Experience

Dignity Health Management Services Organization

• United States
• Hospitals and Health Care
• 100 - 200 Employee

• Quality Management Coordinator

  • Mar 2022 - Present

  - Creating and manipulating data with spreadsheets and/or databases using Excel, Access or other similar programs and/or applications -Responsible for medical record retrieval projects related to HEDIS. Outreach to patients (new and existing) via telephone, text, and patient portal to assure care needs are being met and all care gaps are addressed. -Knowledge of current CPT, ICD-9 and ICD-10 coding procedures and practices. -Experience working with physicians offices in regards to coding, documentation or quality measures. -Extensive knowledge of Microsoft Office applications; Excel, Word, Outlook, PowerPoint. Google drive -Knowledge of HEDIS, UDS, PCMH Show less



Kern Medical

• United States
• Hospitals and Health Care
• 400 - 500 Employee

• Outpatient Consult Representative (Extra-Help)

  • Aug 2021 - Mar 2022

  • Submits necessary documentation to insurance companies in order to obtain required prior authorization for patient care and/or treatment. • Tracks and follows up on outstanding requests for authorization. • Answers patient phone calls, reviews process, and schedules appointments for exam or follow ¬up. • Enters all patient demographic information into electronic patient record system; uses other department applications for eligibility and authorization. • Screens referrals and informs referring physician offices, patients and their families about hospital policies and procedures regarding method of payment sources for services rendered. • Works in collaboration with outpatient scheduling and registration to identify and resolve issues and/or barriers. • Submits and responds to requests for information and inquiries related to outpatient authorization/scheduling processes, policies, and/or other related information; researches and resolves customer problems. Show less



Bakersfield Family Medical Center

• United States
• Hospitals and Health Care
• 1 - 100 Employee

• Hospital Discharge Coordinator

  • Nov 2020 - Aug 2021

  • Ensured availability of treatment information by filing and retrieving patient records. • Maintained patient accounts by obtaining, recording, and updating personal and financial information. • Scanned hospital discharge charts into EMR system (NextGen) • Confirmed and verified insurances (Medical, BlueCross, BlueShield, Medicare, Tricare, etc.) • Mailing and faxing records to PCP/Specialists • Entering authorizations for DME • Filing discharges and authorizations • Scheduling hospital discharges follow up appointments. • Scheduling specialists follow up appointments. Show less