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Customer Service Medical

Location:
Vacaville, CA, 95687
Posted:
May 15, 2020

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Resume:

Jasmine L. Negron-Wakefield * adc8es@r.postjobfree.com * 707-***-****

Jasmine L. Negron-Wakefield

*** ****** ***** #**

Vacaville, California 95687

707-***-****

adc8es@r.postjobfree.com

Career Summary

Results driven, recognized for exceptional ability to demonstrate leadership in complex operational environments, able to establish clear vision of work goals and guide others towards achieving said goals. Other key skills and immediate values:

• Staff training and development.

• Effective communicator – oral and written.

• Organizational/planning and problem-solving skills.

• Diplomatic and tactful with employees, management and customers.

• Prioritizing.

• 25years in customer service

• 15+ years in an administrative role.

Experience

Chronic Condition Management Program Assistant, Kaiser Permanente – Vallejo CA February 2016-Present

• Assists the CCM Manager or care/case manager in screening & enrollment of patients: May conduct population or care/case management program outreach efforts, using the system database or other outreach lists; Obtains & reviews charts or other data related to ER visits & hospital admissions for follow-up & program enrollment; Processes referrals received from electronic referral system; Provides initial outreach to patients, introducing the care/case management program & processing of new referrals; Sets up initial visits and/or classes as appropriate & mails out program materials; Generates authorization letter when requested & follows up to ensure that written authorization is received if not electronically referred from primary care provider.

• Provides logistical support for classes, group visits & clinics: Schedules conference rooms; Schedules patients; Confirms schedule w/ providers & presenters; Provides reminder calls/letters to patients; Assists in preparing charts & supplies; Assists patients in completing program questionnaire or log as needed; Checks blood pressure, pulse, respiration's, height, weight, peak flows, spirometry or downloads glucose meters as needed; Registers members & generates OSCR forms per medical facility policy.

• Conducts visit registration & scheduling of telephone & clinic visits: Schedules appointments; Provides reminders as needed; Coordinates or provides resources for patient-specific prevention activities; Registers members for visits & generates forms per medical facility policy; Processes referrals, schedule classes & follow-up appointments as directed by care/case managers; Contacts overdue patients by phone or letter at direction of care/case mgrs.

Jasmine L. Negron-Wakefield * adc8es@r.postjobfree.com * 707-***-****

• Maintains computer databases: Add/delete patients into the Patient Alert System using program guidelines; Manipulates & utilizes data in current patient population management report system. Enters patients in care/case management software programs & maintains data as appropriate, e.g. AmCare, Lotus Notes Case management System, Cholesterol management Program, MULTIFIT Program, etc. Maintains Access or Excel patient logs if used in conjunction w/ care/case management software applications. Manipulates & utilizes data to generate reports & queries as needed.

• Maintains daily program operations: Prepares, maintains & provides member packets for enrollment, group visits, classes and/or clinics; Sends letters to patients & patients' providers; Makes copies of program materials, send faxes as needed; Establishes & maintains a department filing system; Answers phone & voice mail & routes messages to appropriate person; Provides call backs to patients relaying responses from care/case manager; Sorts & routes department mail; Orders & transfers charts at the direction of care/case managers; Sends memos & progress notes to patient's MD/NPs; Contacts patients by phone or by letter at direction of care/case managers for follow-up; Upon program completion places patients on booking list for routine follow-up appointment w/ their primary care MD/NP per medical center policy; Orders office & program supplies; Works w/ care/case managers & other staff to maintain patient education Hospice Clerk/Assistant to Director of Hospice, Kaiser Permanente – Anywhere, CA When to When

• Employees in this classification may be assigned duties in anyone of the following major functional areas

• Durable Medical Equipment

• Performs a variety of duties in support of the Durable Medical Equipment Program Arranges from DME placement in & removal from patient homes

• Receives & places orders for equipment w/ contract vendors

• Determines patient benefit eligibility & Medicare eligibility through the Membership System (RMIS)

• Follows through to ensure all equipment arrived as ordered

• Set up patient files in HHOS/DME automated system by key entering patient data, type of equipment, rental period, etc, onto pre-screen formats

• Establishes patient Kardex

• Maintains & updates HHOS/DME systems & department records on the regular basis

• Ensures that a current prescription is on file for all equipment items ordered

• Monitors prescription expiration dates & obtains renewal Rx as needed by sending a written request to the attending physician

• Determines if equipment should be leased or purchased based on patient diagnosis, prognosis & established time equipment will be needed

• Contacts patient to determine if equipment continues to be in use

• Calls vendor to arrange for equipment pick-up, rental renewal or purchase

• Receives, verifies & processes vendor invoices for payment following established procedures & time frames

• Key enters invoice data into HHOS/DME systems & reconciles invoiced w/ computer printout

Jasmine L. Negron-Wakefield * adc8es@r.postjobfree.com * 707-***-****

• Verifies that equipment & dollar amounts on invoices balance w/ printout

• Prepares transmittal documents, obtains signature approvals & forwards to A/P for payment

• Edits & corrects HHOS data

• Tracks DME equipment maintained in the department by maintaining sign-out logs & maintaining an inventory list of equipment in the department

• Time Card processing and payroll

• Charting via HCMS and Health Connect

• Record keeping of incoming donations and hospice regional budget quarterly reconciliation

• One- Link processing

• Oriented summer youth students to the department, coordinated assignments accordingly

• Maintained and updated daily hospice and home health regional nursing staffing calendar

• Ordered office supplies, scheduled conference rooms and catering Appointments Clerk, Kaiser Permanente - Vallejo, CA, When to When April 2008- December 2012 / February 2016-March 2016

• Service patients, members, and visitors; acknowledges them in a prompt, courteous and professional manner.

• Maintains general knowledge of current health plan/non plan policies and coverage in accordance w/established regional standards & communications; keeps abreast of all changes regarding health plan benefits

• Verifies health plan and/or non-plan financial status; checks for delinquent accounts; informs patient & refers to appropriate area; explains provisions of annual co-payment maximum, coinsurance and/or deductibles policies to patients/ customers.

• Operates current office equipment & other cash related equipment; assures all equipment in cashiering area are operating in an acceptable manner; assesses status of equipment malfunctions; resolves when appropriate; reports any unresolved problems appropriately and notifies lead or supervisor.

• Serves as clerical resource and contact person to staff as appropriate; collaborates with team to ascertain and coordinate team and individual concerns and issues; collaborates and assists with team, leadership and other committees as appropriate to design, plan, coordinate, and implement process improvements.

• Identifies and resolves issues around improvement as appropriate; recommends ideas and suggestions to improve operation of area.

• Receives incoming and intra-office calls; ascertains need; directs to proper individual or location; takes messages; provides limited non-confidential information.

• Maintains contact with other facilities and support departments. Resolves basic problems; assists with difficult problems when necessary; refers to lead/supervisor after Jasmine L. Negron-Wakefield * adc8es@r.postjobfree.com * 707-***-**** all appropriate alternatives are exhausted; notifies supervisor of process problems/issues that need attention.

• Assists with patient complaints; collaborates with lead/supervisor to develop operational strategies.

• Performs variety of duties pertaining to patient appointments; ascertains patient-s need for routine appointments and schedules appointments according to need or under direction of medical staff; refers to medical staff as appropriate.

• Completes appointment process; enters/updates pertinent patient appointment and registration data in computer; verifies patients- insurance eligibility; captures appropriate guarantor and coverage information as appropriate; provides accurate information to enable accurate collections of funds; notifies members of rescheduled or cancelled appointments.

• Compiles data and information for special and routine reports, studies and statistics as requested.

• Assures departmental and organizational quality of service standards are upheld; works with lead/supervisor in identifying potential and existing barriers to maintaining standards.

• Requests or requisitions material or supplies; ensures adequate inventory; assures all clerical equipment in area is operating in acceptable manner; reports malfunctions to appropriate party; follows appropriate procedure for repair within limits of authority; implements corrective measures, enhancements or modifications as instructed. Teleservice Representative, Kaiser Permanente - Vallejo, CA, May 2006 – April 2007

• Handles continuous inbound telephone volume.

• Identifies the purpose of the member's call and processes the call according to the appropriate script.

• Provides facility and provider information and some laboratory results, makes and cancels appointments, transfers members to Advice Nurses, intakes information from members, and composes messages for providers.

• Resolves problems with facility teleservice teams.

• Effectively processes calls in a systematic and organized manner following Call Center scripts, policies and procedures.

• Processes calls accordingly from hearing-impaired members.

• Receives and relays information regarding appointment cancellations.

• Records instructions from provider in PARRS.

• Updates member demographics.

• Works collaboratively with members and staff across all service lines. Jasmine L. Negron-Wakefield * adc8es@r.postjobfree.com * 707-***-****

• Functions as a team member to achieve Call Center goals.

• Supports and demonstrates Kaiser Permanente's/Call Centers customer service philosophy and manages calls in a professional manner.

• Identifies and/or proposes ways to improve customer service.

• Demonstrates an awareness and sensitivity to patient/family rights.

• Handles inquiries and complaints pursuant to procedure.

• Complies with departmental standards, policies and procedures regarding training, injury prevention, management of workload, and safety/emergency situations.

• Performs other duties as required.

Regional Float Pool Cashier Receptionist,Kaiser Permanente School of Allied Health Sciences – Richmond, California

June 2005- May 2006

• Registered and oriented all new and existing patients to clinic policies and services

• Obtained or provided patient referrals

• Entered all new patient registration information into Epic and Mainframe systems

• Updated patient insurance information at each visit

• Prepared packets for member distribution

• Provided general Support including, but not limited to, revenue capture and reconciliation, multi phone lines, filing, ordering office supplies

• Processed and coded each service rendered

• Input all charges and adjustments on private pay and third -party accounts daily

• Addressed member complaints and inquires

• Scheduled initial and return appointments for medical, nursing visits and specialty departments



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