Ardenia Allen
Las Vegas,NV
Summary
Consulting professional with strong track record in delivering impactful business solutions. Adept at strategic planning, data analysis, and process improvement. Known for fostering team collaboration and adapting to evolving project needs. Brings expertise in client relations, problem-solving, and driving measurable results.
Overview
21
21
years of professional experience
Work History
Consultant Patient Access
Cencora Patient Services, LLC
01.2023 - Current
- Billing and coding support
- Claims assistance, tracking and submission
- Prior authorization assistance and tracking
- Coordination of benefits
- Benefit verification result call
- Welcome calls
- Advanced alternate coverage research
- Appeals/denials, Processes any necessary correspondence
- Coordinates with internal and external service providers to ensure services are performed in accordance with programming policy and within expected service level agreements (SLAs).
- Intakes and reports adverse events as directed, Maintains confidentiality regarding all patient sensitive information
- Provides exceptional customer service to internal and external customers; resolves any customer requests in a timely and accurate manner; escalates complaints accordingly.
- Works on problems of moderate scope where analysis of data requires a review of a variety of factors. Exercises judgment within defined standard operating procedures to determine appropriate action.
- Performs related duties as assigned, which could include well defined services generally performed by other program representatives
- Analyzed patient data to optimize service delivery and improve patient outcomes.
Patient Financial Representative III (Senior)
Christus Health Corporate
09.2016 - 01.2024
- Work very closely with the Reconciliation Supervisor and Team, which leads to reconciling variances, identifying areas for productivity, and cost improvement
- Perform daily job functions as needed to help team meet their service levels and goals
- Work with Collections, Financial Operations, and Accounts Receivables teams in researching
- Training of new employees
- Refunds/Validations, Cash posting, Unapplied team
- Resolves unknown cash allocations in the Cash Management system, Escalate issues for resolution if necessary
- Daily prioritize workload to ensure completion by end of shift and process toward monthly goal
- (In conjunction with Christus Health)
- Processed and verified patient account information for accuracy and completeness.
- Analyzed patient financial data to identify trends and areas for improvement.
- Assisted in training new employees on department procedures, contributing to the development of a skilled workforce within the organization.
Case Management Support
United Health Care
11.2021 - 06.2022
- Responsible for communication and mentoring members of the care coordination team to ensure long-term and home and community base guidelines, policies and procedures are followed
- Completed monthly member calls
- Provided follow-up to the case manager if the member required additional assistance
- Obtaining 3008 physician forms by contacting physician’s office, uploading forms and supporting documents to the document imaging systems
- Provided individualized case management support throughout each participant''s journey from enrollment to post-program followup.
- Provided ongoing case management support for individuals and families participating in various housing assistance programs.
- Supported team members in handling complex cases or escalating issues to management when necessary.
HR Employee Benefits Specialist
CHI St Luke’s Health
06.2015 - 03.2016
- Conducts employee new onboarding benefit Orientation (PPT), benefit enrollments and other employee information sessions to ensure that employees are enrolled in benefit programs on a timely basis
- Enter information into the HR system to meet critical deadlines for payroll and benefits enrollments
- Reports to HR director and Assist company Managers with HR issues
- Communicate with all vendors regarding eligibility and LOA
- Subpoena documentation, Managed employee termination files
- Benefit Verification
- Employment verification/Income
- Answering phone, filing, scanning of employee termination files
- Maintains benefits plan summaries, booklets, forms, and related documents
- Prepares and manages correspondence, memoranda, promotional materials, forms, newsletter, and reports using appropriate word processing, and spreadsheet programs
- Responded to employee inquiries regarding benefits, providing accurate information and guidance on options.
- Administered employee benefit programs, ensuring compliance with regulations and organizational policies.
Office Coordinator (Diabetes/Weight Management), Patient Registrar (Lead), Office Manager (Wound Care)
Mercy Hospital & Medical Center
05.2004 - 04.2015
- Manage medical records and Received patient from registrar, Schedule appointments, and follow infection control guidelines
- Facilitate HMO authorizations for clinic patients
- Kept burden off WCONs by expertly handling clerical work, fielding customer inquiries, and resolving equipment issues without assistance
- Triage all patients calls
- Prepares and coordinates all departmental events
- Training Interns/Residents managing scheduling data base
- Order supplies and material and drinks
- Make corrections in Cerner if patient’s DOS and billing is different
- Type up certificates for volunteers participating in the Diabetes Health Fair
- Set up all Transportation for patients
- Verified completeness and accuracy of patients EMR system Identified and collected copayments to meet patient financial obligations, including applicable deductibles
- Completes and processes forms, necessary for client insurance reimbursement
- Liaison between clients and other departments, correspondence
- Trained new employees, Interviewing, Follow-up with periodic performance reviews with Manager
- Scheduled patient appointments, order medical and office supplies, manage medical records, registration of patients, BE
- Facilitate HMO authorizations for clinic patients, triage all patient calls, collect payment, send clinical notes to physicians
- Training Interns/Residents managing scheduling data base
- Liaison between clients and other departments, correspondence, inventory
- Managed scheduling for team meetings, optimizing time allocation and resource availability.
- Coordinated office operations, ensuring efficient workflow and adherence to organizational policies.
Education
Organizational Leadership
Roosevelt University
Chicago, ILSkills
- Problem-solving
- Attention to detail
- Team leadership & development
- Client relationships
- Subject matter expert
- Customer relationship management
- Analytical thinking
- Time management
Languages
English
Full Professional
Work Availability
monday
tuesday
wednesday
thursday
friday
saturday
sunday
morning
afternoon
evening
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Accomplishments
- Collaborated with team of 8 in the development of Weight Management Program.
Work Preference
Work Type
Full TimeWork Location
RemoteImportant To Me
Work-life balanceHealthcare benefits401k matchPaid sick leaveCareer advancementPaid time offCompany CultureWork from home optionPersonal development programsTimeline
Consultant Patient Access
Cencora Patient Services, LLC
01.2023 - Current
Case Management Support
United Health Care
11.2021 - 06.2022
Patient Financial Representative III (Senior)
Christus Health Corporate
09.2016 - 01.2024
HR Employee Benefits Specialist
CHI St Luke’s Health
06.2015 - 03.2016
Office Coordinator (Diabetes/Weight Management), Patient Registrar (Lead), Office Manager (Wound Care)
Mercy Hospital & Medical Center
05.2004 - 04.2015
Organizational Leadership
Roosevelt University
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