April Miller
Granite City,IL
Summary
Dedicated healthcare professional offering 26 years of well rounded healthcare experience. Successful at fostering collaboration and communication between providers and clients, and building smooth relations for efficient negotiations. In addition, I have equipped myself with various skill sets and certifications outside of the healthcare industry to add value to any organization in need of great collaboration, interpersonal skills and multitasking abilities.
Overview
26
26
years of professional experience
Work History
Regional Float Tech-CSO
BJC Healthcare - St. Louis Region
St. Louis, MO
06.2023 - Current
- Provided direct patient care and assistance to healthcare team members.
- Assisted in preparing patients for examinations and treatments, including vital signs monitoring.
- Performed EKGs, phlebotomy, and other laboratory tests as directed by physician or RN.
- Maintained accurate records of patient care, condition, progress, and concerns.
- Observed changes in patient's conditions and reported any abnormalities to the RN.
- Collected specimens such as urine samples for testing purposes according to established protocols.
- Answered call lights promptly and responded appropriately to requests from patients, families, staff members.
- Reported any observed changes in behavior or physical condition to the nursing staff immediately.
- Conducted safety rounds regularly to ensure safe environment for patients.
- Transported patients to other areas of hospital in wheelchairs and gurneys for tests, treatments and therapies.
- Assisted with patient transfers from bed to wheelchair or stretcher as needed.
- Safeguarded patient privacy with strict adherence to HIPAA protocols.
- Measured and recorded food and liquid intake and output, reporting changes to medical or nursing staff.
- Assisted nurses with wound care for pressure ulcers, bed sores and surgical site wounds.
- Provided physical support to assist patients with bathing, dressing and toileting.
- Supported daily living activities by serving meals, feeding, ambulating and turning over and positioning patients.
- Documented and reported observations of patient behavior, complaints or physical symptoms to nurses.
- Communicated with patients to determine feelings, need for assistance or social and emotional support.
- Supported healthy patient skin with bedside baths, wound care and integrity checks.
- Collected biological specimens and packaged for laboratory transport to complete diagnostic tests.
- Performed minor housekeeping tasks to keep patient areas clean and sanitized.
- Restocked unit frequently with necessary medical supplies.
- Respond quickly in emergency situations by providing appropriate first aid measures.
- Participated in quality improvement activities within the department.
Security Officer
Allied Universal Security Services
Roxana, IL
09.2022 - 03.2023
- Monitored surveillance cameras and responded to suspicious activity.
- Conducted regular security patrols of the facility grounds, parking lots, and perimeter areas.
- Confirmed visitor identification prior to granting entry into the building.
- Enforced access control measures in accordance with established procedures.
- Maintained accurate logs of all security related activities.
- Provided escorts for visitors as needed throughout the facility.
- Performed first aid and CPR when necessary during emergency situations.
- Investigated any suspicious persons or vehicles on premises and contacted appropriate authorities if necessary.
- Prepared detailed reports regarding daily activities, unusual occurrences, maintenance issues.
- Monitored entrances and exits for unauthorized personnel or prohibited items being brought onto premises.
- Adhered to post orders while maintaining a visible presence around the property.
- Operated communication systems between officers stationed throughout the facility.
- Surveyed multiple CCTV feeds to closely monitor important areas on grounds.
- Searched bags manually to identify prohibited items and contraband.
Patient Care Technician
Ortho Trauma/Med Surg Line, Mercy Hospital
St. Louis, MO
03.2019 - 07.2022
- Obtained patient vital signs and reported results to staff nurse or physician to identify changes from prior measurements.
- Documented patient intake and dietary requirements and aided with feeding and monitoring.
- Looked for physical, emotional and symptomatic changes in patient condition and obtained necessary care for medical concerns.
- Supported healthy patient skin with bedside baths, wound care and integrity checks.
- Collected biological specimens and packaged for laboratory transport to complete diagnostic tests.
- Examined and treated patient lacerations, contusions and physical symptoms and referred patients to other medical professionals.
- Identified and reported observations and clinical symptoms to appropriate healthcare professionals, driving timely intervention.
- Responded to bell or light signal calls to assist patients with needs.
- Recorded patient conditions and vital signs before and after medical operations.
- Transported patients to other areas of hospital in wheelchairs and gurneys for tests, treatments and therapies.
- Performed minor housekeeping tasks to keep patient areas clean and sanitized.
- Assisted with patient admissions, discharges and transfers.
- Kept instruments and equipment clean and sanitized.
- Performed variety of delegated basic patient care services to support nursing functions and activities of daily living.
Contract Negotiator I
CENTENE Corporation
Chesterfield, MO
02.2014 - 05.2018
- Recruit physician, hospital and ancillary service providers to sign network participation agreements that are in accordance with corporate, health plan and state guidelines
- Ensure that all necessary documentation and information are included
- Recruit and develop network for a region and set of providers. Lead assigned recruitments (i.e Physician, hospital and ancillary) and ensure they result in complete and accurate standard contracts that meet objectives
- Facilitate and oversee to the provider set-up and contract configuration to ensure accurate claims adjudication
- Initiate contact and identify potential providers by geographic and specialty needs and update database
- Coordinate with internal departments and contracted providers to implement and maintain contract compliance
- Provide credentialing and provider data management services to health plans who are contracting and re-credentialing providers and individual practitioners with our network.
- Enroll providers/practitioners both in/out of network into Portico database while maintaining an audit average of 98% or higher.
- Maintain flexibility of knowledge, for project assistance to plans in each state, as requirements vary from state to state.
Customer Service Professional/Seasonal
H&R Block
Granite City, IL
12.2013 - 04.2014
- Greet clients upon entrance
- Review tax documents and secure them according to HIPAA guidelines
- Determine which tax professional is best suited to meet the needs of the client and assign them accordingly
- Maintain an atmosphere of satisfaction and contentment while clients await their appointment
- Answer inbound calls and accurately schedule appointments vía appointment manger
- Utilize the client's wait time to promote products that could benefit them now and in the future
- Assist tax professionals in providing a positive experience for clients in a manner that secures repeat business
- Reach goals set by the office manager to ensure a successful tax season upon completion.
Claims Specialist
Patients First Healthcare
Washington, MO
01.2008 - 01.2010
- Provide medical billing assistance for Patient's First physicians and patients
- Identify and provide resolution to medical billing errors
- Provide verbal and written appeals to insurance companies when it is necessary to dispute their decision
- Assist patient accounts with patient objections.
Collector/Medical Billing
EBO Financial Services
Ballwin, MO
01.2007 - 01.2008
- Maintain FACS database for accuracy concerning patient demographics
- Immediately identify primary, secondary or third-party insurance, attorney/Workman’s Comp, VOC,
- Medicaid/Medicare information
- Immediately identify the billing status on each account (first time UB-92/UB-04 to primary/secondary insurance, pending additional information (coordination of benefits, medical records accident detail, etc.)appeals, or default to patient responsibility) and bill them accordingly
- Overcome patient objections regarding patient responsibility, as well as denials from insurance companies concerning pre-authorization, while maintaining compliance with HIPAA regulations
- Adhere to guidelines set forth by the FDCPA.
Provider Data Specialist
Great West Healthcare
St. Louis, MO
01.1998 - 01.2007
- Maintain database for accuracy concerning provider demographics, fee schedules, and tax id numbers
- Work with Provider Relations and Credentialing departments to verify current information concerning newly credentialed providers, contracted medical groups, hospitals and other facilities
- Contact external providers to verify accuracy of information for data entry, and process faxes requesting maintenance from local plan offices
- Correct all unidentified areas on electronic claims according to turnaround standards while maintaining/ exceeding an average of 98.5% audit accuracy on all corrections made to provider info.
Education
NREMT
MedicOne ACE
St Louis, MO12-2022
Transportation Worker Identification Credential (TWIC) -
08.2022
High School Diploma -
Lighthouse Christian Academy
Ledbetter, KY05.1997
Associate of Applied Science - Nursing
St. Louis Community College
St Louis, MOCPR/BLS/AED -
American Heart Association
PERC Card
Security And Protective Services
Employee Possessor Letter of Federal Clearance
.
Skills
- Database Management (8 years)
- AMISYS (5 years)
- CRM (5 years)
- Customer Relationship Management (8 years)
- EXCEL (10 years)
- CPR
- Inpatient Care
- Vital Signs
- Triage
- Phlebotomy
- Medical Terminology
- Medical Office Experience
- Medical Billing
- Hospital Experience
- HIPAA
- Communications (10 years)
- Customer Relationship Management (5 years)
- Sales (6 years)
- Customer Support (10 years)
- Contract Negotiations (5 years)
- ICD-10
- Medicare
- Data collection
- Incident Response
- Critical Thinking
- De-Escalation Techniques
- Analytical Skills
- Problem-solving abilities
- Relationship Building
- Coaching and Mentoring
- Time Management
- Interpersonal Skills
- Adaptable and Flexible
- Written Communication
- Attention to Detail
- Honest and Dependable
- Team building
- Team Collaboration
- Task Prioritization
- Team Player
Additional Information
- Willing to relocate: Anywhere, Authorized to work in the US for any employer
Timeline
Regional Float Tech-CSO
BJC Healthcare - St. Louis Region
06.2023 - Current
Security Officer
Allied Universal Security Services
09.2022 - 03.2023
Patient Care Technician
Ortho Trauma/Med Surg Line, Mercy Hospital
03.2019 - 07.2022
Contract Negotiator I
CENTENE Corporation
02.2014 - 05.2018
Customer Service Professional/Seasonal
H&R Block
12.2013 - 04.2014
Claims Specialist
Patients First Healthcare
01.2008 - 01.2010
Collector/Medical Billing
EBO Financial Services
01.2007 - 01.2008
Provider Data Specialist
Great West Healthcare
01.1998 - 01.2007
NREMT
MedicOne ACE
Transportation Worker Identification Credential (TWIC) -
High School Diploma -
Lighthouse Christian Academy
Associate of Applied Science - Nursing
St. Louis Community College
CPR/BLS/AED -
American Heart Association
PERC Card
Security And Protective Services
Employee Possessor Letter of Federal Clearance
.
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