Charmaine Collins
The Bronx,NY
Summary
Detailed oriented professional with over 10 years of experience in optimizing authorization processes and enhancing operational efficiency. Proficient in coordination and prioritization, scheduling, and issue resolution with a strong background in customer service and office administration. Highly organized and detail-focused, committed to continuous improvement and innovative solutions in healthcare service delivery.
Overview
12
12
years of professional experience
Work History
Clinical Correspondence Specialist
Molina Healthcare, Inc (MHI)
Brooklyn, NY
10.2020 - 06.2024
- Demonstrated the skills and knowledge to effectively deliver quality and timely results to enhance operational efficiency
- Supported the Utilization Management Department and Processed diverse authorization, prioritizing due dates to meet regulatory requirements across multiple markets, ensuring timely service delivery
- Maintained 100% accuracy in documents by identifying and correcting errors
- Verified service requests against Medical Director approvals to meet member needs
- Provided crucial weekend and overtime coverage, ensuring uninterrupted processing of Authorization for client services and maintaining departmental responsiveness during peak periods
- Created and edited authorization to facilitating smooth workflow and approval processes.
Care Worker/Correspondence Specialist
A-Line Staffing Services solutions (Magellan Healthcare)
Brooklyn, NY
01.2020 - 10.2020
- Supported utilization and case management workflows, ensuring compliance with legal requirements
- Created and modified denial correspondence, maintaining state regulation consistency
- Monitored and generated member denial letters, improving process efficiency
- Processed and edited correspondence, ensuring alignment with state standards
- Contributed to the creation and modification of denial correspondence, significantly improving compliance and reducing potential legal risks.
Prior Authorization Coordinator – Clinical Dept.
Lancesoft, Inc. (Magellan Healthcare)
Brooklyn, NY
08.2018 - 02.2019
- Monitored letter management queues for accurate faxing of authorizations to the correct vendors
- Identified issues with failed faxes and provided feedback to the clinical team regarding errors
- Managed CaseTrakker alerts and service requests queues ensuring timely authorizations
- Utilized RightFax for efficient provider communication, minimizing service delays.
Intake/Case Coordinator – HRA & LHCSA Housekeeping Dept.
Selfhelp Community Services
New York, NY
01.2016 - 06.2018
- Processed case referrals from contracted vendors, ensuring timely authorizations and continuous care
- Optimized scheduling software for efficient coordination, enhancing service quality
- Maintained contractor relationships, ensuring high member satisfaction and service continuity
- Communicated with Case Managers to address member concerns and service issues
- Generated weekly reports to prevent service delays, ensuring uninterrupted care
- Fostered productive relationships with contractors, ensuring quality member service
- Liaised with Case Managers to address member concerns promptly
- Meticulously documented service changes and performance issues
- Maintained clear communication channels with Case Managers and Social Workers
- Ensured uninterrupted service by proactively following up on staff replacements
- Coordinated with multiple stakeholders to maintain high-quality care.
Case Coordinator – Long-term Homecare Services Department (LHCSA)
Selfhelp Community Services
New York, NY
10.2013 - 07.2015
- Coordinated home care services for 100+ clients using HC Plus/Sandata software, ensuring smooth operations
- Enhanced productivity and retention by monitoring provider activities, leading to measurable improvements
- Acted as liaison among agency, vendors, referrers, and patients to manage referrals and service changes
- Ensured all shifts were filled to meet client needs, contributing to increased revenue
- Documented and communicated occurrences to supervisors and managers, proactively addressing issues to maintain high-quality care
- Implemented strategies to ensure all shifts were filled, meeting member needs while driving revenue growth for the organization.
Claims Representative
Prime Staffing (Visiting Nurse Services)
New York, NY
10.2012 - 10.2013
- Reviewed and researched authorizations and reimbursements, reducing potential costs
- Reprocessed claims adjustments, improving data processing accuracy
- Secured monthly payments by examining check tracer using Facets
- Enhanced productivity and efficiency using MS Word and Excel during special projects.
Education
Bachelors in Business Administration - Health Services Administration -
Monroe College
New York, NYAssociates of Arts in Office Technology/Medical -
TCI-College of Technology
New York, NYSkills
- Office Administration
- Customer Service
- Case Coordination
- Data Management
- Computer Applications
- Issue Identification & Resolution
- Home & Healthcare Service
- Scheduling
- Prioritization
- Phone Etiquette
- MS Office - MS Word, Excel, PowerPoint, Outlook
- Teams
- Ability to juggle between multiple software
- Documents Review
- Team Collaboration
Timeline
Clinical Correspondence Specialist
Molina Healthcare, Inc (MHI)
10.2020 - 06.2024
Care Worker/Correspondence Specialist
A-Line Staffing Services solutions (Magellan Healthcare)
01.2020 - 10.2020
Prior Authorization Coordinator – Clinical Dept.
Lancesoft, Inc. (Magellan Healthcare)
08.2018 - 02.2019
Intake/Case Coordinator – HRA & LHCSA Housekeeping Dept.
Selfhelp Community Services
01.2016 - 06.2018
Case Coordinator – Long-term Homecare Services Department (LHCSA)
Selfhelp Community Services
10.2013 - 07.2015
Claims Representative
Prime Staffing (Visiting Nurse Services)
10.2012 - 10.2013
Bachelors in Business Administration - Health Services Administration -
Monroe College
Associates of Arts in Office Technology/Medical -
TCI-College of Technology
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