Water Department Care Representative
Resume:
Robert C. Newman
Long Beach, CA 90806
Email: adrlc7@r.postjobfree.com
Objective
To obtain an administrative position that utilizes my skills and qualifications working within a hospital or office setting that will challenge me and offer me the opportunity for professional growth.
Skills
10-key by touch, excellent Customer Service skills, advanced knowledge of the Meditech and Emstat Programs, Microsoft Office Suite, excellent organizational, clerical, and office skills.
Work Experience:
College Medical Center
Managed Care/Commercial Account Specialist. April 2018 to Current Proficient in auditing claims for Medicare and Medicaid plans. Strong knowledge of CMS. requirements regarding claims processing. Have knowledge of DOFR (Division of Financial Responsibility, COB (Coordination of Benefits). Knowledge of standard Coding and reference materials used in a claim setting, such as CPT4, ICD9, ICD10, DRG and HCPCS. Knowledge of health care benefits structures and insurance Procedures.
Financial Counselor April 2016 to April 2018
Duties include, proper identification of patient, collection of demographics informa- tion, manage hospital signature log, financial counseling, anticipating authorizations, denials, and initiate appeal process. Coordinate and inform Case Management of clinical denials. Verify patient eligibility and update insurance information. Assist self pay patient’s with Hospital Presumptive Medical enrollment Assisted Business Office with managed healthcare related to claims processing/audit.
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Intake Specialist -Behavioral Health Unit Access April 2015 to April 2016
Duties include, proper identification of the patient, collection of demographics, coor- dinate hospital's BHU bed assignment process and direct admissions, referrals, transfers from other facilities as well as anticipating and responding to the non-clini- cal information, forwarding clinical information to nursing staff for admission determi- nations. Financial counseling for uninsured patients, enroll low income patients for Hospital Presumptive Medi-cal. Work closely with doctors and secretaries to expedite the ER visit and/or hospital admission.
Saint Mary’s Medical Center/Long Beach, CA January 2014 to July 2017 Access Care Representative Emergency Department
Duties include assisting in proper identification of the patient, collection of patient demographics information, financial counseling, coordination with the hospital's bed assignment process as well as anticipating and responding to the non-clinical needs of patients and their families. Financial counseling for uninsured patients as well as assist in sign low income, self-pay patients up for presumptive medi-cal. Works closely with doctors and secretaries to expedite the ER visit and/or hospital admis- sion.
Saint Joseph Hospital/ Orange, CA July 2004 to September 2012 Admitting Registrar II (Lead)
Interviewed and created accounts for new patients admitted to the ER (Emergency Room). Acted as a liaison between patients and health insurance companies as well as performed inpatient and behavioral health admits. Worked with hospital staff to place patients in proper care facilities. Made updates to patient’s information verifying insur- ances and collected copayments. Arranged placement of behavioral health patients which included; getting the patient medically cleared by an Emergency Department physician, finding placement for behavioral health patient based on their insurance and providing patients medical history records at the receiving facility and arranging transfer of patients.
Performed in a supervisory role when there was no supervisor on the schedule by overseeing staff, this included scheduling zones and break-relief, completing incom- plete patient accounts, and assisting staff with various issues that arise. Also assisted with the training of new staff members.
Dept. of Parks Recreation and Marines/ Long Beach, CA March 2003 to June 2004 Recreation Specialist
Duties consisted of assisting with supervision of after school programs, summer youth camps, and the coaching youth sports.
Water Department/ Long Beach, CA February 2003 to March 2004 Water Utility Mechanic
Duties consisted of changing water meters, upgrading galvanize pipes to copper from water main to service meter, fixing breaks on water main, and operating sewer cleaning truck.
Education
September 1994 to May 1999
David Starr Jordan High School/ Long Beach, CA – Diploma received
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