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Medical Manager

Shawnee, KS
March 08, 2018

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Rhonda Adams

**** *****

Lenexa, KS 66215


Sept. to present

Maritz, CX

I was informed needed call center experience. I have been working in this setting 6 months and this has been very educational. My responsibilities are: incoming & outbound calls,documenting all contact and reason for contact, educating people on what they are/have signed up for, invoicing their jobs, debriefing, computer software need for a tasks, and how the services fit into their current & future quality of life.

December 1998 to February 2017

Good Samaritan Project Kansas City, MO

Senior Medical Case Manager

Advised patients on community resources, made referrals and devised realistic treatment plans. Assessed patient and deliver

ed comprehensive case management services. Compiled socio-psychiatric case histories to facilitate accurate diagnoses. Comm

unicated with public social and welfare agencies to obtain and provide information. Presented case history material for rev

iew and discussion with other staff members. Evaluated and addressed individual client needs and concerns. Maintained a cas

eload of 70-75. Consulted with other professionals regarding the treatment of specific clients. Completed intake assessments

with patients and drafted community re-entry plans following treatment. Educated residents and their families regarding oth

er community resources. patients, working under strict deadlines. Housing. Medications, and insurance, Marketplace, and e

mployer based insurance.

Medicare and Medicaid---cost effectiveness and enrollment and billing.

**Medicaid--Many MO. and KS. residents need help but do not know what services are available. The MO & KS Pre-Eligibility

Tool can be used to determine if a person may be eligible to receive benefits. If person is eligible for Medicaid pro

ceed with all of the paperwork to submit to the state. Mo paperwork takes 30-90 days waiting period to make a determi

nation from MRT(Medical Review Team). If person is KS and they qualify proceed and process is much less intensive.

**Medicare--Medicare has Cost Savings Programs and these programs are eligible to a person who financially meets criteria.

The purpose of these programs is to assist indiviuals by paying: Medicare premiums and by making payments to medical

providers for coinsurance and deductibles for Medicare services; or Medicare Part B premiums only. To qualify for state

assistance with Medicare candidates must meet 3 general eligibility requirements. Income plays a big part in eligibility

for premium assistance and or tie in plan.

**Medicare & Medicaid is based on resources, income, and Social Security

Education and Training

1991 University of Kansas Lawnrence, KS

Bachelor of Social Work Social Work

Continuing education at least 6 a year and every other year Social Work Conference somewhere in the United States. Am able to provide certificates from trainings and conferences.

Also monthly trainings on separate aspects of the job, AIDS/WAIVER training and in home care, and billing.

Activities and Honors


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