Karesa T. Ruffin
St. Marys,GA
Summary
Years of customer service and call center experience, Nearly 5 years medical office, healthcare administration expertise. Accurate and timely data entry; Detail oriented and organized Advanced communication skills both written and oral - clear/professional with customers Dedicated Medical professional with history of meeting company goals utilizing consistent and organized practices. Skilled in working under pressure and adapting to new situations and challenges to best enhance the organizational brand. Covid Vaccinated and Boosted
Overview
6
6
years of professional experience
Work History
Medical Care Coordinator
One Call Care Management
Jacksonville, FL
06.2017 - Current
- Schedules Workers compensation patient for treatment in continuing care practices and provides required documentation for said appointment
- Intake telephonic and non-telephonic, developing referrals for physical therapy, medical, diagnostic, home health, transportation and DME
- Tracks And Documents Inbound Support Requests and ensures proper notation of problems or issues
- Updates Patient Sensitive medical information and ensures accurate entry of information
- Troubleshoots Patient Problems, identifies root causes of problems, and uses tools and resources appropriately to determine how to resolve problems
- Address 3rd Party issues from contractors, vendors and others
- Processes minimum of 35+ referrals each shift
- Contacts Nurse Case Manager, Discharge Planners, Physicians, Nurses and/or Adjusters to obtain authorizations for additional or continued service
- Developed and Provided Guidance, Tools and offered mentoring to less experienced coordinators
- Performed daily processing high volume of patient inquiries about One Call Care Management products and services and resolves targeted percentage of those inquiries.
Administrator
Professional Debt Mediation
Jacksonville, FL
08.2016 - 06.2017
- Scan, upload and electronically file over 100 forms of correspondence daily
- Input demographic and financial information from paper and electronic files for collections
- Sort, log and categorize over 100 forms of correspondence daily
Education
Master’s degree - Health Administration & Management
University of Phoenix
Tempe, AZ03.2019
Bachelor of Health Administration - Health Information Systems
University of Phoenix
Tempe, AZ05.2017
Skills
- Microsoft Word, Excel, PowerPoint, Access
- Project Management/Analytical Skills
- HIPAA & Health Care Privacy Law Certified
- Lean Six Sigma Certified – Yellow Belt
- Prior Authorization Processing
- Coaching and Mentoring
- Customer Satisfaction
- Problem Identification
- Health Information Systems (HIS)
- Patient Care Assessment
Timeline
Medical Care Coordinator
One Call Care Management
06.2017 - Current
Administrator
Professional Debt Mediation
08.2016 - 06.2017
Master’s degree - Health Administration & Management
University of Phoenix
Bachelor of Health Administration - Health Information Systems
University of Phoenix
Similar Profiles
DEBORAH OGIEGLODEBORAH OGIEGLO
MEDICAL SERVICES COORDINATOR 1 at One Call Care ManagementMEDICAL SERVICES COORDINATOR 1 at One Call Care Management
Margaret OmowaiyeMargaret Omowaiye
Medical Coordinator at One Call Care ManagementMedical Coordinator at One Call Care Management
Dionis XhaferiDionis Xhaferi
Information Security Intern at One Call Care ManagementInformation Security Intern at One Call Care Management