Summary
Overview
Work History
Education
Skills
Certification
Timeline
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Bethany Alberts

Lima,OH

Summary

Accomplished Referral Coordinator with a proven track record at Humana Government Business, adept in insurance precertification processes and Microsoft Office. Spearheaded major software transitions, enhancing operational efficiency. Known for exceptional organizational growth skills and a deep understanding of HIPAA regulations. Demonstrated leadership by mentoring new hires and improving team communication.

Overview

10
10
years of professional experience
1
1
Certification

Work History

Referral Coordinator

Humana Government Business
Van Wert, Ohio
02.2019 - Current
  • Processed and reviewed all prior authorizations for TRICARE beneficiaries.
  • Communicated with providers and facilities to obtain medical necessity, appropriate CPT codes, and ICD-10 codes.
  • Supported leadership in executing special projects.
  • Prioritized authorizations based on the urgency and needs of beneficiaries.
  • Facilitated the transition from Skype to Microsoft Teams, ensuring seamless communication and collaboration.
  • Spearheaded the transition from outdated Onbase software to the latest version, ensuring seamless integration and minimal disruption.
  • Mentored new hire associates to ensure smooth onboarding and integration.
  • Ensured compliance with TRICARE policy and procedures.
  • Demonstrated comprehensive knowledge of all TRICARE benefits and services.
  • Proposed the implementation of shared team chats to leadership, enhancing work accuracy and continuity during leadership absences.

Medical Records Clerk

Van Wert County Hospital
Van Wert, Ohio
01.2015 - 06.2025
  • Issued medical files to authorized persons and agencies in compliance with legal regulations.
  • Distributed medical charts to appropriate hospital departments, ensuring timely access to patient information.
  • Assisted with departmental audits and investigations to ensure compliance with regulatory standards.
  • Collaborated with healthcare providers to ensure the accuracy and quality of medical records in compliance with hospital policies and procedures.
  • Facilitated the transition from paper records to Electronic Health Records (EHR) using Epic Software.
  • Developed comprehensive training materials for veteran employees to facilitate a seamless transition to the Electronic Health Record (EHR) system.

Care Management Support Assistant

Humana
Tampa, Florida
02.2019 - 02.2021
  • Provided non-clinical support to assess and evaluate members' needs, guiding them towards resources for optimal wellness.
  • Executed basic administrative and clerical tasks to support daily operations.
  • Adhered to defined parameters and quality standards while managing work expectations and priorities.
  • Trained new employees on care management procedures to ensure consistency and quality.
  • Assessed members using clinical questionnaires to identify their healthcare needs.
  • Facilitated care for members during mental health crises, coordinating with managers and first responders to ensure timely emergency care.
  • Acted as Subject Matter Expert for associates in the absence of managers, ensuring accuracy and continuity of daily tasks.

Office Assistant

Gulf Coast Medical Group
Venice, Florida
07.2018 - 02.2019
  • Responded to all in-person, phone, and email inquiries, ensuring timely and accurate communication.
  • Scheduled and confirmed routine and urgent care appointments.
  • Processed and prepared medical files accurately and efficiently.
  • Managed inventory of office and medical supplies, ensuring availability and optimal stock levels.
  • Processed payments and accurately recorded them in patient records, ensuring proper documentation.
  • Coordinated scheduling needs with administration, leadership, and providers to enhance patient care and maintain provider satisfaction.
  • Trained new employees, tailoring instruction to their individual learning needs.

ED Greeter/Registration Clerak

Van Wert County Hospital
Van Wert, Ohio
07.2015 - 01.2018
  • Greeted all visitors promptly and courteously.
  • Registered Emergency Department patients using hospital computer systems.
  • Anticipated patient needs based on symptoms upon arrival.
  • Collaborated with Emergency Department staff, including providers, nurses, and case managers, to facilitate patient care.
  • Maintained workspace to ensure a clean and comfortable environment for all visitors.
  • Maintained inventory and placed orders for necessary supplies.
  • Verified patient information and updated records to ensure accuracy.
  • Assisted clinical staff during high-pressure situations, ensuring optimal patient care.

Education

High School Diploma -

Delphos Jefferson Highschool
Delphos, OH
05-2015

Skills

  • Multi-line phone proficiency
  • Notetaking and documentation
  • Insurance precertification processes
  • Multi-line telephone operation
  • Patient records oversight
  • Organizational growth
  • Medical terminology
  • HIPAA regulations
  • Skilled in Microsoft Office

Certification

  • HIPAA Industry Standards Training
  • Certification in Runnings Meetings in Better Directions

Timeline

Referral Coordinator

Humana Government Business
02.2019 - Current

Care Management Support Assistant

Humana
02.2019 - 02.2021

Office Assistant

Gulf Coast Medical Group
07.2018 - 02.2019

ED Greeter/Registration Clerak

Van Wert County Hospital
07.2015 - 01.2018

Medical Records Clerk

Van Wert County Hospital
01.2015 - 06.2025

High School Diploma -

Delphos Jefferson Highschool

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Bethany Alberts