Patient Care Coordinator
Resume:
Sharone Love Lewis
Ellenwood, GA
Summery
Patient Care Coordinator with over 8 years of experience in enhancing patient outcomes through meticulous documentation and streamlined pharmacy operations. Demonstrates expertise in time management, medical billing, and compliance with healthcare regulations, driving towards a reduction in medication errors. Committed to fostering collaborative relationships with healthcare providers to deliver exceptional patient care and support seamless care transitions.
Professional Experience
Remote Appeals and Grievances Coordinator Amerihealth Caritas March 2023 - present
●Coordinated appeals processing, ensuring timely resolutions that enhanced client satisfaction and minimized escalations.
●Provided guidance to team members on compliance regulations, nurturing a culture of knowledge sharing and professional growth.
●Promoted a culture of collaboration and open communication, enhancing team dynamics and overall workplace morale.
●Managed appeals processing workflows, achieving timely resolutions and significantly enhancing client satisfaction metrics.
●Streamlined grievance really protocols, resulting in reduced turnaround times and improved service efficiency.
Patient Care Coordinator/Pharmacy Tech US Bio Specialty Pharmacy February 2022 - March 2023
●High volume call queue/ maintaining call quality standards. Medical and Pharmacy terminology, Medicare & Medicaid familiarity. ICD-9, ICD-10, HCFA, & 1500 form familiarity.
●Analyzed medication dispensing patterns, identifying trends that led to a 15% reduction in errors and improved patient safety.
●Coordinated with healthcare providers to ensure accurate medication management, fostering strong relationships that enhanced patient outcomes.
●Streamlined medication reconciliation processes, reducing discrepancies and enhancing compliance with healthcare regulations.
●Maintained accurate patient records and documentation, ensuring compliance with legal standards and facilitating seamless care transitions.
●Ensured meticulous documentation of patient records, maintaining compliance with regulations and supporting effective care transitions.
Pharmacy Care Coordinator United Healthcare (Briova Home Infusion Pharmacy) October 2018 - November 2019
●Coordinated home infusion services, enhancing patient care and satisfaction.
●Streamlined pharmacy operations, resulting in improved service delivery.
●Facilitated communication between patients, providers, and insurers, ensuring seamless care.
●Managed patient records with precision, supporting accurate medication management.
●Contributed to a collaborative team environment, fostering effective healthcare solutions.
●Coordinated with multidisciplinary teams to manage patient records effectively, supporting accurate medication management and enhancing overall care quality.
GA Licensed Pharmacy Tech Kroger Pharmacy June 2018 – October 2018
●Managed inventory and conducted audits, enhancing medication availability.
●Handled Medicare and Medicaid reimbursements, ensuring compliance.
●Provided expert customer service, fostering a supportive pharmacy environment.
●Coordinated with pharmacists to ensure accurate medication dispensing, fostering a team environment focused on patient safety.
PCA Home Instead Senior Care June 2018 – October 2018
●Assist clients with daily tasks, improving their independence and well-being.
●Coordinate with families and healthcare teams, ensuring comprehensive care delivery.
●Maintained detailed records of client progress and care activities, ensuring compliance with healthcare standards and improving service delivery
Benefit Enrollment Specialist (Contract) Paramount Staffing June 2017 - June 2018
●Delivered top-tier customer service, boosting satisfaction during peak call times.
●Streamlined benefit processes, significantly reducing enrollment time.
●Executed precise administrative tasks, ensuring compliance and operational success.
●Addressed client concerns with empathy, enhancing trust in services.
●Managed enrollment accuracy, achieving substantial processing time improvements.
●Provided empathetic assistance to clients, ensuring a positive experience that reinforced trust in our services
Remote Beneficiary Service Representative Humana Government June 2016 – June 2017
●Resolved customer inquiries, boosting satisfaction and loyalty.
●Managed high-volume calls while maintaining quality standards.
●Navigated multiple systems for efficient issue resolution.
●Streamlined processes, reducing response times and enhancing efficiency.
●Maintained accurate records of customer interactions and billing adjustments, ensuring compliance with CPT and ICD-9 standards.
●Cultivated a positive customer experience by actively listening to inquiries, contributing to heightened satisfaction and loyalty.
Remote Care Management Associate / Claims Benefit Specialist Aetna Healthcare January 2013 – June 2016
●Processed claims, adjusted payments and referral submission to determine, review, or apply appropriate guidelines, coding, member identification processes, provider selection processes, claim coding, including procedure, diagnosis, and pre-coding requirements.
●Assisted members and providers through high-volume call queues, ensuring clear communication and maintaining exceptional call quality standards, maintaining quality and resolving claims efficiently
●Enhanced processing workflows, boosting efficiency and member satisfaction.
●Following prescribed operational guidelines, manages claims on the desk, route/queues, and ECHS within specified turn-around-time parameters
●Utilizes all applicable system functions available ensuring accurate and timely claim processing service
Admissions Clerk Bunker Hill Community College August 2008 - July 2012
●Provided exceptional customer service by efficiently managing multi-line phone and computer systems, enhancing user experience and satisfaction.
●Streamlined admissions processes by implementing organized filing systems, resulting in faster application processing and improved accuracy.
●Coordinated with multiple departments to schedule and conduct campus tours, fostering a welcoming environment for prospective students.
●Maintained accurate data entry for student records, ensuring compliance with institutional guidelines and facilitating effective communication
Education
2009 – 2012 Bunker Hill Community College Boston, MA • Associate Degree in Psychology. Incomplete
2016 – 2018 Herzing University Online
Bachelor Degree in Medical Office Management. Incomplete
1995-1999 Boston Evening Academy Boston, MA • High school diploma
2018 – 2024 State of Georgia Pharmacy Technician License
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