RODRIGUEZ D. RAINER

Dacula, GA *****

704-***-**** ad37f5@r.postjobfree.com

SKILLS

Proficient in Microsoft Office Emdeon Matrix Care

American Health-Tech & LTC. Zoom /Skype

EMR Electronic Medical Records. CAM

Gammis Training Smart Data

EXPERIENCE

Pruitt Health Atlanta, GA. Financial Counselor 10/2022 - Present

Primary contact for partners, patients/residents, and family members

Provide comprehensive guidance and information to family members, offer insights to available services and explain diverse payment options, encompassing Medicare, Medicaid, insurance, and private pay

Ensure the accuracy of patient information and review admission files for completeness and compliance

Maintain and update the daily census with precision, ensuring accuracy of patient records

Consistently make daily deposits and maintain timely records; expertly reconcile facility petty cash to ensure financial accuracy

Provide support for Medicaid pending procedures, including assisting with the Medicaid application

Perform human resources recruiting and payroll functions with proficiency

Distribute funds efficiently and meticulously record transactions from patient trust fund and facility petty cash; prepare transfer of expense forms

Successfully completely new vendor process and ensure all vendors are contracted with Pruitt Health

Assist with month end and year end processes and procedures

Adhere to all company policies and procedures, as well as state and federal laws and regulations, and responsible for promptly reporting any violations to the relevant supervisor

VillageMD Atlanta, GA. High Risk Care Coordinator 08/2019 – 10/2022

Developed and coordinated healthcare programs

Facilitated communication between staff, patients, and their families

Successfully managed patient cases and provided comprehensive patient education to enhance healthcare outcomes

Oversaw the recruitment, training, and scheduling of staff

Structured and refined patient-specific goals, meticulously monitored progress, and adjusted care plans as needed to ensure optimal healthcare outcomes

Exemplified a commitment to maintaining strict patient confidentiality while consistently delivering high-quality care

Pruitt Health Atlanta, GA. Medicaid Specialist 11/2016 – 08/2019

Proficiently prepared and submitted Medicaid claims, conducted thorough research to identify discrepancies, initiated corrections, and efficiently resubmitted Medicaid claims for reimbursement

Effectively tracked patients in Medicaid pending status and collaborated with families to facilitate the completion of Medicaid applicants

Collaborated closely with nursing home administrators and office personnel to oversee and manage Medicaid patients within the facility

Consistently executed all responsibilities with a steadfast “Commitment to Caring” ethos, aligning with the company’s mission, vision, and philosophy, always upholding the highest standards of honesty and integrity

Adhered diligently to company’s policies, state and federal laws, and regulatory requirements, promptly reporting any violations to appropriate supervisor, while maintaining open communication of daily activities and any arising issues

Pruitt Health Atlanta, GA. Collection Specialist 09/2012 – 11/2016

Established and maintained communication with clients possessing open or outstanding receivables to assess payment status or final resolution aiming to reconcile accounts to current status efficiency

Implemented a structured follow-up protocol to capture pending payments and action items

Managed the mailing of collection letters and monthly statements to prompt payments for delinquent accounts

Collaborated with Healthcare Center Administration to track and resolve outstanding balances

Managed incoming calls while concurrently utilizing the account management system and assisted customers in resolving their concerns

Utilized American Health-Tech/LTC software to process patients’ payments and maintained a 99% cash velocity for private pay accounts

Assigned to train and orient new Billing Coordinators

Pruitt Health Atlanta, GA. Source Care Manager 11/2011 – 09/2012

Coordinated services with community service providers and conducted outreach to Source clients

Scheduled and conducted in home visits

Participated in weekly team meetings with the Medical Director to present new admissions, annual assessments, hospitalizations, home health admits and discharges, repeat variances, members with potential for discharge or actual discharges, and situations threatening members’ health or functional status

Completed Care Paths and appropriate referrals sent to following team meetings

Tracked all hospitalizations and emergency room visits by requesting records and communicating with hospital staff

Coordinated with outpatient therapy centers, home health agencies, healthcare centers (short term), and rehab facilities by collaborating with their staff and completing skilled care track forms

Communicated with DFACS agencies for Adult Protective Service and Child Protective Services referrals

EDUCATION

Associate Degree in Health Administration, Strayer University, Atlanta GA

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