Candi Ward
Springfield,MO
Summary
Organized Healthcare Manager with outstanding record of communicating with members of staff to provide administrative needs and requirements. Conducted meetings with staff concerning budgets, program management and compliance. Consistently achieved outstanding ratings for quality care and community presence. Authorized to work in the US for any employer. Willing to relocate.
Overview
13
13
years of professional experience
Work History
Care Manager
Populus Group/IQVIA
Durham, NC
04.2024 - Current
- Perform outbound calls to obtain appropriate information and document accurately.
- Answer in-bound calls and assist customers with pharmacy related services.
- Maintain strict professionalism in all communication methods while providing efficient, courteous, and friendly service.
- Contact insurance companies for benefit investigation and coverage eligibility.
- Provide prior authorizations and appeal support.
- Assist patients with the enrollment process for manufacturer and non-profit organization copay assistance programs.
- Update job knowledge by participating in educational opportunities and training activities.
- Work efficiently both individually and within a team to accomplish required tasks.
- Maintain and improve quality results by adhering to standards set forth by program KPI's
- Report ADE's according to program policy and guidelines, adhere to all HIPAA guidelines, and assist with onboarding for new employees.
Long Term Care Auditor
Gainwell Technologies LLC
Springfield, MO
05.2022 - 11.2023
- Interpreted and applied federal and state Medicaid regulations, statutes, and policies pertaining to long term care
- Analyzed provider records from multiple accounting software programs
- Identified improper payments relating to inaccurate payments, collections, and coordination of benefits
- Acted as the primary liaison with the assigned long term care providers
- Managed 40+ audits in varying phases
- Responsible for provider reporting and communication
- Responsible for status reporting to management.
Revenue Integrity Analyst
CARTI
Little Rock, AR
11.2020 - 05.2022
- Reconciled past due accounts achieving 75% reduction in outstanding invoices
- Strengthened financial operations by conducting bank reconciliations and financial reporting
- Initiated remedial actions by decreasing financial inconsistencies, reducing expenditures and eliminating system imperfections
- Ensured the revenue department was operating efficiently
- Cross-trained management & other staff members on financial processes
- Generated invoices upon receipt of billing information and tracked collection progress
- Supported clinical team members with revenue cycle procedures and addressed issues
- Monitored and guided revenue cycle operations
- Reviewed outpatient records and interpreted documentation to identify diagnoses and procedures.
Access Coordinator III
UAMS Hospital
Little Rock, AR
08.2018 - 11.2020
- Contributed to reduction of accounts receivables by adhering to predetermined policies and procedures to recover amounts due from patients
- Determined patient financial needs and referred eligible patients to proper county, state or federal agencies to obtain financial assistance
- Utilized knowledge of electronic medical record systems and medical terminology to perform diverse data entry tasks
- Obtained patient's insurance information and determined eligibility for benefits for specific services rendered
- Received patient deductibles and co-pay amounts and discussed options to satisfy remainder of patient financial obligations
- Managed team of 15 employees, overseeing hiring, training, and professional growth of employees
- Established and checked coding procedures, monitored reports and updated internal files
- Supported financial director with special projects and additional job duties.
Outpatient Clinic Administrator
Medical Center of South Arkansas
El Dorado, AR
08.2011 - 08.2018
- Developed and executed standards and objectives to promote corporate vision
- Partnered with clinic staff to manage patient satisfaction
- Managed financial counseling, appointment scheduling and in-office payments
- Observed staff performance to monitor conflict management and performance skills
- Monitored number of patients and wait times to create efficient flow of patients from check-in to check- out
- Monitored duties assigned to personnel to promote high levels of patient care and job efficiency
- Conducted frequent clinic walk-throughs to maintain safe work environment
- Oversaw day-to-day business and clinical activities by establishing goals, objectives, standards of performance and policies and procedures when managing a $1.7 million annual budget
- Coordinated patient care services with staff, physicians, patients and other practice departments
- Addressed employee conflicts with appropriate urgency, following all corporate procedures
- Collaborated with entire human resource department to discuss new ways to recruit top talent.
Education
Bachelors Degree - Healthcare Management
American InterContinental University-Online
08.2021
Associate Degree - Process Technology
South Arkansas Community College
08.2017
Associate Degree - Healthcare Administration
Virginia College
06.2011
Skills
- Program Management
- Leadership
- Supervising Experience
- System Administration
- Microsoft Powerpoint
- Epic
- Administrative experience
- Healthcare Management
- Auditing
- Budgeting
- Accounts Receivable
- Financial management (5 years)
- Revenue cycle management (5 years)
- HIPAA (8 years)
- Word processing
- Writing skills
- Customer service
- Microsoft Excel
- Documentation review
- Typing
- Medical records
- Microsoft Word
Timeline
Care Manager
Populus Group/IQVIA
04.2024 - Current
Long Term Care Auditor
Gainwell Technologies LLC
05.2022 - 11.2023
Revenue Integrity Analyst
CARTI
11.2020 - 05.2022
Access Coordinator III
UAMS Hospital
08.2018 - 11.2020
Outpatient Clinic Administrator
Medical Center of South Arkansas
08.2011 - 08.2018
Bachelors Degree - Healthcare Management
American InterContinental University-Online
Associate Degree - Process Technology
South Arkansas Community College
Associate Degree - Healthcare Administration
Virginia College