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Case Manager Medical

Location:
Houston, TX
Posted:
July 16, 2018

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Resume:

Verhonda Wiltz

832-***-****

ac6aeo@r.postjobfree.com

Experienced manager with excellent client and project management skills. Action oriented with strong ability to communicate effectively with technology, executive, medical and business audiences

EXPERIENCE

Americorp, Houston Council for Literacy, Houston, Texas-GED/ESL Tutor/Instructor Volunteer 08/2016-present

Proctored TABE and BEST testing, tutored and mentored adult students for GED exam, Instructor for beginner and intermediate adult ESL classes, assisted with student data collection, taught professionals using the BurlingtonEnglish ESL software program ProHealth Staffing, Houston, TX-Content Abstractor RN 1/2016-03/2016

Audited medical records in Clinic Station EMR for correct medications, medical histories and social information, HEDIS goals and transferred corrected information to EPIC EMR Harris Health System, Houston, TX Clinical Nurse Case Manager 8/2006- 6/2014

Coordinate outpatient medical and mental health care and provide community social resources for homeless individuals and families

Processed Social Security Disability applications with 90% positive results Prepared mandatory reports for city, county and state health departments Educated and instructed clients with managing chronic conditions Educated clients on preparations for ancillary testing Increased housing for clients by 10%

Houston ISD, Houston, TX Elementary School Nurse 8/2004- 8/2006

Triaged for illnesses, injuries and special needs of students and faculty Filed initial Workman’s Comp Claims and Risk Management forms for injured faculty Performed state mandated hearing and vision testing on all required students Monitored and maintained student immunization records with 80% compliance rate. Recommended community resources for faculty and families Planned and coordinated community resource representatives in providing on site trainings, services and screenings for students and faculty

Amerigroup, Bellaire,TX High Risk OB Case Manager 11/2002 - 8/2004

Coordinated telephonic medical care inpatient and outpatient for Medicaid high risk OB clients Audited and reviewed all medical requests for hospital admissions, medications, home health and durable medical equipment for medical necessity Educated clients on importance of health maintenance and compliance Harris County Hospital District, Houston, TX-Nurse Auditor 1/2000-11/2002

Reviewed and provided comments on the accuracy of Medicare/Medicaid billing and took necessary steps to correct any deficiencies

Prepared correspondence, accounting and financial documents for analysis Provided on site revenue management training

EDUCATION

Alvin Community College, Alvin, TX Associate

8/1983 - 5/1986

Registered Nursing

Lamar University, Beaumont, TX Bachelor

8/1979 - 8/1981

Speech Pathology

SKILLS

Certified TABE Administrator

Certified BEST Administrator

BurlingtonEnglish Administrator

ESL instructor

EPIC user specialist

Pharmaceutical knowledge

Creative problem solving

Customer needs assessment

Client Advocacy

Revenue management

Accurate data management

Experienced event coordinator

Detailed quality assurance auditing

Financial saving problem solving

Medical chart auditing

Quality assurance auditing

Experience in Medicare billing regulations

AWARDS

Customer Service Employee of the month

Outstanding Employee Service Award



Contact this candidate