Primary Care Coordinator

Experience

Senior Transition of Care Coordinator /Quality Improvement Specialists

*/****- ****** ******* **. Joseph’s Health Partners, ACO/CIN/Population Health, Paterson, NJ

Assisting Accountable Care Organization with annual wellness visit and scheduling

Educating patients on the importance of annual wellness visits, and ER discharge hospital visit

Working with primary care physician on transitional care management to avoid emergency visit to the hospital

Works collaboratively with others to develop evidence based interventions for improving or preventing chronic health conditions

Delivers planned interventions as agreed on with health care team, in an effective style

Provides resources to individuals in the community based on approved programs identified by St. Joseph Healthcare System

Records all interventions with clients and reports all session outcomes

Identifies gaps in health care services in the community and shares information with the team

Works within the community to reduce hospital re-admissions and improve medication management

Participates in Community events such as health fairs, community meetings, community outreach

Meets all required competencies for department, unit and/or hospital

Responsible for performing all other duties as assigned

Provide all front desk support for a busy medical clinic-based facility

Prioritizes phone calls and direct patients to appropriate services/area

Handle all aspects of patient care including initial interview with patients, gather general demographic, insurance and health information to perform proper registration

Establish and maintain relationships with client, providing contact and support.

Act as liaison between service providers, community and the client and provides comprehensive initial assessment of need areas for all clients referred.

Conducts risk assessment with each client and formulates a crisis plan.

Assists individuals in scheduling and attending medical appointments as well as accessing outpatient mental health treatment.

Assists individuals with official correspondence pertaining to insurance eligibility, social security and other entitlement programs

Help the client identify and access appropriate resources to support the client’s recovery, self-manage

Point of care reports sent to primary care providers

Office Administrator/Biller

11/2014-08/2019- St. Joseph’s Health, Clifton, NJ

Assist the supervisor and director with meetings, scheduling and coordinating lunches with healthcare reps

Trained and navigated new employees around e-clinical works, insurance verifications and insurance billing

Assist the supervisor setting up patients for annual wellness visits and closing Medicare gaps

Collect office mail and distributed to the correct teams

Assist the office to set-up events for the new residents and help with the exiting process

Address and help the patients concerns and complaints in the office

Provide all front desk support for a busy medical clinic-based facility

Prioritizes phone calls and direct patients to appropriate services/area

Handle all aspects of patient care including initial interview with patients, gather general demographic, insurance and health information to perform proper registration, charity care process, community outreach and services obtained for patients

Maintain responsibility for scheduling accurate appointment based on patient needs and maintain follow up appointments

Handle the tasks of identifying billing claims, correcting and submitting insurance claims

Responsible for posting payable bills and adjustment in billing database, working with charity care and all insurances

Responsible for assisting patients, carriers, and other concerned parties in areas if insurance payment issues

Perform responsibilities of reporting the billing supervisor and managers in matters of the medical bills

Prior-Authorizations for services rendered, surgical or any services rendered at the time of services

Medical Receptionist/Precertification Specialist

8/12-3/13- University Orthopedic Center, PA. Hackensack, NJ

•Entered data regarding patient information

•Managed multi-lined phones

•Process patients’ files and schedule appointments

•Billing and calling insurance companies

•Handle various medical insurance duties

•Maintain and manage check in and check out patients

•Filling out medical disability forms

•Medical Records

•Calling insurance verify benefits and precertification for radiology images

Medical Biller and Coder/Precertification Specialists

05/10-10/10- Morris County Orthopedic Group Denville, NJ

•Entered data regarding patient information

•Managed multi-lined phones

•Process client files and schedule appointments

•Handles various medical insurance duties

•Maintain and manage check in and checkout patients

•Medical Records

•Medical billing and coder

•Called claims resolved settlements

Medical Office Administration/Biller

10/04-05/10- Orthopedic Specialists of NJ Hackensack, NJ

• Assisted staff with multiply phones lines, making appointments for patients

• Calling insurances for precertification, Billing and coding

• Scanning patients records into E Clinical works

• Referring patients to different facilities for radiologic procedures

• Entered date regarding patient information

Medical Office Administrative

07/01- 09/03 - Dr. Robert Fernand Orthopedic Group Wayne, NJ

• Managed office documentation

• Billing and coding, medical insurance collections

• Answered multi-line telephone, routed calls, and took accurate messages

• Performed faxing, photocopying and filing duties

• Called insurances for precertification, check in and check out

• Assisted supervisor with special projects

Worker’s Compensation Specialists

04/00-06/01- Premier Orthopedics & Sports Teaneck, NJ

•Managed office documentation

•Calling adjustor for prior authorizations for treatments, office visits and imaging services

•Faxing and scanning information to files, pulling charts for next day office visits

•Data entry, making new appointments and calling for prior authorizations for worker’s compensation patients

•Answered multi-line telephone and routed calls to the correct location, photocopying

•Speaking with employers and attorneys, regarding worker’s compensations claims and insurance verifications

Qualifications Summary

A seasoned administrative/executive assistant able to prioritize, multitask, and communicate effectively with all levels of management and staff

Experienced coordinator providing calendar management, conference/meeting set up; bilingual Spanish communicator

Facilitates as liaison for families by means of counseling, support and community resources.

Excels in public relation, human resource, and procedural administration.

Proven abilities in a wide range of social services skills related to care planning crisis intervention career related programs.

Electronic Medical Records Cerner Healthcare Systems/Millennium Platform/eClinicalWorks/Athena

Capable of working in a fast-paced and pressured environment efficiently and effectively

Excellent knowledge of medical terminology, interpersonal skills, quick learner, always ready to take on additional challenges and good sense of humor

Fluent in Spanish

Education

Bachelor Degree in Arts of Social Science Ramapo College of New Jersey, Mahwah, NJ Graduated 12/2018

Associates Degree Human Services Passaic County Community College, Paterson, NJ Graduated 5/2016

Certificate Medical Office Administrative Berdan Institute, Totowa, NJ Graduated 5/1998

Certificate Community Health Worker Passaic County Community College of New Jersey Graduated 11/2019

Certificates Programs in Social Work Credits Passaic County Community College/Ramapo College

Narcan Training Certificate 12/12/2019 St. Joseph's Health/Hospital

Contact this candidate