Summary
Overview
Work History
Education
Skills
Timeline
Generic

Ieisha Washington-Bradford

Atlanta,GA

Summary

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

8
8
years of professional experience

Work History

Clinical Care Navigator

United Health Group
06.2021 - Current
  • Outreached members on caseload consistent with program guidelines.
  • Complete all required data entry into the appropriate systems to include formatting, auditing, and tracking of completed assignments.
  • Completes telephonic outreach to DSNP members utilizing auto dialer and manual dialing
  • Educates members on gaps in care and assists with scheduling provider appointments.
  • Maintains confidential health information according to state and federal regulations including HIPAA
  • Attend team meetings as required and participate in discussions and process improvement projects.
  • Meet the performance goals established for the position in the areas of productivity, quality, and attendance.
  • Maintain flexibility in an ever-changing environment
  • Answer incoming calls from our members as needed
  • Delivered support to medical staff in completion of patient paperwork.
  • Resolved customer complaints using established follow-up procedures.
  • Verified patient insurance eligibility and entered patient information into system.
  • Facilitated communication between patients and various departments and staff.
  • Identified gaps in care and assisted in closure of gaps.
  • Utilized Microsoft Word to edit, create and save confidential documents.
  • Worked with patients to ascertain issues and make referrals to appropriate specialists.
  • Compiled and maintained patient medical records to keep information complete and up-to-date.
  • Offered simple, clear explanations to help clients and families understand hospital policies and procedures.

Benefits Support Specialist

CareSource Health Plan
02.2017 - 06.2021
  • Collaborate with healthcare providers and insurance companies to resolve discrepancies and expedite claims processing
  • Coordinate patient benefits and insurance eligibility for over 70 patients daily, ensuring timely and accurate verification and authorization of services
  • Educate patients on their insurance benefits, coverage options, and financial responsibilities, enhancing patient understanding and satisfaction
  • Maintain accurate and up-to-date records in the electronic medical record system, ensuring compliance with HIPPA regulations
  • Assist in the appeals process for denied claims, researching and providing necessary documentation to support resolutions
  • Managed patient inquiries via telephone and email regarding insurance benefits and billing, providing clear and concise information to enhance understanding
  • Managed high call volumes while providing exceptional customer support and maintaining professional composure.

Education

High School Diploma -

South Cobb High School
Austell, GA
05.2010

Skills

  • Proficient in Windows Operating Systems
  • Excel and Outlook Expertise
  • Billing Coordination
  • Insurance Claims Processing
  • ICD-10 Management
  • Care coordination
  • Data entry
  • Insurance verification
  • Claims resolution
  • Electronic records management
  • Customer service
  • Healthcare systems
  • Medical terminology

Timeline

Clinical Care Navigator

United Health Group
06.2021 - Current

Benefits Support Specialist

CareSource Health Plan
02.2017 - 06.2021

High School Diploma -

South Cobb High School

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Ieisha Washington-Bradford