Randi Thoune
Peyton,CO
Summary
Goal-driven Healthcare Administration professional well-versed in recruiting, training and managing employees to provide exceptional patient services. Highly organized and hardworking with excellent planning and program management skills. .
Overview
16
16
years of professional experience
Work History
Practice Manager
Spruce Health Group
06.2022 - 07.2023
- Maintained accurate medical records, applied ICD-10 coding, obtained pre-authorizations and referrals, and verified eligibility and benefits
- Performed payroll, and other HR duties.
- Improved practice revenue through effective financial management and strategic cost reductions.
- Enhanced staff productivity by providing comprehensive training programs and regular performance evaluations.
- Developed strong relationships with patients, ensuring a high level of care and satisfaction throughout their experience.
- Managed office budget, reducing unnecessary expenses and allocating funds for necessary improvements.
- Coordinated with physicians to optimize appointment schedules and maximize daily patient flow.
- Facilitated communication between staff members, fostering a collaborative work environment that improved overall team performance.
- Oversaw the hiring process for new employees, selecting candidates who aligned with the practice's mission and values.
- Reduced employee turnover by implementing competitive compensation packages and creating a supportive work atmosphere.
- Addressed patient concerns promptly and professionally, demonstrating empathy and excellent problem-solving skills.
- Collaborated with marketing teams to develop promotional materials that effectively highlighted the practice's unique offerings.
- Oversaw facility maintenance projects, ensuring a safe and comfortable environment for both patients and staff members.
Patient Family Service Specialist
Children’s Hospital Colorado
02.2021 - 06.2022
- Met with patient and/or patient's caregiver to exchange necessary information and documentation
- Provided explanation of visit, instructions, and addresses concerns and questions
- Communicated with referring provider's office, clinical department(s), and/or other appropriate personnel to exchange necessary information and determine schedule
- Verified insurance benefits and obtains pre-certification/authorization as necessary
- Determined and accepted required payments, including co-pays and deductibles, or refers to financial counselors for follow up
- Ensured that all necessary demographic, billing, and clinical information is obtained and entered in the registration system with timeliness and accuracy.
Special Education Educational Manager
McAuliffe Elementary
01.2019 - 08.2020
- Aided and supported teachers and staff
- Lead small group invention teams in reading, writing, and math for grades k-5
- Handled escalated situations between students, teacher, parents, and staff
- Provided social and emotional support
- Followed state and federal laws regarding special education services
- Adhered to all requirements of each student’s individual learning plan
- Assisted with Occupational therapy and Physical therapy services
- Assisted with Medicaid and Medicare billing.
Patient Access Representative
UCHealth Orthopedics
10.2018 - 01.2019
- Met with patient and/or patient's caregiver to exchange necessary information and documentation
- Provided explanation of visit, instructions, and addresses concerns and questions
- Communicated with referring provider's office, clinical department(s), and/or other appropriate personnel to exchange necessary information and determine schedule
- Verified insurance benefits and obtains pre-certification/authorization as necessary
- Determined and accepted required payments, including co-pays and deductibles, or refers to financial counselors for follow up
- Ensured that all necessary demographic, billing, and clinical information is obtained and entered in the registration system with timeliness and accuracy.
Patient Access Representative
UCHealth Urgent Care
01.2017 - 10.2018
- Met with patient and/or patient's caregiver to exchange necessary information and documentation
- Provided explanation of visit, instructions, and addresses concerns and questions
- Communicated with referring provider's office, clinical department(s), and/or other appropriate personnel to exchange necessary information and determine schedule
- Verified insurance benefits and obtains pre-certification/authorization as necessary
- Determined and accepted required payments, including co-pays and deductibles, or refers to financial counselors for follow up
- Ensured that all necessary demographic, billing, and clinical information is obtained and entered in the registration system with timeliness and accuracy.
Customer Service Representative Lead for Military and Veterans
United Healthcare
01.2013 - 01.2016
- Worked with patients and providers on their medical benefits, claims, referrals, and authorizations
- Managed large number of inbound calls in a timely manner
- Respected all HIPAA requirements
- Directed multi-line calls to the proper locations
- Processed orders and updated patient information
- Earned 100% marks in all categories including communication and listening skills, problem resolution and politeness
- Met and exceeded company goals and metrics
- Resolved a wide base of multicultural clientele technical issues
- Opened troubleshooting tickets and accessed accounts to resolve a variety of technical disputes
- Received payments in different forums
- Submitted request to the proper department to prevent reoccurring issues.
Signal Support Specialist
U.S. Army
01.2008 - 01.2009
- Provided administrative support to office staff
- Maintained office files and unit personnel records
- Handled confidential information
- Handled office duties to include data entry, scheduling, and personnel support
- Submitted comprehensive and timely reports to supervisor
- Troubleshoot and maintain communication equipment
- Completed training essential to operate satellite radios and telecommunications computers
- Passed all necessary background tests to obtain Security Clearance
- Honorable discharge.
Education
Ph.D. - Healthcare Leadership
Colorado Technical University
Colorado Springs, CO07.2026
MBA - Healthcare Management
Colorado Technical University
Colorado Springs, CO05.2022
Bachelor of Science - Healthcare Management
Colorado Technical University
Colorado Springs, CO05.2020
Skills
- Referral Management
- Resource Utilization
- Policy and Procedure Development
- Medical Personnel Recruitment
- Workflow Management
- Electronic Health Records
- Continuous Improvement
- Staff Management
- Policy Implementation
- Appointment Scheduling
- Medical Billing
- Training Program Implementation
- Patient Relations
- Human Resources Management
Job Related Training
- BLS/CPR/AED Certification, 2022
- CPI- Nonviolent Crisis Intervention, 2019
- HIPAA Certification, 2018
- Epic and Sytoc Training- Electronic Health Records, 2018
- Client Relations Training, 2015
- Administrative Assistance Training, 2015
- Insurance Specialist Training, 2013
- Call Center Agent Development Training, 2013
- Signal Support Systems Specialist Training, 2008
- Basic and Advanced Military Training, 2008
Timeline
Practice Manager
Spruce Health Group
06.2022 - 07.2023
Patient Family Service Specialist
Children’s Hospital Colorado
02.2021 - 06.2022
Special Education Educational Manager
McAuliffe Elementary
01.2019 - 08.2020
Patient Access Representative
UCHealth Orthopedics
10.2018 - 01.2019
Patient Access Representative
UCHealth Urgent Care
01.2017 - 10.2018
Customer Service Representative Lead for Military and Veterans
United Healthcare
01.2013 - 01.2016
Signal Support Specialist
U.S. Army
01.2008 - 01.2009
Ph.D. - Healthcare Leadership
Colorado Technical University
MBA - Healthcare Management
Colorado Technical University
Bachelor of Science - Healthcare Management
Colorado Technical University
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