Admission Coordinator

DEBRA L RETZLAFF

N**** LOON LAKE DR

SHAWANO WI *4166

715-***-****

OBJECTIVE: To obtain employment that will expand on my current knowledge and allow for growth and opportunity.

EDUCATION: Currently working towards CBRF Administration certificate, Business Law, Accounting and Medical Terminology. Several collection and customer service seminars.

EMPLOYMENT:

2008- Admissions Coordinator, Kindred Healthcare

Present Responding to inquiries from hospitals, discharge planners, families and other referral sources, assessing referrals for potential placement at a Skilled Nursing Facility. Meeting with referral sources, potential admit and their families. Working with internal management to ensure the needs of referrals are met upon entering the facility, preparing admission paperwork and obtaining signatures from the resident or responsible party. Develop and implement sales and marketing plans. Chair-marketing meetings, monitor budgets and track results. Maintaining and exceeding census and revenue goals. Responsible for conducting sales calls outside the facility to medical, insurance, legal and financial professionals as well as special interest groups, hospital discharge planners and community contacts. Establish and maintain relationships with referral sources and advise them of current bed availability. Develop special events and presentations aimed at community education, representing the facility as the expert on skilled nursing, specialty programs and rehabilitation care. Continuous follow up on all active and pending referrals. Monitor and evaluate customer satisfaction. Manage and supervise employees, operations of building, and report incidents regarding resident’s health and welfare during specified times of Manager on Duty. Discuss day to day operations with Executive Director and other management staff. Participate in decisions of improving daily operations and resident’s wellbeing.

2006- Grievance & Appeals Specialist, Humana Insurance

2008 Research, investigate and resolve customer appeals, provider grievances, and complaints within the state-mandated time frames. Issues include payment of claims, pre-authorization of services, and billing discrepancies. Educate member regarding the provisions of their policy and reply by written response to all issues involved. Respond to Department of Insurance complaints, submitting internal and external reviews, and working grievance panels.

2004- Claim Review Analyst, Humana Insurance

2006 Conduct medical claim reviews on individual insurance policies to determine pre-existing medical conditions and accuracy of applications. Payments of medical claims, review medical records, verify insurance benefits and provide customer service. Call Center experience.

2000- Patient Accounts Representative, Shawano Medical Center

2004 Patient admission and registration. Responsible for obtaining and negotiating payments and payment plans for self-pay account balances. Submitted invoices to insurance companies, Medicare and Medicaid. Contacting self-pay and large balance accounts to determine ability to pay and negotiations of payment plans. Pre-qualifying candidates for charity care and various community programs. Sent monthly billing statements, performed cash posting bank deposits and payment of invoices. Working directly with community services, lending institutions and collection agencies. Handling of bankruptcies, probates and legal filings along with representation during court hearings.