DARLENE M. BAHUN

**** ******* ****

Abrams, Wisconsin 54101 C # 920-***-****

E-mail: ac1m70@r.postjobfree.com

Objective: Continue a career in Administrative Business Management

EMPLOYMENT HISTORY

Director Green Bay, Wisconsin

Nov 2013 to May 2017

Alpha Senior Concepts

Administrative and Operations Management: Retain resident occupancy. Maintain standards complying with State regulations and licensing. Schedule daily team duties/responsibilities. And complete additional delegated duties from owners.

Program and Service Implementation: Provide leadership to the resident programs, delivery of care and services to residents. Ensure meal service designed to meet resident needs.

Assessment and Care Planning: Responsible for Admits and Discharges of residents. Completed individual Care Plans (34) rooms. Assess services and responsible for setting monthly rates. Monitored health and emotional conditions of each resident. Ensure safe and appropriate administration of medications by staff. Schedule regular training, drills and equipment reviews.

Personnel Management: Responsible for recruitment, orientation, training and coaching of the team members. Responsible for staff supervision, discipline, performance evaluations and salary increases. Completion of time sheets and wages assignments.

Marketing: Maintain and uphold the highest standard of image and reputation of the house.

Promote Alpha in the community through an active referral network.

Family Support: Form and build relationships with the residents’ families. Assisted families in understanding Alzheimer’s disease and related dementias.

Patient Care Coordinator Green Bay, Wisconsin

Dec 2012 to Nov 2013

Unity

Coordinate daily patient’s admissions, visit appointments, assign cares, handle incoming

phone calls using conflict resolution. Review medical records and certification/recertification materials. Monitor referral activity. Process continuity of care and staff consistency when scheduling. Respond to staff and issues with knowledge/facts. Coordinate daily medication deliveries. Monitor staff hours, overtime, coverage areas, needs & PTO approval process.

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Director Green Bay, Wisconsin

Sept 2011 to Aug 2012

Azura Memory Care of Green Bay

Administrative and Operations Management: Responsible for financial management of the house, operating expenses and revenue. Retain resident occupancy. Maintain standards complying with State regulations and licensing. Schedule daily team duties/responsibilities.

Program and Service Implementation: Provide leadership to the resident programs, delivery of care and services to residents. Ensure meal service designed to meet resident needs.

Assessment and Care Planning: Responsible for Admits and Discharges of residents. Completed individual Care Plans (19) rooms. Assess services and responsible for setting monthly rates. Monitored health and emotional conditions of each resident. Ensure safe and appropriate administration of medications by staff. Schedule regular training, drills and equipment reviews.

Personnel Management: Responsible for recruitment, orientation, training and coaching of the team members. Responsible for staff supervision, discipline, performance evaluations and salary increases. Completion of time sheets and wages assignments.

Marketing: Promote Azura in the community through an active referral network.

Family Support: Form and build relationships with the residents & families with understanding Alzheimer’s disease and related dementias.

Medical Records Director Green Bay, Wisconsin

Feb 2010 to Sept 2011

Parkview Manor Health and Rehabilitation Center

Responsible for all legal documentation, compliance, medical records functions,

and ICD-9 Coding. Set up & close out all residents’ charts according to policies and procedures. Compiled Census of residents and Key information into computer

Prepare notice of residents discharge, death, or transfer to inform Business Office Manager

Requisition supplies and nursing forms designated by nursing staff

Prepare RM/QI monthly reports along with QM/QI weekly reports for management staff.

Handle Medical Records requests from physicians, insurance companies, attorneys and state

Purge all medical records from nursing units to storage facility, in accordance with State regulations

Business Analyst/System Abstract-Plan Profile Coordinator II Green Bay, Wisconsin

Oct 2001 to Feb 2010

Claims Management Services, Inc., Anthem Blue Cross Blue Shield

Assist with translation of business needs into application software requirements.

Translate business requirements to technical staff to ensure that requirements are incorporated

into the system design. Run tests and document solutions

Review insurance plan documents to build case specific plan designs into the system with IT to establish eligibility connectivity

Develop the perimeters of each plan by interpreting the Summary Plan Descriptions to insure proper claim adjudication. Includes accurately reviewing deductibles, out-of-pocket, coinsurance, maximums, limitations, exclusions and managed care of the plan document.

Maintained a work load of specific Group Plans and handle any changes

Assist with auditing work completed by fellow coordinators.

Handle changes in the South Carolina Distinct system for the Inter-Plan Teleprocessing Services.

Developed Alpha prefixes’/profiles for Groups which chose to have PPO/ Non-PPO network re-pricing in the Inter-Plan Teleprocessing Service system.

Maintained communication with Blue Cross Blue Shield Association to ensure changes and updates.

Other Experience:

Sentry Insurance Company Stevens Point, Wisconsin

Health, Dental Claims Representative I, II, & III,

Workers’ Compensation Technician / Medical Cost Containment Technician

Investigated, adjusted, coordinated benefits, and processed claims for payment or denial

Handled bill review/cost containment procedures: fee, scheduling, surcharges and re-pricing issues and bill negotiations from physicians and hospitals

Supported incoming overflow calls and corrected monthly coding errors

Assist supervisor with various administrative duties.

Knowledge of subrogation, pre-existing, and accident involvement.

Ability to handle a high volume of claims and maintain standards of quality.

SUMMARY OF CONTINUING EDUCATION

WALA 83.15 Administrator course DHS 83.20 Fire Safety

DHS 83.20 Standard Precautions Corporate Compliance

DHS 83.20 First Aid and Choking Training Communicating with Older Adults

Resident Rights Safe Food Handling

Medication Management Cert (WI) Connect and Communicate

Welcome to Knowledge Wire HIPAA: General Awareness

HIPAA: Privacy Standards Difficult People in the Workplace

Introduction to Blue 3.1 Wisconsin Workers’ Compensation Claims Training

Dental Claims Training Health Claims Training

Customer Relations Stress Management I and II

Time Management Seminar AAI-Supervisory Management

Better Business Writing

Distinct/Inter-Plan Teleprocessing System-Programs Training

Education: Stevens Point Area Senior High School Diploma Stevens Point, Wisconsin

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