Dedra Akins

***** ******** ***. #**, *******, CA 92335

626-***-****

adjkyy@r.postjobfree.com

A Healthcare Coordinator with over 10 years of experience. Possesses an Associate’s Degree in Social and Behavioral Sciences and a Medical Billing Certificate PROFESSIONAL WORK EXPERIENCE

Easterseals Southern California Ontario, CA

Intake coordinator 01/2020 to present

● The initial point of contact person to participants, practitioners, management, and medical provider personnel in matters related to the Intake department;

● Respond, redirect, or document inquiries as appropriate. Explain to participants about the delivery of services, processes, and financial obligations

● Review, input and maintain client information and documentation in EMR databases necessary for scheduling, treatment, and billing of services.

● Submit and receive Treatment Authorization Requests and monitor medical codes received are entered appropriately for billing and treatment of services.

● Verify and monitor the financial obligation is coordinated with the client, medical providers, and/or other external service coordinators (i.e. regional centers) for continued services to participants.

IEHP Healthcare Rancho Cucamonga, CA

Provider Relations 7/2016 to 01/2020

● Excellent interpersonal/communication skills, problem-solving capabilities, ability to establish and maintain effective working relationships, trustworthy, reliable, and an independent worker

● Educate providers regarding policies and procedures related to referrals and claims submission; web site education, grievance & appeals, and problem solving (liaison responsibilities)

● Assist providers with troubleshooting on the provider portal, interpreting member eligibility and benefit information for any and all lines of business, Inpatient, Outpatient, UM/BH authorizations and denials

● Intensive telephone use, computer knowledge Windows, Excel, MS Office, Word Outlook, PowerPoint,NCCB

● Research complaints (grievances) and log and track the information as it moves through the clinical process or is tasked through internal departments

● Contact stakeholders to collect information and communicate disposition of the case, document all interactions

● Use appropriate templates to complete the necessary documentation for final appeals or grievance determination

Epic Hearing Healthcare Pomona, CA

Eligibility Coordinator 3/2013 – 7/2016

● Extensive phones assisting members and providers regarding eligibility, benefits, and pre-certification

● Submit completed TAR’s for medical authorization

● Superior customer service, communication skill

● Work closely with management to resolve customer concerns

● Detail-oriented and able to multitask in a fast-paced environment

● Ensures compliance with all mandated Federal, State, and County regulatory requirements. Marinello Schools of Beauty Ontario, CA

Cosmetology Instructor 2007-2013

● Instructed 30 students daily on developing skills for a career while maintaining classroom management

● Demonstrated motivational techniques for student success

● Consistently meeting and exceeding all departmental quotes and quality control requirements

● Instrumental in my department achieving an increase in passing rate to 80% in 12 months

● Facilitated seminars for job search, resume writing, interviewing skills, and job placement EDUCATION

Chaffey Community College

AA in Social and Behavioral Sciences

AA in Psychology

ADDITIONAL SKILLS

Strong knowledge of federal & state regulations

Medicare, Medi-Cal, HMO, and PPO regulations

CERTIFICATIONS

Medical Billing

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