Illinois University Care Coordinator
Resume:
Jaysha Patty
Jaysha Patty
Apt. A
Maryland Heights MO, 63043
***********@*****.***
ㅡ
Objective
To secure a position with a stable and profitable organization, where I can be a member of a team and utilize my experiences to the fullest.
ㅡ
Experience
BJC Christian Northeast / Medical Transporter
January 2013 - July 2014
●Transports patients by assisting patients in and out of taxis, ambulances, cars, and helicopters; lifting patients on and off beds; moving them to and from special service and treatment areas, and operating rooms; using wheelchairs or moveable beds.
●Comforts patients and their families by offering support and encouragement; being punctual and attentive to procedure schedules; demonstrating caring and cultural sensitivity.
●Transports equipment and supplies by picking-up requisitioned orders; delivering them to assigned treatment areas and patient care areas.
●Transports laboratory specimens by picking-up specimens and delivering them to specified laboratories.
●Transports deceased patients by following protocols and delivering them to the mortuary.
●Maintains safe, secure, and healthy work environment by following standards and procedures, complying with federal and state legal regulations
Southern Illinois University Edwardsville Union Station / Manager July 2014 - August 2016
●Develop business strategies to raise our customers’ pool, expand store traffic and optimize profitability
●Meet sales goals by training, motivating, mentoring and providing feedback to sales staff
●Inventory
●Ensure high levels of customers satisfaction through excellent service
●Complete store administration and ensure compliance with policies and procedures
●Maintain outstanding store condition and visual merchandising standards
●Report on buying trends, customer needs, profits etc.
●Propose innovative ideas to increase market share
●Conduct personnel performance appraisals to assess training needs and build career paths
●Deal with all issues that arise from staff or customers (complaints, grievances etc.)
●Be a shining example of well behavior and high performance
1st Choice Healthcare / Personal Care Assistant
June 2015 - December 2016
●Travel to clients’ homes, arriving on time
●Greet clients in a warm, professional manner
●Understand the limitations and needs of each individual client
●Provide basic domestic services e.g., meal prep, laundry, light housework
●Provide companionship and engage in conversation with the clients
●Run errands, either with or for the client, as needed
●Assist with mobility issues, helping the client get in and out of bed, wheelchair, etc.
●Remind the client to take medications and document them accordingly
●Help with personal hygiene e.g., brushing teeth, toileting, bathing
●Change bed linens regularly
●Assist with all daily activities, based on the client’s limitations and needs
●Provide a caring and positive presence for the client
●Document/log client’s’ progress and overall, well-being for daily reports
Acceptance Now Financing / Manager
December 2016 - August 2017
●Daily reporting.
●Analyzing targets.
●Meeting with department heads.
●Managing and coordinating monthly reporting, budgeting and reforecast processes.
●Providing back-office services such as accounts payable, collection and payroll.
●Monitoring cash flow.
●Providing insights on the financial health of the organization.
●Ensuring the business meets all its statutory and compliance obligations, including statutory accounting and tax issues.
●Keeping track of market trends.
●Looking for cost-reduction opportunities.
●Developing relationships
●Supervising staff
UnitedHealthcare / Dual Special Needs Care Coordinator
October 2017 – August 2021
●Provide concierge and white-glove level service, removing burdens and providing end-to-end resolution for customers
● Serve as a single point of contact for the customer and form a strong relationship to support them
● Own problem through to resolution on behalf of the member in real time or through comprehensive and timely follow-up with the member
●Research complex issues across multiple databases and work with support resources to own the resolution of all customer issues and anticipate their future healthcare needs or potential opportunities to improve the experience
● Respond to and own consumer inquiries and issues
● Conduct proactive research on assigned member accounts to identify service issues
●Evaluation of member discharge needs including delays in care and readmission prevention plan
● Identify gaps in processes and work closely with other departments for process improvement
●Provide education and status on previously submitted pre-authorizations or pre-determination requests
● Meet the performance goals established for the position in the areas of efficiency, call quality, customer satisfaction, first call resolution and attendance
Medica / Health Plan Coordinator
October 2021 – Present
Responsible for utilizing patients' electronic health records to code medical procedures and examine insurance claims.
Maintain meticulous records of medical costs, adjustments, co-payments, and other billing details.
Communicating with other insurance carriers
Updating internal billing databases,
Electronically storing patients' records,
Filing registration forms,
Analyzing insurance claims,
Detecting coding errors and verifying medical coverage.
Take an active role in helping patients obtain and understand their medical benefits.
Follow all regulations and coding procedures to allow for prompt payment of medical services.
Obtain insurance prior authorizations, gap exceptions and referrals for outpatient PT, OT, and ST for all regions.
Perform verification of benefits, obtain preregistration patient demographic information and insurance information required to create a medical record and input collected information into billing software in a complete and accurate
manner.
Serve as intermediary between patients and outside sources related to questions or problems which patients may have regarding bills for services provided.
Communicate payment policies to patients and finalize payment arrangements with patient or guarantor, as needed.
Facilitate all necessary communication between the clinical team and the referring providers.
Organize and transmit necessary documents to referring providers validating and approving the plans of care constructed by the clinical team.
Ensures the prompt return of initial and recertified signed Plans of Care from referring providers.
Perform general business office work including answering phones, retrieving voice mail and returns calls to patients and providers.
Organize and scan and/or save all paper and/or electronic documents
ㅡ
Education
Hazelwood Central High School/ High School Diploma
August 2011 - May 2014
GPA 4.0
Southern Illinois University Edwardsville
August 2014 - May 2016
Kaplan University
August 2017 - May 2018
ㅡ
Awards / Certification
Dean's List August 2014 - May 2016
Excellence Award for Social Work Program December 2015
CPR - Present
Contact this candidate