Summary
Overview
Work History
Education
Skills
Timeline
Generic

DARLENE HOLMES

Jersey City,NJ

Summary

Skilled team player with strong background in Customer Service. Works well independently to handle assignments and always ready to go beyond basic assignments. Quick learner with good computer abilities. Capable Patient Representative dedicated to providing superior support for patients in need of reliable information regarding insurance coverage, finance options and documentation requirements. Well-versed in scheduling and database management functions for streamlined communication and reduced correspondence backlogs. Excels at identifying client needs and concerns to improve engagement strategies and overall service.

Overview

5
5
years of professional experience

Work History

Clinical Care Coordinator

NAVVIS Healthcare
07.2023 - Current


  • Communicated with insurance companies to verify coverage and obtain authorizations for medical treatments and procedures.
  • Acted as main point of contact for patients, doctors, and hospital staff by closely reviewing medical charts and maintaining high levels of communication.
  • Maintaining compliance with guidelines relating to HIPAA, benefits administration and general liability.
  • Assisted patients with coordinating long-term care for chronic conditions to support and manage illnesses.
  • Answered incoming calls, scheduled appointments and filed medical records.
  • Oversaw quality assurance programs to enhance performance and consistently achieve superior care standards. (HEDIS Background)
  • Updated claims system to track claim status and provide relevant information to other department.
  • Coordinated, monitored, assigned, and documented patient and clinical care activities.
  • Set up educational programs for clinical staff to enhance skills and knowledge.

Patient Care Navigator

Robert Wood Johnson Barnabas Health
05.2022 - 12.2022
  • Followed document protocols to safeguard confidentiality of patient records.
  • Managed over 20 calls per day, scheduled appointments and filed medical records.
  • Greeted and assisted patients with check-in procedures.
  • Helped address client complaints through timely corrective actions and appropriate referrals.
  • Verified patient insurance eligibility and entered patient information into system.
  • Resolved customer complaints using established follow-up procedures.
  • Applied administrative knowledge and courtesy to explain procedures and services to patients.
  • Worked with patients to ascertain issues and make referrals to appropriate specialists.
  • Utilized Microsoft Word to edit, create and save confidential documents.
  • Provided excellent customer service to patients and medical staff.
  • Facilitated communication between patients and various departments and staff.
  • Trained new staff on filing, phone etiquette and other office duties.
  • Processed payments using cash and credit cards, maintaining accurate records of transactions.

Clinical Care Technician

RWJ Barnabas
06.2021 - 10.2022
  • Cleaned and sterilized instruments, equipment and surfaces.
  • Monitored patient vital signs, lab results and other indicators of health.
  • Educated patients about procedures, answered questions, and provided comforting words to control anxiety and enhance procedure results.
  • Evaluated patient histories and medical records for accuracy and completeness.
  • Collected and documented patient medical information such as blood pressure and weight.
  • Operated and maintained medical equipment used to diagnose and treat patients.
  • Utilized effective communication and active listening skills when interacting with physicians, nursing staff, and patients.
  • Maintained accurate patient charts and medical records.
  • Assisted patients with basic care needs.
  • Assisted with routine checks and diagnostic testing by collecting and processing specimens.
  • Utilized medical software to document and track patient progress.
  • Gathered, charted, and analyzed patient history data and discussed key points with clinicians.
  • Cared for patients by providing personal assistance and ambulation.

Asisstant Front Desk Manager

Ivy Rehab Physical Therapy
10.2018 - 01.2022
  • Managing the staff schedules
  • Tending to guests' complaints and questions and providing exceptional customer service
  • Maintaining office supplies and equipment
  • Managing budgets, records, and contracts
  • Managing High Volume phone, chat, fax, mail, and e-mail inquiries
  • Patient intake forms
  • Worked closely with patients to deliver excellent and direct individualized patient care.
  • Upheld confidentiality requirements and regulatory compliance guidelines.
  • Scheduled approximately 200 patients per week and made reminder calls.
  • Assisted patients with completing necessary paperwork and forms to provide healthcare facilities with essential information to bill for services.
  • Acted as main point of contact for patients, doctors, and staff by closely reviewing medical charts and maintaining high levels of communication.
  • Communicated with insurance companies to verify coverage and obtain authorizations for medical treatments and procedures.
  • Screened patients for financial assistance and aided in preparing required funding documents.
  • Greeted and directed patients to examination rooms and verified insurance coverage and collected co-payments.
  • Coordinated transportation to get patients to and from medical appointments.

Education

Bachelor of Science - Exercise Science

Kean University

High School Diploma - undefined

William L. Dicksinson Highschool
Jersey City, NJ

Skills

  • Customer service
  • Recording Histories
  • Interpreting Physician Orders
  • Benefits Explanations
  • Insurance Authorizations
  • Verifying Coverage
  • Medical History Documentation
  • Verbal communication Document scanning
  • Case Management
  • Resource Coordination
  • Time Prioritization
  • Claims Handling and Coverage Verification

Timeline

Clinical Care Coordinator

NAVVIS Healthcare
07.2023 - Current

Patient Care Navigator

Robert Wood Johnson Barnabas Health
05.2022 - 12.2022

Clinical Care Technician

RWJ Barnabas
06.2021 - 10.2022

Asisstant Front Desk Manager

Ivy Rehab Physical Therapy
10.2018 - 01.2022

Bachelor of Science - Exercise Science

Kean University

High School Diploma - undefined

William L. Dicksinson Highschool

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DARLENE HOLMES