Angel Monroe
Aurora,CO
Summary
Accomplished healthcare professional with over 9 years of experience in the medical field, specializing in patient care coordination, regulatory compliance, and healthcare administration. Skilled at leading teams, managing day-to-day operations, and ensuring delivery of high-quality, patient-centered care. Adept at fostering strong relationships with patients, families, and medical staff while maintaining compliance with state and federal regulations. Recognized for strong leadership, problem-solving abilities, and a commitment to improving operational efficiency and patient outcomes—making me an excellent fit for advancing quality and growth within a home health organization.
Overview
10
10
years of professional experience
Work History
Senior Claims Representative
Kaiser Permanente
12.2020 - Current
- Improved team productivity by providing ongoing training and support to junior claims representatives.
- Reduced backlog of pending claims by introducing an effective triage system based on priority levels.
- Collaborated with legal and medical professionals to gather necessary information for claim assessments.
- Analyzed complex claims data, identifying trends, and recommending improvements to reduce future risks.
- Enhanced customer satisfaction with timely and accurate resolution of claims disputes.
- Increased company profits by minimizing fraudulent activities through diligent research and validation of claim details.
- Reduced claim denials with thorough verification of insurance coverage and patient eligibility before submitting claims.
- Improved coding accuracy by consistently reviewing and updating medical records, ensuring compliance with industry standards.
- Implemented new ICD-10 codes efficiently upon release, minimizing disruptions in claims processing while maintaining accuracy levels.
- Optimized workflows for faster claim processing through regular analysis of current procedures and identification of bottlenecks.
- Assisted management in budget planning by providing insights into revenue trends based on historical data analysis.
- Collaborated with healthcare providers to clarify documentation discrepancies, resulting in more accurate claim submissions.
- Responded to customer concerns and questions on daily basis.
- Used data entry skills to accurately document and input statements.
- Handled account payments and provided information regarding outstanding balances.
- Collaborated with customers to resolve disputes.
- Audited and corrected billing and posting documents for accuracy.
- Maintained accurate records of customer payments.
- Monitored outstanding invoices and performed collections duties.
- Generated monthly billing and posting reports for management review.
- Processed payment via telephone and in person with focus on accuracy and efficiency.
- Produced and mailed monthly statements to customers and assisted with related requests for information and clarification.
- Reconciled accounts receivable to general ledger.
- Enhanced patient satisfaction by implementing comprehensive care plans tailored to individual needs.
- Conducted regular quality assurance audits to maintain high standards of care throughout the organization.
- Implemented staff training programs to improve skills and ensure consistent delivery of high-quality care.
Home Health Aide Supervisor
Touching Hearts At Home
04.2019 - 12.2020
- Supervised daily operations of home health aides, ensuring high-quality patient care and adherence to protocols.
- Trained and mentored new staff on best practices in patient support and safety compliance.
- Coordinated communication between healthcare providers, families, and caregivers to optimize patient outcomes.
- Developed and implemented care plans for clients.
- Oversaw daily operations, ensuring compliance with company policies and safety regulations.
- Offered companionship and kindness to elderly patients.
- Cleaned house, ran errands, managed laundry, and completed weekly grocery shopping.
- Assisted with personal hygiene tasks such as bathing, grooming, dressing, feeding, toileting giving attention to detail.
- Assisted clients with daily living needs to maintain self-esteem and general wellness.
- Assisted clients in maintaining a safe and clean living environment, promoting health and wellbeing.
- Maintained clean, safe, and well-organized patient environment.
- Provided emotional support to seniors, fostering positive relationships and enhancing their overall mental health.
- Enhanced elderly residents'' quality of life by providing compassionate care and assistance with daily activities.
- Observed health status of clients to report changes and unusual occurrences to appropriate medical personnel.
- Responded promptly to emergency situations, providing first aid treatment when necessary and alerting medical personnel if required.
- Maintained detailed records of client progress, updating healthcare professionals on any changes or concerns regularly.
- Actively participated in departmental meetings, sharing knowledge on emerging trends in the field of medical billing and coding practices.
- Maintained up-to-date knowledge of regulatory changes impacting medical billing practices to ensure ongoing compliance within the organization.
- Coordinated outreach efforts within the community to raise awareness about available home health services.
- Enhanced patient satisfaction by implementing comprehensive care plans tailored to individual needs.
Medical Administrator
Denver Health Medical Center
03.2016 - 04.2019
- Maintained a positive work environment by fostering open lines of communication among staff members and addressing any concerns or conflicts promptly and professionally.
- Increased overall patient satisfaction with the implementation of an efficient feedback mechanism.
- Ensured compliance with healthcare regulations through meticulous record-keeping and documentation practices.
- Coordinated continuing education opportunities for medical staff members, promoting professional development within the organization.
- Handled sensitive patient information with confidentiality, adhering to HIPAA guidelines at all times.
- Collaborated with clinicians to develop and implement quality improvement initiatives, resulting in better patient outcomes.
- Reduced wait times for patients by optimizing appointment scheduling methods.
- Assisted physicians in coordinating care plans by maintaining accurate records of treatment progress notes and diagnostic results.
- Negotiated contracts with vendors, achieving favorable terms for medical supplies and services utilized within the facility.
- Enhanced communication between medical staff and patients through the introduction of a secure messaging system.
- Verified accuracy of patient information in medical records.
- Sorted and distributed incoming and outgoing medical records.
- Enhanced patient satisfaction by implementing comprehensive care plans tailored to individual needs.
- Coordinated outreach efforts within the community to raise awareness about available home health services.
- Oversaw financial management processes, including budgeting, cost control, and billing procedures.
Education
No Degree - Health Administration
Community College Of Aurora
Aurora, COHigh School Diploma -
McIntosh County Academy
Darien, GASkills
- Coverage verification
- Claims investigation
- Claims analysis
- Claims processing
- High exposure claims experience
- Insurance claims review
- Multitasking Abilities
- Problem-solving abilities
- Attention to detail
- Reliability
- Critical thinking
- Organizational skills
- Excellent communication
- Effective communication
- Verbal and written communication
- Teamwork skills
- Appointment scheduling
- Professionalism
- Medical record review
- Medical terminology expertise
- ICD-10 proficiency
- HIPAA compliance
- Insurance coding (ICD-9 and CPT)
- Multitasking proficiency
- Continuous learning commitment
- Organizational skills development
- Patient care coordination
- Medical records management
- Scheduling coordination
- Staff management
Timeline
Senior Claims Representative
Kaiser Permanente
12.2020 - Current
Home Health Aide Supervisor
Touching Hearts At Home
04.2019 - 12.2020
Medical Administrator
Denver Health Medical Center
03.2016 - 04.2019
No Degree - Health Administration
Community College Of Aurora
High School Diploma -
McIntosh County Academy
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