Catherine Haynes
Arlington,WI
Summary
Patient Accounts Representative (July 2015 to June 2017) Divine Savior Healthcare-Business Office-Portage, WI. Fluent on computer skills, customer service and billing procedures. Trained in health insurance claim processing Fluent on Appealing medical claims with insurance company. Validated numerous claims to assure proper processing and possible appeals with the insurance carriers Attained a complete knowledge of all necessary information needed for insurance claims and patient eligibility Developed a great working relationship with patients and insurance carriers to assure satisfaction with billing and payment Very capable to work with others effectively and efficiently Enhanced skills in Microsoft Word and Excel programs Objective Knowledge in CPSI, Chart links, Insurance, Rehab, CPT codes, HCPCS code Fluent with ICD 10 and adding modifiers when required on medical claims. Able to work as a team an impended Fluent on insurance portals fluent on getting prior authorizations. To obtain a position as a Rehabilitation Aide Qualifications - Strong grasp of emergency procedures and able to stay calm in stressful situations. - Uncommon ability to make decisions and take prompt effective action in emergency situations. - Immense ability to prepare and maintain routine records and logs. - Knowledge of business and management principles involved in strategic planning, resource allocation, human resources modeling, leadership technique, production methods, and coordination of people and resources. Experienced Case Manager offering educational enrichment and demonstrated academic progress for students with disabilities. Proven history of implementing personalized instructional practices and designing quality Individualized Education Programs in collaboration with students, parents and teachers to support learning plans. Excellent collaborator dedicated to providing first-rate supportive counseling and guidance. Energetic leader promotes 10 + years of industry experience with superior record of accomplishment. Ambitious and highly motivated Senior lead surpasses demanding objectives and achieves or exceeds set goals. Knowledgeable Case Manager experienced in coordinating care for CBRF individuals. Proactive and resourceful with strong knowledge of community resources. Strong communicator with passion for helping others.
Overview
9
9
years of professional experience
1
1
Certification
Work History
Senior Patient
SSM Health care, Catherine Haynes
Fitchburg, WI
03.2020 - Current
- CBO
- Running Reports sharing with Billers on what accounts need to work weekly
- Dialysis claims specialist
- Lead biller for Government Team (Medicare and Medicaid plans)
- Fluent on computer skills, customer service and billing procedures
- Trained in health insurance claim processing
- Fluent on Appealing medical claims with insurance company
- Validated numerous claims to assure proper processing and possible appeals with insurance carriers
- Attained complete knowledge of all necessary information needed for insurance claims and patient eligibility
- Developed great working relationship with patients and insurance carriers to assure satisfaction with billing and payment
- Very capable to work with others effectively and efficiently
- Able to work over 60 patient accounts daily
Customer Service Rep
Nord Gear
Waukee, WI
09.2018 - 04.2019
- Answering phones
- Helping customers with selecting Gearbox/ motor for there application
- Working up Quotes for customers
- Looking up status on orders
- Managed 35+ calls daily
- Provided primary customer support to internal and external customers
- Maintained customer satisfaction with forward-thinking strategies focused on addressing customer needs and resolving concerns
- Answered constant flow of customer calls with minimal wait times
- Answered customer telephone calls promptly to avoid on-hold wait times
- Communicated with vendors regarding backorder availability, future inventory and special orders
- Provided information regarding charge accounts and loyalty programs
- Collected customer feedback and made process changes to exceed customer satisfaction goals
- Consulted with outside parties to resolve discrepancies and create expert solutions
- Cultivated customer loyalty, promoted repeat business and improved sales
- Developed community reputation through commitment to customer satisfaction and strong client relationships
- Fielded customer questions regarding available merchandise, sales, current prices and upcoming company changes
- Leveraged sales expertise to promote products and capitalized on upsell opportunities
- Recommended products to customers, thoroughly explaining details
- Used company troubleshooting resolution tree to evaluate technical problems and find appropriate solutions
- Responded to customer requests for products, services and company information
- Evaluated account and service histories to identify trends, using data to mitigate future issues
- Offered advice and assistance to customers, paying attention to special needs or wants
- Assisted customers with setting appointments, special order requests, and arranging merchandise pick-up
- Followed-through on all critical inter-departmental escalations to increase customer retention rates
- Promoted available products and services to customers during service, account management and order calls
- Managed timely and effective replacement of damaged or missing products
- Investigated and resolved accounting, service and delivery concerns
- Developed highly empathetic client relationships and earned reputation for exceeding service standard goals
- Met customer call guidelines for service levels, handle time and productivity
- Implemented and developed customer service training processes
- Surpassed sales goals through implementation of effective marketing strategies
- Created and maintained detailed database to develop promotional sales
- Reached out to customers after completed sales to suggest additional service or product purchases and inquire about needs or concerns
- Reduced process inconsistencies and effectively trained team members on best practices and protocols
- Trained new personnel regarding company operations, policies and services
- Monitored cash drawers in multiple checkout stations and maintained adequate cash supply
- Bolstered customer retention by creating and offering unique discount options and inspiring interest in new product lines
- Cross-trained and provided back up for customer service managers
- Communicated professionally with colleagues, freelancers and clients
- Liaised with sales, marketing and management teams to develop solutions and accomplish shared objectives
- Improved sales abilities and product knowledge on continuous basis to provide optimal service and achieve quotas
- Effective liaison between customers and internal departments
- Increased efficiency and team productivity by promoting operational best practices
- Delivered exceptional customer service to every customer by leveraging extensive knowledge of products and services and creating welcoming, positive experiences
- Promptly responded to inquiries and requests from prospective customers
- Provided excellent customer care by responding to requests, assisting with product selection and handling ordering functions
- Maintained clean and orderly checkout areas by mopping floors, emptying trash cans and wiping down surfaces
Med
CNA, Surg and ICU
Portage , WI
03.2013 - 02.2015
- Conduct vital and wellness assessments - Document changes in patient conditions - Assisting RN with daily activities - Assisting PT and OT - Complete patient care - Removal of IV's and Foley catheter - Conduct blood sugar assessments - Conduct complete shift report for on-coming shift
- Managed from 15-17 patients shift
- Established good working relationship with RN's
Case Manager
Infinite Ability Inc. Sun Prairie
Sun Prairie, WI
07.2012 - 06.2013
- For 8 residents - Schedule daily activities for clients - Create adequate nutritional based meal menus - Schedule off-site resident medical appointments - Transport residents to appointments and maintain proper documentation during medical appointments and procedures
- Open and manage resident accounts - Supervise daily operations of facility - Create staffing patterns/including employee schedules - Train employees on proper techniques in performing daily tasks
- Schedule and conduct staff meetings - Conduct new employee interviews - Conduct Emergency Management Procedures including medical emergencies, server weather, bomb threats, and maintaining proper updated fire equipment
- Create and update policies fit for facility needs.
- Established good relationship with clients family
- Managed caseload of 16 children in welfare system to provide comprehensive, community-based care
- Reduced care costs without sacrificing quality through service coordination and multidisciplinary collaboration
- Liaised with teachers to develop Individualized Education Programs to provide quality education for students with disabilities
- Addressed delays in discharge, postponed procedures and discharge equipment unavailability
- Monitored student progress and reviewed and revised IEP to meet emerging student needs
- Partnered with physicians, social workers, activity therapists, nutritionists and case managers to develop and implement individualized care plans and documented patient interactions and interventions in electronic charting systems
- Facilitated special education placement process in partnership with parents to provide free appropriate public education for eligible referrals
- Developed and implemented transition services plan to facilitate movement from school to activities
- Developed positive relationships with parents to foster communication and encourage involvement for student growth
- Helped patients receive appropriate, high-quality care with reasonable results
- Consulted with clinicians to devise and manage ongoing care plans for at-risk patients
- Managed support services and fostered communication among social workers, therapists, hospital staff and patients
- Participated in professional growth programs to support special education improvement efforts
- Identified care needs of individual patients and coordinated responses based on physician advice, insurance limitations and procedural costs
- Increased referral rates by providing excellent service and building meaningful relationships with patients and caregivers
- Evaluated treatment plans against individual goals and healthcare standards
- Educated patients and loved ones about different treatment options and outside care approaches to reduce burden on hospital resources
- Evaluated IEP for compliance with state and federal requirements regulations and rectified non-compliance issues immediately
- Collaborated with external agencies to meet educational and transitional needs of students
- Improved staff performance by recreating disciplinary procedures commensurate with level of infraction
- Conducted training for educational staff to properly identify learning disabilities and remediation strategies
- Assisted personnel with assessments to identify student academic level and guide instruction
House Manager
Lakeview Neurorehabilitation
Westfield, WI
12.2010 - 03.2013
- - Case manager for 8 residents
- - Schedule daily activities for clients
- - Create adequate nutritional based meal menus
- - Schedule off-site resident medical appointments
- - Transport residents to appointments and maintain proper documentation
- During medical appointments and procedures.
- - Open and manage resident accounts
- - Supervise daily operations of facility
- - Create staffing patterns/including employee schedules
- - Train employees on proper techniques in performing daily tasks.
- - Schedule and conduct staff meetings
- - Conduct new employee interviews
- - Conduct Emergency Management Procedures including medical
- Emergencies, server weather, bomb threats, and maintaining proper
- Updated fire equipment relationship
- - Create and update policies fit for facility needs
- - Established good working relationship with staff and Clients
- Coordinated holiday parties, cocktail parties and small gatherings for household
- Supervised residents preparing meals and handling chores and provided constructive feedback
- Communicated with delegating nurse to coordinate and complete medical services
- Modernized and improved operational procedures to increase productivity and profitability while tightly controlling costs
- Devised new promotional approaches to boost customer numbers and market penetration while enhancing engagement and driving growth
- Evaluated performance, adjusted strategies and maintained agile, sustainable operations
- Assisted residents with daily hygiene and living tasks
- Managed all intake and discharge paperwork and procedures for residents
- Managed day-to-day operation of home to comply with regulations and agency standards
- Set aggressive targets for employees to drive company success and strengthen motivation
- Reduced waste and pursued revenue development strategies to keep department aligned with sales and profit targets
- Supervised staff of 25 personnel by implementing company policies, protocols, work rules and disciplinary action
- Evaluated employee performance and conveyed constructive feedback to improve skills
- Utilized exemplary negotiation skills to obtain manufacturing service agreements and assure quality standards
- Used industry expertise, customer service skills and analytical nature to resolve customer concerns and promote loyalty
- Evaluated existing operations and current market trends to identify necessary improvements and capitalize on changes
- Implemented and executed reviews of computer systems for compliance with state and federal regulations
- Developed detailed plans based on broad guidance and direction
- Communicated best practices among on-site and external personnel to align efforts and goals
- Assisted in organizing and overseeing assignments, planning and coordinating in-house and outsourced resources
Caregiver
Infinite Ability Inc
Portage , WI
02.2010 - 03.2011
- Care for clients with disabilities that are not able to care for themselves
- Dispense medications and maintain accurate medication profile logs
- Transport patients to medical appointments and special events
- Provide patients with help moving in and out of beds, baths, wheelchairs, or automobiles and with dressing and grooming.
- Established relationship with clients
- Managed care for 6 clients shift
- Helped clients manage money, pay bills and shop for groceries or personal items.
- Monitored client vital signs, administered medications and tracked behaviors to keep healthcare supervisor well-informed.
- Engaged patients in meaningful conversation, socialization and activity while providing personal care assistance.
- Conferred with supervisor to discuss patient condition and medical care.
- Planned healthy meals, purchased ingredients and cooked meals to provide adequate nutrition for client wellbeing.
- Assisted with dressing guidance, grooming, meal preparation and medication reminders.
- Helped patients care for themselves by teaching proper, safe use of ambulation assistive devices such as canes or walkers.
- Entertained, conversed and read aloud to keep patients mentally alert.
- Provided safe mobility support to help patients move around personal and public spaces.
- Transported patients via wheelchair to and from rehabilitation and daily activities.
- Determined specific needs and provided most appropriate level of services for patient well-being.
- Monitored, tracked and conveyed important patient information to healthcare staff to help optimize treatment planning and care delivery.
- Maintained frequent supervision of residents unable to call for assistance.
- Built strong relationships with clients to deliver emotional support and companionship.
- Shopped for groceries regularly in order to keep house stocked with necessities.
- Documented residents' mental status, sleep and eating patterns in medical record books.
- Changed dressings, bandages and binders to maintain proper healing and sanitary measures.
- Transported individuals to events and activities, medical appointments and shopping trips.
- Assisted patients with self-administered medications.
- Assisted clients with daily living needs to maintain self-esteem and general wellness.
- Recognized and reported abnormalities or changes in patients' health status to case manager.
- Provided transportation to doctor's appointments, grocery stores, salons and barbershops.
- Cleaned house, ran errands, managed laundry and completed weekly grocery shopping.
- Turned and positioned bedbound patients to prevent bedsores and maintain comfort levels.
- Maintained clean personal areas and prepared healthy meals to support client nutritional needs.
- Supported clients with mental support and physical activities to accomplish quality of life and sustain needs.
Education
No Degree - Nursing
Wisconsin CNA Training
Appleton, WI11.2013
High School Diploma -
Parents Association
2004
Skills
- Enhanced skills in
- Microsoft Word and Excel programs
- Objective
- Knowledge in CPSI, Chart links, Insurance, Rehab, CPT codes, HCPCS code
- Fluent with ICD 10 and adding modifiers when required on medical claims
- Able to work as team or impended
- Fluent on insurance portals
- Fluent on getting prior authorizations
- Fluent on computer skills, customer service and billing procedures
- Trained in health insurance claim processing
- Fluent on Appealing medical claims with insurance company
- Validated numerous claims to assure proper processing and possible appeals
- Experience insurance carriers
- Attained complete knowledge of all necessary information needed for
- Insurance claims and patient eligibility
- Developed great working relationship with patients and insurance carriers to
- Assure satisfaction with billing and payment
- Very capable to work with others effectively and efficiently
- Handling Mitchell medical claim send back files
- Setting up actives for desk adjuster when needed
- Looking up auto, renter or property claims
- Knowing Policy Prefix
- Fluent with ABI website for requesting medical records
- No how to read and Police report and but in file
- Fluent with Mitchell 3rd party medical request review and their system
- Fluent with computer base phone system
Certification
Certifications that I have had
- Certified Red Cross instructor for First Aid/CPR/AED
- Certified Abuse and Neglect trainer for nursing homes and CBRFs
- Certified Fire Safety
- Certified Nursing Assistant
- Current state registry for medication distribution
Specialty Training
- Standard P trained
- MANDT trained
- Able to read doctor’s orders and submit them in MARS
- Efficient use of Hoyter lifts and Patient lifters
Timeline
Senior Patient
SSM Health care, Catherine Haynes
03.2020 - Current
Customer Service Rep
Nord Gear
09.2018 - 04.2019
Med
CNA, Surg and ICU
03.2013 - 02.2015
Case Manager
Infinite Ability Inc. Sun Prairie
07.2012 - 06.2013
House Manager
Lakeview Neurorehabilitation
12.2010 - 03.2013
Caregiver
Infinite Ability Inc
02.2010 - 03.2011
No Degree - Nursing
Wisconsin CNA Training
High School Diploma -
Parents Association