Medical Billing *CPT Coding / ICD-9/10
Sending denial letters 1st & 2nd level appeals letter to payers , claim status resubmitting bills and corrective claims
Responsible for working closely with veterans and providers to schedule appointments outside of the Veteran’s Administration hospital/clinics. •Awarded Top PSR for effectively modifying authorizations and appointment scheduling. •Led a small team in various software training. •Handled inbound phone calls from Providers, VA, and other customers. •Interacted with customers in a professional, formal manner where the focus is on completing the task pleasantly and with high quality and accuracy. •Documented all communications involving provider contacts. •Protected the privacy of health information of patients when using or disclosing Protected Health Information (PHI). PHI is any information about health status, or healthcare services that is linked to an individual. •Complied with HIPAA regulations to protect privacy of beneficiaries' health information. •Consistently met department productivity and performance metrics.
Responsible for entering specific data/information from Veteran Administration and Veterans into the authorization system, achieving required production quota/quality standards. •Reviewed and processed Veteran care referral requests and health care authorizations from the Department of Veterans Affairs (VA) Medical Centers and community health care professionals. •Reviewed and processed medical documentation from community providers following Veteran care and treatment. •Transmitted information to the referring VA Medical Center to complete the Veterans medical record and ensure ongoing care coordination. •Worked with VA Care in the community staff and community medical offices to address and resolve any incomplete information required for Veteran treatment and care. •Utilized standard coding systems including standard medical taxonomy, International Classification for Diseases, Current Procedural Terminology, and Health Care Common Procedure Coding System.
Caring for residents needs daily by providing one-on-one service in a hospice facility. •Assisted approximately 12 residents each shift with activities of daily living; ensured they were on time for all meals and activities. •Provided social and emotional support to improve residents’ morale. •Established rapport with team members, residents, and families. •Helped residents with daily hygiene, including showering, oral and peri care, incontinence care, minimizing rashes, sores, and soiling •Ensured the accurate, timely flow of information by maintaining thorough patient records and updating healthcare team on patients’ status.