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Click here or scroll down to respond to this candidateCandidate's Name
Topeka, KSEMAIL AVAILABLE PHONE NUMBER AVAILABLESummaryEnthusiastic healthcare professional with 5 years of experience seeking a role in a Remote position. Skilled in case processing, eligibility assessments, and delivering exceptional customer service in healthcare settings. Proficient in remote communication, documentation, and upholding regulatory compliance. ExperienceMedicare Part D Prior Authorizations and Appeals Representative Integrated ResourcesNov 2023 - Apr 2024 (6 months) Conducted comprehensive case reviews for Medicare Part D appeals, ensuring adherence to regulatory turnaround times and quality benchmarks. Upheld elevated expectations of productivity, consistently meeting or surpassing departmental objectives for case processing. Maintained currency with evolving Medicare Part D regulations to accurately process prior authorizations and appeals.Member Service RepresentativeBroad Path Healthcare SolutionsNov 2021 - Feb 2023 (1 year 4 months) Addressed and resolved member inquiries by providing detailed explanations of health plan benefits, coverage, and eligibility, ensuring accurate and efficient information dissemination. Employed advanced systems and databases to accelerate problem-solving and information retrieval, meticulously documenting all interactions for quality assurance and trend analysis. Provided exemplary customer service, characterized by patience, empathy, and active listening, cultivating positive relationships, and skillfully managing complex customer situations. Eligibility SpecialistManpower GroupSep 2019 - Jan 2020 (5 months) Executed in-depth evaluations of Medicaid applications, scrutinizing essential factors such as household composition, financial status, and expenditures to ascertain eligibility accurately. Rendered precise eligibility verdicts and effectively communicated outcomes to applicants, utilizing formal written notifications to simplify complex information. Orchestrated ongoing client interactions, soliciting required documentation and updating case developments, while rigorously recording all communications in the designated database system. Patient Care CoordinatorIntegrated Sleep ResourcesFeb 2018 - Dec 2018 (11 months)Candidate's Name - page 1 Collaborated with patients, physicians, and staff to conduct a comprehensive analysis of medical charts, enhancing open communication and teamwork. Demonstrated proficiency in accurately inputting patient insurance, demographic, and health information into software, ensuring record completeness. Proactively communicated with medical providers to ensure prompt resolution of inquiries and concerns, following up on requests as needed. Ensured efficiency and precision in processing distinct documentation, facilitating seamless workflows. Adhered strictly to HIPPA standards and organizational protocols, protecting the confidentiality and security of patient records during data transfers. Program CoordinatorPreferred Family HealthcareJan 2017 - Dec 2017 (1 year) Orchestrated comprehensive training sessions to enhance staff members' knowledge of clients' medical needs, preferences, and care plans, fostering a supportive and informed environment. Ensured staff remained vigilant of clients' medication protocols and potential side effects, facilitating timely updates and changes to maintain optimal client care. Oversaw and audited daily residential notes, goal progress, health tracking, and Medication Administration Records (MARS) for precision, securing necessary approvals to uphold care standards. Streamlined staff scheduling processes and coordinated coverage for absent personnel, guaranteeing the continuity of client care services.Direct Support StaffPreferred Family HealthcareOct 2016 - Jan 2017 (4 months) Coordinated client engagement in diverse activities, including medical appointments, recreational outings, and community events, by providing essential transportation and personal assistance. Administered medication in strict adherence to prescription schedules, maintaining meticulous records to ensure error-free documentation.EducationVatterott CollegeDiploma, Medical Office Assistant2005 - PresentSkillsHIPPA Customer Support Time-Management Multitasking Adaptability Detail Orientated Phone Etiquette Teamwork EmpathyCandidate's Name - page 2 |
