ILA CAIN
Auburn,GA
Summary
Provider relationship & customer service-driven professional offering more than 20 years of overall experience working in diverse backgrounds such Admissions, and Intake Liaison for Behavioral Health hospital, Provider relations, and referrals for Managed Health Care Network EAP programs, Payment Program Coordinator for non profit, Social Worker, International Flight Manager , Admissions & Marketing Director. Poised, and confident in building long-lasting relationships with clients and providers. I have a positive, and professional disposition, and successful problem-solver.
Overview
23
23
years of professional experience
Work History
International Manager
MAJOR U.S. AIRLINE
Dulles, VA
11.2015 - Current
- Improved operations by working with team members and customers to find workable solutions.
- Controlled flight environment by responding to disruptive passengers per FAA and federal guidelines.
- Attended trainings in customer service, conflict resolution techniques, and safety procedures to remain current on new requirements and procedures.
- Demonstrated self-reliance by meeting and exceeding workflow needs.
- Recognized by management for providing exceptional customer service.
- Demonstrated and clearly explained safety processes and emergency procedures to passengers before takeoff.
- Completed flight logs, passenger action reports and inventory paperwork with high attention to detail.
Director of Social Services
Tennessee Healthcare Management
Cordova, TN
01.2014 - 05.2015
- Handled 20+ insurance verifications per month. Verified that each met standards of admissions for processing.
- Maintained consistent personal interaction with residents/clients in addition to administrative duties to assure optimum care firsthand.
- Advocated for residents in response to stated needs for care quality, food, facilities and resident interactions.
- Implemented social services care plan for each resident and updated plan annually in consultation with resident and family.
- Supervised resident records according to federal and state requirements using specialized software program for maximum compliance and data accessibility.
- Educated residents and families regarding private insurance, Medicare, Medicaid, Veterans Administration and other possible sources of funding for required care.
- Facilitated weekly care meetings with residents and families to verify adherence to care plan and sufficiency of actual everyday care.
- Coordinated referrals to community services by advocating for individual needs and addressing roadblocks.
- Collaborated with team members to identify and accomplish agency objectives.
- Supervised a team of social workers, counselors and other professionals providing direct services to clients.
- Conducted assessments of clients' needs and developed individualized plans of care.
- Provided ongoing training and support to staff members ensuring up-to-date knowledge of laws, regulations, policies and procedures related to social services field.
- Implemented strategies designed to increase public awareness about available services provided by the agency.
Social Services & Admissions Marketing Director
Kindred Healthcare
Walnut Creek, CA
01.2008 - 06.2009
- Helped patients with admissions process and adhered to state and federal laws.
- Handled insurance claim duties and verified that each met standards of admissions.
- Collaborated with medical and program directors to establish and execute policies and procedures for facility.
- Compiled and analyzed marketing data to generate reports for corporate office.
- Addressed, documented, and responded to incoming and outgoing calls and correspondence.
- Scheduled and confirmed patient appointments for diagnostic, surgical and consultation services in busy environment.
- Interviewed patients to collect medical information and insurance details.
- Created and maintained accurate and confidential patient files.
- Contacted other medical facilities to confirm medical histories and prevent inaccurate diagnoses.
Admissions and Provider Liaison
St. Helena Center for Behavioral Health
Vallejo, CA
01.2007 - 01.2008
- Developed and maintained effective relationships with internal providers for outpatient referrals .
- Worked with cross-functional teams to achieve goals.
- Worked successfully with diverse group of coworkers to accomplish goals and address issues related to our services, and client intake process
- Conducted concurrent reviews to monitor the ongoing appropriateness of services provided to members.
- Collaborated with physicians, nurses, case managers, discharge planners, social workers and other healthcare professionals to develop a comprehensive plan of care within specified guidelines.
- Analyzed treatment plans for appropriateness, effectiveness and medical necessity in accordance with established criteria.
Payment Program Coordinator
Community Childcare Coordinating Council
Oakland, CA
10.2002 - 11.2006
- Processed and sent monthly invoices to customers on standard billing cycle, including adjustments, credit memos and corrections.
- Tracked expenses and entered deposits, while reconciling monthly bank accounts to verify accuracy.
- Completed day-to-day financial transactions, including processing provider timesheets/payroll
- Performed day-to-day financial transactions, including verifying, classifying, computing, posting and recording accounts payable data and reconciled daily totals to confirm proper accounting.
- Coordinated budget information by assessing estimated income and expenses as well as historical budgets.
- Made weekly deposits
- Recertified providers/ families on in subsidy programs
- Provided monthly case management to families
Provider Referrals Specialist
Managed Health Network
San Rafael, CA
10.2001 - 09.2002
- Verified accuracy of customer information by collecting and inputting data into system.
- Developed and maintained strong relationships with providers by responding promptly to inquiries, resolving issues and providing ongoing support.
- Maintained accurate records of all communications with providers including emails, letters, phone calls.
- Collaborated with other departments within the organization to resolve complex issues related to provider relations activities.
- Conducted initial assessments to determine appropriate EAP provider referral for clients accessing EAP benefits.
Education
Bachelor of Arts - BSW- Bachelor in Social Work
Jackson State University
Jackson, MSSkills
- Provider Relations
- Sales & Marketing
- Experience in working with Salesforce
- Account Management
- Reputation for building long lasting-relationships
- Experience in maintaining individual book of business
- Effective verbal, and written communication
- Planning & Coordination
- Experience working in cross-functional professional settings with internal and external stakeholders
- Client Advocacy
- Client need assessments
- Problem-Solving
- Calm Under Pressure
- Community Training
- Records Management
- Resource Navigation
- Training and coaching
- Leadership & Development
- Team building
- Relationship development
- Attention to Detail
- Time Management
Timeline
International Manager
MAJOR U.S. AIRLINE
11.2015 - Current
Director of Social Services
Tennessee Healthcare Management
01.2014 - 05.2015
Social Services & Admissions Marketing Director
Kindred Healthcare
01.2008 - 06.2009
Admissions and Provider Liaison
St. Helena Center for Behavioral Health
01.2007 - 01.2008
Payment Program Coordinator
Community Childcare Coordinating Council
10.2002 - 11.2006
Provider Referrals Specialist
Managed Health Network
10.2001 - 09.2002
Bachelor of Arts - BSW- Bachelor in Social Work
Jackson State University
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