Emily E. Rosales

*** ********* ***. ***** ****, IN 46619 Phone: 574-***-**** Email: HYPERLINK "mailto:advsyx@r.postjobfree.com" HYPERLINK "mailto:advsyx@r.postjobfree.com"advsyx@r.postjobfree.com

Very experienced with VA policies, highly organized, expert in communication with multiple departments and tasks. I have stepped into lead and surrogate roles without hesitation and completed the tasks within a timely manner with respect of fellow colleagues. I have sat on multiple committees to find solutions to high importance matters for patient experience as well as VA associates. Helped implement and complete action plans for the Optometry department. Flexible to schedule changes. Able to recognize and help in problem solving and /or action plans to resolve issues.

Work Experience:

Compliance Coordinator and Credentialing Specialist

April 2022 to November 2022: 40-60 hours per week

NeuroPsychiatric Hospitals (Physicians Leasing) - Corporate Office South Bend, IN

•Managed compliance for a multi-state, multi-campus hospital system in Indiana (5 locations), Arizona (2 locations), Texas (2 locations) and Michigan (1 location).

•Reviewed and updated patient and employee handbooks for each state.

•Managed, reviewed, approved and sent exemption approvals and denials for all hospitals in regards to Covid and influenza vaccination exemption requests per each states’ requirements.

•Maintained and reviewed each compliant, whether family or patient, and assigned or conducted internal investigations to allegations reported to one of two reporting hotlines.

•Conducted internal investigations on employee staff, patients, family, and any incidents that happened on the campus of said hospital.

•Researched and designed new trainings and tests for employee education.

•Conducted search for a more user-friendly and improved learning management system.

•Received and tracked all legal subpoenas and on-going matters.

•Reviewed subpoena requests and either requested the information or sent to correct department for subpoena fulfillment.

•If subpoena was in regards to information that would be managed by compliance, documentation reviewed, compiled documents, and information was sent to legal team.

•Maintained a professional and working relationship with all law offices working with NeuroPsychiatric Hospitals.

•Identified major process issues with subpoena receival at facility campus and compliance not being notified. Formulated a quick and effective process change that improved corporate reporting and tracking for accuracy in Governing Board meetings.

•Talent acquisition team specifically requested assistance in implementing not only medical specific questions for interviewees changing from primary care to psychiatric care but also due to over a decade of experience with “round robin” interviews.

Compiled compliance reports (grievances and percentages of pre-determined grievance categories.

•Completed initial and re-credentialing (every two years) for all providers in each state. • Credentialing completed according to local, state, and federal requirements.

•Presented reports for providers to be granted full privileges to Governing Board for call campuses.

•Completed monthly reports for providers’ validity for DEA, medical license, and OIG reports.

•Tracked all provider trainings and due dates of expiration of certifications including BLS/CPR, disruptive behavior training, patient advocacy, etc.

•Sent reminders via email in advance to each provider in regards to upcoming expiration dates.

•Suspended and restored provider privileges due to non-compliance of corporate professional expectations.

•Tracked all provider required vaccinations/exemptions for yearly vaccination (flu), risk assessments (yearly TB), and all other updated required provider vaccinations.

•HazMat, Stericycle, and DOT 3 trained and certified.

•Placed IT work tickets/requests via NPH IT application.

Lead Advanced Medical Support Assistant (AMSA) for Care in the Community (CITC)

July 2020 to April 2022: 40 - 80 hours per week

Tennessee Valley Healthcare System – Care in the Community Murfreesboro, TN

•Received in consults for community care for all specialties

•Processed consults for specialties.

•Faxed authorization for care to selected facilities.

•Worked in conjunction with Optum and TriWest; in regards to billing issues.

•Over saw 20 to 40 employees on site and via telework.

•Entered in community care provider information for pharmacy (address/DEA/NPI).

•Completed supervisor training for health system record in order to manipulate consult issue/expiration dates.

•Completed OIG exclusion search for prescribing community care providers.

•Complete referral and authorizations for dialysis receiving Veterans.

•Only super user for Community Care Customer Relationship Management (ComCare CRM).

•Requested access and input employee information for ComCare CRM.

•Handled all patient advocate cases for Community Care.

•Review and send patient advocate case to correct processor.

•Reviewed all bills from patient advocates for determination of which department would handle said case.

•Entered all resolutions for patient advocate cases in PATS-R system.

•PATS-R expert (Dynamics software platform)

•Uploaded correct documentation needed for completion of patient advocate cases.

•Trained all new employees on processes and procedures for Care in the Community (CITC).

•Delegated projects to team.

•Fixed issues with consults (missing information/work arounds/resetting validity dates on authorizations) • Worked with Optum closely to onboard a health system in a specialty provider desolate area (Hamilton Physicians/have email from point of contact for Optum).

•Reviewed and completed score cards for over 150+ resumes (BQE reviews).

•Lead and conducted interview panels on multiple occasions.

•Completed and implemented specialty services workload assignments.

•Comfortable with completing counseling sessions with employees for documentation purposes before reprimand from supervisor (if insubordinate action happens again).

•Worked and completed multiple OIG/RCI requests from VISN 9.

•Placed stock replenishment orders via VISTA (R3) • Placed work orders for maintenance via VISTA (R3).

•Placed IT tickets for new employee access or computer issues via yourIT application.

•Working knowledge of Veeva Vault

Financial Revenue Technician

May 2020- July 2020: 40 hours per week

Tennessee Valley Healthcare System- Mid South Consolidated Patient Accounts Center Nashville, TN

•Reviewed patient charges for billable and non-billable insurance.

•Reviewed encounters for non-billable prosthetics and durable medical equipment (DME).

•Assessed patient medical charges pending further information; requested said information for revenue purposes.

•Released patient charges for billing purposes.

•Assisted with patient waivers and hard ship forms.

•Generated reports as needed by supervisor.

•Placed new community care provider’s information into VA data base.

Advanced Medical Support Assistant

January 2020 – May 2020: 40 hours a week

Tennessee Valley Healthcare System-Transplant Services Nashville, TN

•Experienced and proficient with the Department of Veteran Affairs (VA) electronic medical record (EMR), Computerized Patient Record System, including but not limited to updating demographics, insurance information and health information.

•Confidently able to operate Vista, including but not limited to the following: Scheduling appointments and completing patient check-in, cancelling or no-showing appointments, checking expanded entry, changing date range, checking appointment code, placing patients in recall, and changing recall.

•Skillfully able to use Vet Link to perform the following: Changing contact information, checking in patients, making memos on patient’s check-in, and changing settings regarding clinic profiles.

•Proficient with graphical user interface scheduling system.

•Able to take thorough message notes from phone conversations and place notes within CPRS to the appropriate person.

•Efficient with scanning documents onto the patient’s EMR.

•Experienced with release of information requests and communication with outside providers.

•Able to complete travel pay admissions for patients.

•Proficient with locating information within Joint Legacy Viewer.

•Responsible for maintaining spreadsheets and databases to track labor mapping, monitor clinic utilization, display reports and conduct audits.

•Communicate with a variety of staff within the Medical Center, including administrative and clinical staff to ensure accurate information while properly completing assignments.

•In-depth working knowledge and demonstrate proficiency in use of VISTA< CPRS, all Microsoft Office applications, and the internet to perform needed computer functions, generate reports, perform appropriate data audits and informatic searches.

•Ability to function and cooperate as a productive member of a professional-level team, keeping in mind the overall team objectives, while at the same time performing individual work assignments.

•Proficient in ability to organize, coordinate and prioritize simultaneous work assignments that are both individual and team related.

•Completed departure packets for patients and home VA providers.

•Proficiently placed lab test orders for provider.

•Responsible for placing diagnostic imaging consults and scheduling.

•Configured new patient enrollment/welcome packets.

Advanced Medical Support Assistant

September 2017 – January 2020 40 hours a week

St. Joseph County VA Health Care Center – Optometry Department/PACT/Audiology Mishawaka, IN

•Experienced and proficient with the Department of Veteran Affairs (VA) electronic medical record (EMR), Computerized Patient Record System, including but not limited to updating demographics, insurance information and health information.

•Confidently able to operate Vista, including but not limited to the following: Scheduling appointments and completing patient check-in, cancelling or no-showing appointments, checking expanded entry, changing date range, checking appointment code, placing patients in recall, and changing recall.

•Skillfully able to use Vet Link to perform the following: Changing contact information, checking in patients, making memos on patient’s check-in, and changing settings regarding clinic profiles.

•Proficient with graphical user interface scheduling system.

•Able to take thorough message notes from phone conversations and place notes within CPRS to the appropriate person.

•Efficient with scanning documents onto the patient’s EMR.

•Experienced with release of information requests and communication with outside providers.

•Able to complete travel pay admissions for patients.

•Proficient with locating information within Joint Legacy Viewer.

•Responsible for maintaining spreadsheets and databases to track labor mapping, monitor clinic utilization, display reports and conduct audits.

•Communicated with a variety of staff within the Medical Center, including administrative and clinical staff to ensure accurate information while properly completing assignments.

•In-depth working knowledge and demonstrate proficiency in use of VISTA< CPRS, all Microsoft Office applications, and the internet to perform needed computer functions, generate reports, perform appropriate data audits and informatic searches.

•Ability to function and cooperate as a productive member of a professional-level team, keeping in mind the overall team objectives, while at the same time performing individual work assignments.

•Proficient in ability to organize, coordinate and prioritize simultaneous work assignments that are both individual and team related.

•Broad range of administrative skills, as well as knowledge of VISN 10 and medical center organizational structure, missions, functions, and processes.

•Back up support for supervisor regarding AMSA team.

•Comfortable presenting to groups and providing training on new materials.

•Surrogate to Audiology AMSA.

•Provided support to PACT 38. Provided support to the lab.

•Trained surrogates for Optometry 40. Chaired interview process for a range of different clinics.

•Checked and documented reference responses for possible new hires.

•Collected and reviewed required documentation for new hires.

•Coordinated training and new employee orientation for new hires.

•Helped with completion of finger printing and data entry for new hires.

•Submission of action items for new hires 46. Volunteered for time keeper.

•Phone operator for multiple facilities regarding patient care.

•Temporary acting AMSA Lead for Specialty care

Medical Support Assistance/Phlebotomist/Medical Assistant

April 2012 – September 2017 45-48 hours a week

South Bend VA Community-Based Outpatient Clinic – Ambulatory Care Solutions South Bend, IN

•Skillfully able to note patient concerns and was effectively able to alert providers and nurses 50. Worked intimately and efficiently with Patient Aligned Care Team.

•Efficiently able to enter and/or document changes on means tests.

•Trained new employees with PACT scheduling, daily tasks, and checking in and out.

•This position encompassed many similar tasks as was listed above.

•Acting supervisor for administrative associates for three months; every month after for detail.

•Month-to month detail rooming patients, vitals and completing clinical reminders.

•Phlebotomy and processing of specimens 57. Completed clinical reminder report twice a month.

•Filled out and completed release of information.

•Coded (ICD 10) patient appointments.

•Scanned pertinent patient information onto EMR.

Medical Assistant (Externship)

August 2011 – November 2011

Del Pilar Medical & Urgent Care – Externship Mishawaka, IN

•Recorded and documented patient vitals including, but not limited to, height, weight, blood pressure, temperature, pulse, pulse oximetry, and respiratory count.

•Performed and documented hearing tests including, but not limited to, the following steps: placing the patient in testing booth, having the patient put on headphones, instructing the patient to push the button on top of the handheld indicator, and printing the results for provider review.

•Performed and documented visual testing, electrocardiograms, and pulmonary function tests.

•Assisted with and administered antibiotic, vaccine, vitamin and testosterone injections.

•Completed seasonal flu collection/testing and allergy testing (skin only).

•Collected HIPPA-compliant release of information, reviewed medical record for proper release of record, and released said information.

•Scheduled patients for doctor and nurse practitioner appointments.

Education:

Ross Medical Education Center – Granger, IN January 2011 – November 2011

•Payroll

•Insurance claims/billing

•Medical coding

•Phlebotomy

•Autoclaving

•EKG

•Patient record charting

•Patient vitals

•Injections (immunization, TB testing, vitamin and antibiotic)

•Medical terminology

Additional Training:

•St. Joseph County VA Health Care Center

•Mishawaka, IN September 2017 – April 2022

•Self-initiated attendance at non-required class: Own the Moment

•Self-initiated attendance at non-required class: Goal Setting

•Self-initiated attendance for AMSA Lead/Supervisor training program not-required

•Volunteered for the Patient Advocate Liaison, which is a program to further assist veterans

•Volunteered for the All-Employee Survey subcommittee

•Volunteered for the Call Center Focus Group

•Volunteered to be a Controlled Substance Inspector

•Volunteered for Phones Committee

•Completed business office training academy (BOTA)

•Volunteered for Morale Committee

•Certified Yellow Belt within Lean Sigma Six methodology

•Instructor for Own the Moment training

•Multiple ICARE award recipient

•Employee of the Month for August 2018-Optometry department

•Recipient of multiple Teamwork awards for AMSA (specific to St. Joseph County VA)

•Creator and editor of the St. Joseph County VA Employee Newsletter (issued every month)

•Employee Association member

•Morale Committee member (implemented St. Joseph County VA only/Employee of the Month)

**References available upon request**

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