Ashton Moore
Harrisburg,PA
Summary
Detailed-oriented healthcare professional with a track record in patient- centered care coordination, complex caseload management, and optimizing healthcare workflows. Skilled in Medicare compliance, HIPPA standards, and EHR systems to ensure data accuracy and streamline service delivery. Recognized for achieving high patient satisfaction through compassionate communication and efficient resolution of patient needs. Committed to enhancing patient outcomes and operational efficiency through a collaborative approach in dynamic healthcare settings.
Overview
6
6
years of professional experience
1
1
Certification
Work History
Care Coordinator
ECCM/ Highmark
09.2024 - Current
- Coordinate care for diverse caseload ensuring that members receive timely and appropriate services according to established healthcare guidelines
- Collaborate with healthcare providers, insurance representatives, and patients to facilitate seamless service delivery and improve care outcomes
- Conduct regular assessments, monitor patient progress, and provide resources to support patient health goals
- Maintain compliance with HIPPA and organizational protocols, ensuring confidentiality and accuracy in all documentation and interactions
Certified Nursing Assistant
Helen M. Simpson Rehabilitation Hospital
07.2023 - Current
- Assisted patients with daily activities, personal hygiene, and mobility support, contributing to quality patient care.
- Maintained 98% accuracy in EHR documentation, supporting efficient and compliant patient records.
- Collaborated with nursing and therapy teams to ensure safety and comfort, following universal precautions.
- Cared for clients with diagnoses such as respiratory failure, diabetes, Parkinson's disease, and muscular dystrophy.
Medicare Care Coordinator
Healthfirst
03.2022 - 09.2024
- Managed a caseload of over 200 members, ensuring compliance with Medicare and HIPPA regulations.
- Reduced processing time for prior authorizations by 20%, boosting team productivity
- Maintained a 95% member satisfaction score by addressing patient concerns with empathy and efficiency.
- Collaborated with healthcare teams to optimize treatment planning ensuring comprehensive and effective patient care
Client Care Coordinator
Freedom Care
08.2020 - 08.2022
- Oversaw a caseload of 250+ clients, serving as the main contact for inquiries, scheduling, and service coordination.
- Trained and supervised new coordinators, increasing team efficiency and contributing to high service standards.
- Achieved 95% on-time completion of data entry and authorization requests, maintaining regulatory compliance.
- Resolved 95% of inquiries on first contact, enhancing patient experience and overall satisfaction.
Prior Authorization Specialist
Preferred Home Care Of New York
10.2019 - 08.2020
- Managed high volumes of prior authorization requests, achieving a 90% approval rate on first submission by working closely with insurance carriers.
- Researched and resolved claim denials, improving authorization processing time by 15%
- Ensured compliance with payer guidelines and healthcare regulations, reducing delays and enhancing patient care continuity
Home Care Coordinator
Preferred Home Care Of New York
10.2018 - 08.2020
- Coordinated care services and schedules, improving client satisfaction through reliable support
- Developed workflows that reduced authorization processing time by 15%, contributing to operational efficiency.
- Achieved a 90% approval rate on first submissions for authorizations by collaborating with insurance providers.
- Led training for new coordinators, resulting in a 20% decrease in onboarding time.
- Provided on call support from 7am to 11pm, ensuring timely responses to patient and caregiver needs outside regular hours.
Education
Associate of Science - Nursing
Harrisburg Area Community College
Harrisburg, PA01-2027
High School Diploma -
Praise Christian Academy
Port Royal, SC05.2006
Skills
- Patient Coordination: Caseload management, patient- centered care, high first- contact resolution rate
- Techinical Proficiency: EMR/EHR systems( Epic, salesforce, Trucare, Citrix, Careport, Epaces, Maximus, Now Pow, Interaction, Avaya, Microsoft Office Suite)
- Healthcare Knowledge: Medicare compliance, medical terminology, HIPPA guidelines
- Data Management: Documentation accuracy (98%), record maintenance, workflow optimization
- Customer Service: Compassionate communication, problem-solving, training and development
Certification
- CNA - Certified Nurse Assistant
- HHA - Home Health Aide
- BLS/AED
- HIPPA Compliance
Timeline
Care Coordinator
ECCM/ Highmark
09.2024 - Current
Certified Nursing Assistant
Helen M. Simpson Rehabilitation Hospital
07.2023 - Current
Medicare Care Coordinator
Healthfirst
03.2022 - 09.2024
Client Care Coordinator
Freedom Care
08.2020 - 08.2022
Prior Authorization Specialist
Preferred Home Care Of New York
10.2019 - 08.2020
Home Care Coordinator
Preferred Home Care Of New York
10.2018 - 08.2020
Associate of Science - Nursing
Harrisburg Area Community College
High School Diploma -
Praise Christian Academy
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