Care Coordinator Data Entry

Eric Tran

***** ******* **., ***********, ** ****3

************@*****.***; Mobile 714-***-****

Career Objective: To obtain a position in the medical field that offers growth advancement and job stability based upon dependability, diligence, and quality performance. Qualifications:More than 15 years of diverse experience in the healthcare industry, emphasizing provider and member services. Knowledge of CalOptima, Medi-Cal, Medicare, OneCare, and Commercial healthcare systems. Proven ability for problem-solving daily, working under pressure, and developing strong health plans, and hospital, and provider relationships.

PROFESSIONAL EXPERIENCE

Conifer Health Solutions

Personal Care Coordinator

July 2015 – Present

Assist with discharge planning as needed.

Conduct Post Discharge Calls to members as assigned.

Actively participate in in-services, training, staff meetings, and other departmental meetings.

Process appeals within the required turnaround time as required.

Maintain confidentiality of all member information and MHC business.

Efficiently navigate and utilize computer data entry programs not limited to Practice Connect, Microsoft Office Outlook, Word, and Excel, Right Fax, and Adobe Standard for the fax attachment process.

Conifer Health Solutions

Provider Network Quality Coach

July 2013 – July 2015

Serve as liaison between primary care physicians, specialists, and healthcare networks to enhance provider relations and improve patient care quality.

Ensure provider compliance with regulations, including HEDIS measures, quality, health plan, and IPA initiatives policies and procedures.

Organize, coordinate, and conduct PCP and Office Manager Forums, new provider in- services, and provider office visits to ensure IPA membership growth, retention, and compliance with quality metrics.

Recruit additional providers as needed to maintain, and grow volume, and ensure that at least 95% of the DOC panels are complete and closed PCP panels do not fall below the 85% threshold.

Participate in and coordinate the IPA, physician, hospital, and community events.

Coordinate outreach efforts with the health plans and employer groups to organize marketing events and health fairs.

Review the Encounter Data and Electronic Authorization Submission reports to identify providers for in-services.

Maintain and keep in total confidence, all files, documents, and records that pertain to the operation of the business for Cap Management Systems.

Perform all other job-related duties as related to job function or as delegated by the management team.

Trieu T. Tran, M.D., Inc.

X-Ray Technician/Medical Assistant

November 2012 – July 2013

Perform X-Ray procedure on Chest, Extremities, and Torso skeletal.

Cast patients with fractures and remove all sutures and staples.

Fitting all DME Braces on patients.

Maintain inventory back office and X-Ray department.

Take patient histories and vital signs.

Set up surgical tray for minor procedure.

Jason J. Chiu, M.D., Inc.

X-Ray Technician/ Surgery Coordinator

September 2007 – November 2012

Schedule patient surgery appointments and make the confirmation call.

Communicate with insurances for patient's eligibility and coverage.

Provide billing for HMO and PPO insurance, and Medi-Cal.

Electronic billing for Medicare.

Worker compensation and personal injury liens.

Education

X/Ray Tech and Medical Assistant Certificate

Bilingual English and Vietnamese

Computer Proficiency

Window 95, 98, 2000, and XP

MicrosoftWord, Excel, Access, and Outlook 2000

Cap Connect software, EMR (Practice Fusion), Ascender, EZ-Cap, EZ Reporting& (Prime Clinical System) Patient Chart Manager

References

Available upon request

Contact this candidate