Channon Caston
Joshua,TX
Summary
Knowledgeable patient advocate with demonstrated skills in case management and service coordination. Expertly handles complaints, inquiries, claims, disputes, and service issues related to care. Well-versed in policies, procedures, and standards.
Overview
1
1
Certification
8
8
years of post-secondary education
20
20
years of professional experience
Work History
Patient Care Coordinator
OptumRx
Dallas, TX
10.2025 - Current
- Coordinated patient care by scheduling appointments and managing follow-up activities.
- Facilitated communication between healthcare providers and patients for streamlined care.
- Managed patient records using electronic health record systems for accurate documentation.
- Assisted patients with insurance inquiries and benefits verification processes.
- Ensured that all necessary documentation was completed accurately and submitted in a timely manner.
- Ensured compliance with HIPAA regulations when dealing with confidential patient information.
- Utilized ICD-10 and CPT coding systems for patient billing processes.
- Reviewed medical records for accurate coding and compliance with regulations.
- Assisted in resolving claim disputes by coordinating between clients and adjusters.
- Assisted with the resolution of complex insurance claim disputes between policyholders and insurers.
- Conducted thorough investigations of claims by reviewing documents, interviewing involved parties, and consulting with experts.
- Worked closely with underwriting and risk management teams to provide insights from claims experiences.
Customer Service Specialist
Frontier Communications
Allen, USA
09.2014 - 06.2019
- Assisted customers with service inquiries and technical issues.
- Coordinated billing adjustments and account updates efficiently.
- Resolved customer complaints through effective communication and problem-solving.
- Collaborated with technical teams to troubleshoot complex issues.
- Developed training materials for new employees across multiple departments.
- Collaborated with management to identify training needs and priorities.
- Facilitated onboarding sessions for new hires, ensuring smooth integration into teams.
- Designed and developed training materials for new employees in the organization.
Engineering Administrative Assistant
MGM/Bellagio
Las Vegas, USA
04.2006 - 05.2011
- Created continuing education courses for existing employees.
- Ensured compliance with EEOC and relevant policies, fostering a fair workplace environment.
- Coordinated engineering schedules and meetings, facilitating project updates and effective communication.
- Developed computerized software training courses for new employees, as well as continuing education courses for existing employees.
- Assured company and employee adherence to EEOC and other applicable policies and procedures to ensure positive outcomes.
- Liaised with vendors and tracked orders to support procurement processes and maintain project timelines.
Education
Associate of Arts - Medical Social Work
Regis University
Denver, CO 09.2013 - 09.2017
Bachelor of Science - Computer Information Systems
Regis University
Denver, CO 08.2013 - 09.2017
Skills
- Patient billing systems
- Patient coding protocols
- ICD-10 coding
- Insurance claims management
- Insurance verification
- Claim dispute resolution
- Healthcare compliance
- Healthcare documentation
- HIPAA protocol adherence
- Policy compliance
- Technical troubleshooting
- Technical support
- EHR system management
- Data management
- SQL/Oracle database support
- Microsoft Office expert
- Microsoft Excel
- Microsoft Word
- Microsoft Project
- Microsoft dynamics 365
- Office 365 security
- Microsoft Azure
- SharePoint administration
- Visual studio
- Adobe Acrobat,Photoshop, Premier
- SQL, C, Java/Javascript, Visual Basic, HTML, Python
- Attention to detail
- Effective communication
- Problem solving
- Conflict resolution
- Healthcare navigation
- Data privacy regulations
- IT documentation
- Operating system expertise
- Patient support services
- Microsoft SQL server
- Microsoft Graph API
- Microsoft planner
- Microsoft Security Compliance
- Microsoft Project
- Microsoft dynamics 365
- Office 365 security
- HIPAA compliance
- Microsoft Word
- Adobe Acrobat,Photoshop, Premier
Certification
- ACLS Heart Certification
Timeline
Patient Care Coordinator
OptumRx
10.2025 - Current
Customer Service Specialist
Frontier Communications
09.2014 - 06.2019
Associate of Arts - Medical Social Work
Regis University
09.2013 - 09.2017
Bachelor of Science - Computer Information Systems
Regis University
08.2013 - 09.2017
Engineering Administrative Assistant
MGM/Bellagio
04.2006 - 05.2011