Health Care and Insurance Professional
Resume:
JENNIFER K POOLE
*********@*****.***
EDUCATION
DeVry University –Bachelors of Business, Major: Technical Business Management, with a focus in Healthcare Services
Denver Technical College -Associates of Applied Science, Double Major: Medical Assisting and EKG Technologies
Summary of Qualifications
Over 20 years’ experience in a work environment serving the public, to include business offices, call centers, medical offices, and inpatient treatment facilities.
Current CPR AED certification from the AHA
Experienced in Microsoft office suite, Word, Excel, Access, Power Point, and Project Manager
Excellent Knowledge of Medical Terminology, CPT, ICD-9, ICD-10, and HCPCS
Trained in HIPAA rules and regulations, MMC Policies, and URAC
Transitional Skills
Reputation for excellence and high quality customer service to clients/patients.
Excellent customer service skills, interpersonal listening skills, written and oral communication skills.
Highly effective in promoting a positive, productive work environment
Flexible and able to deal with demanding situations
Skilled in Critical thinking and problem solving
Equally effective working independently and in cooperation with others
Successful in mastering new skills through hands-on experience
Good eye for detail, well organized, skilled in setting priorities
Professional Experience
Peak View Behavioral Health (Mental Health Hospital)
Mental Health Technician July 2014 to Current date
Assisted doctors and nurses with the treatment of patients who have various behavioral problems, such as substance abuse, post-traumatic stress disorder, mental instability and physical and emotional abuse
Performed daily data entry of Progress notes, Inputs and Outputs, behaviors, vital signs, and symptoms of illness
Provided direct patient care including administration of Breathalyzer and collection of urine
Understood and implement individual treatment plans
Recorded and reported patient behavior, and performed patient locators every 15 minutes
Led patients in groups such as Psych ED, Goal Group, and Wrap up.
Assisted patients with daily activities, and encourage activities to improve mental health
Provided a safe and supportive environment for patients, visitors, and co-workers.
Responsible for inbound and outbound calls
Primary Home Health Care INC (Home Health Care Organization)
Supervisor of Home Care Based Services August 2012 to May 2014
*I started as a Homemaker and was promoted to HCBS Supervisor
Interviewed clients to determine medical needs, develop and implement treatment plans, and open services
Triaged inbound calls
Scheduled and confirmed patient appointments
Responsible for on–call phone services to address overnight client/employee issues.
Communicated with insurance companies to get pre-authorization of services
Performed Billing Procedures
Audited Care Plan compliance, digital/paper charts, and compiled compliance reports on HCBS employees
Performed daily data entry into computer system of new care plans, billing, audits, and reporting for PAC
Performed data entry for documentation of patients’/caregivers’ information
Counseled employees on company policies and care services
Trained employees, and performed monthly staff meetings
Triwest Health Care (Military Health Care Benefits Provider)
Tricare Service Representative April 2005 – November 2011
Greeted and provided assistance to walk-in and telephone customers/patients.
Supported TRICARE Service Center with various clerical activities, including ordering marketing materials, forms, and supplies, preparing correspondence and reports, routing mail, and processing shipments
Provided information and assistance regarding eligibility, enrollment process, and referrals
Documented customer inquiries in the computer system and processed on-line tasks
Supported the consult tracking function by following-up with specialty providers on consult reports
Aurora Health Care (Medical Clinic)
Medical Assistant October 2001 - July 2002
Greeted patients and caregivers
Interviewed patients to assess and identify clinical issues, then documented patient history and symptoms
Educated and Instructed patients on how to take medications, use of DME, and prep for a test or procedure
Assisted doctors with paper work and all other office procedures
Answered Inbound calls and resolved customer complaints, answer question, and schedule appointments
Performed outbound calls to schedule appointments,procedures for customers, and make pharmacy orders
Established preauthorization requirements, and prepared insurance forms
Community Health Center Inc. (Medical Clinic)
Medical Assistant/Medical Records Clerk September 1997 - June 2000
Provided direct patient care including administration of Breathalyzer and collection of urine
Educated and Instructed patients on wound care, medication, DME, and the prevention of illness in the future
Interviewed patients to assess and identify clinical issues, then document patient history and symptoms
Answered questions for patients and helped them find resolutions to their concerns and complaints
Performed phone TRIAGE, appointment scheduling and referrals
Verified eligibility and prepare insurance forms
Collected payments
Answered inbound call questions for patients, doctors, and other care facilities
Performed Data entry to maintain charts and computer system to be positive that all information is accurate
Western Home Health (Home Health Care Agency)
Office Assistant and Personal Care Provider August 1999 - May 2000
Managed home office by answering calls, and responding to patient/provider questions or complaints.
Greeted patients and caregivers
Performed data entry, and basic office responsibilities
Offered resolutions to patient concerns
Processed Medicaid/ Medicare billing
Prepared and purged patient charts
Prepared and submitted insurance forms
Outbound calls to doctors to get approval for treatments, and medication changes
Documented changes in patient condition
Scheduled PCP, CNA and RN visits
Ordered/ inventoried medical and office supplies
Acquired estimates and ordered repairs on office equipment
Performed home visits to assist patients with household responsibilities, personal hygiene and medical care
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