Enid Kemlage
Hopewell Junction,NY
Summary
Focused patient care professional accustomed to prioritizing and delivering basic patient care. Offers 10 years of comprehensive experience in recording vital signs, collecting specimens and preparing accurate documentation. Recognized by patients for delivering five-star patient care.
Experienced nursing professional providing quality care to patients in variety of medical settings. Delivers excellent communication and task prioritization skills for effective patient care coordination. Proven ability to stay organized and prioritize tasks in fast-paced environment.
Overview
20
20
years of professional experience
Work History
Claims Representative
Optum Health Care
09.2016 - 06.2021
- Processed and reviewed medical claims in accordance with company policies and regulatory standards, ensuring accuracy in coding and documentation.
- Analyzed claims to determine coverage eligibility, making payment decisions based on medical necessity, policy guidelines, and fee schedules.
- Conducted detailed investigations to resolve discrepancies, collaborating with healthcare providers and policyholders to gather additional information.
- Provided outstanding customer service, addressing inquiries and resolving claim issues with clear, concise communication.
- Maintained comprehensive records of claims activities and generated reports to track metrics and performance.
- Ensured compliance with industry standards through regular audits and quality checks, identifying potential fraud or abuse.
Office Assistant
SEP-Tech, Inc.
08.2003 - 09.2016
- Provided administrative support in the daily operations of a residential building company, performing tasks such as scheduling appointments, managing correspondence, and coordinating meetings.
- Assisted in data entry and the preparation of time-sensitive reports, including client and vendor lists, while tracking time sheets, check requests, and receipts.
- Delivered high-quality customer service by handling front desk reception, answering phones, and assisting walk-in clients with inquiries related to building projects.
- Streamlined office operations by maintaining filing systems, managing office supply inventory, and ensuring efficient interoffice communication.
- Operated and maintained key office equipment such as photocopiers, faxes, printers, and scanners, ensuring optimal functionality for smooth operations.
- Collaborated with team members to ensure timely completion of administrative tasks, contributing to a well-organized and productive office environment.
Patient Care Technician
Putnam Hospital Center
09.2009 - 03.2011
- Assisted with patient care by monitoring vital signs, aiding with daily living activities, and documenting patient information accurately.
- Supported healthcare professionals with medical procedures, ensuring patient comfort and safety.
- Maintained patient charts and ensured compliance with infection control protocols to provide a safe hospital environment.
- Assisted in transferring patients, beds and patient care equipment to other rooms adhering to necessary safety precautions.
- Assisted with feeding and monitored intake to help patients achieve nutritional objectives.
- Maintained clean and safe environment to promote patient safety and comfort.
- Supported needs of 10 + residents in care.
Claims Customer Service Representative
Federated Insurance
05.2001 - 06.2003
- Delivered exceptional customer service by assisting policyholders and healthcare providers with medical claims inquiries.
- Provided customer service and support to policyholders and healthcare providers regarding medical claims, addressing inquiries and ensuring accurate processing.
- Verified claim eligibility and documentation requirements, maintaining organized claim files in accordance with company policies and regulatory standards.
- Conducted investigations into medical claims, collaborating with internal departments to gather information and make appropriate coverage decisions.
- Processed claim payments efficiently and calculated reimbursement amounts based on policy provisions and industry guidelines.
Education
Bachelor of Science - Nursing
Mount Saint Mary College
New York, NY05-2027
Certified Nursing Assistant -
Connecticut Health Career Institute
Connecticut04-2025
Associate Science -
SUNY Empire State College
New York, NY05-2024
Skills
- Patient hygiene management
- Infection prevention
- ADL support
- Bed preparation
- Vital signs monitoring
- Basic nursing care
- Patient assistance
- Catheter care
- Blood glucose monitoring
- Vitals documentation
- Professional bedside manner
- Safety protocols
- Patient services
- Monitoring patient conditions
- Adaptable
- Compassionate care
Timeline
Claims Representative
Optum Health Care
09.2016 - 06.2021
Patient Care Technician
Putnam Hospital Center
09.2009 - 03.2011
Office Assistant
SEP-Tech, Inc.
08.2003 - 09.2016
Claims Customer Service Representative
Federated Insurance
05.2001 - 06.2003
Bachelor of Science - Nursing
Mount Saint Mary College
Certified Nursing Assistant -
Connecticut Health Career Institute
Associate Science -
SUNY Empire State College
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