Janelle Kennedy
Lithonia,GA
Summary
Experienced and customer-focused professional with over 15 years of expertise in providing exceptional service within the healthcare industry. Proven ability to navigate complex patient inquiries, resolve issues efficiently, and enhance overall patient satisfaction. Skilled in addressing customer concerns, verifying benefits, and coordinating with healthcare providers to ensure seamless service delivery. Adept at managing high-volume calls, maintaining accurate records, and offering compassionate support to patients and their families. Strong knowledge of healthcare policies, HIPAA compliance, and medical terminology, combined with excellent communication and problem-solving skills. Committed to delivering positive experiences and fostering long-term relationships with patients, healthcare teams.
Overview
16
16
years of professional experience
Work History
Appeals Assistance / Intake Coordinator
Kaiser Permanente
12.2021 - Current
- Receive and review incoming appeals, complaints, and inquiries from providers, members, and other stakeholders, ensuring all documentations was complete before initiating processing. Log appeals into the case management system for tracking and further action.
- Maintain accurate and detailed records of each appeal, ensuring all documents were correctly entered into the internal tracking system. Keep case files up to date with relevant correspondence, notes, and updates from other departments.
- Assign appeals/grievances to the appropriate department or team members base on the nature of the case, collaborating with internal teams such as member service and claims to ensure a timely resolution.
- Act as the primary point of contact for customers submitting appeals, answering questions, and providing updates on case statuses. Maintain a high level of professionalism in all written and verbal communications.
- Work proactively to address any delays or issues in the appeals process, escalating cases as necessary to management or other departments to ensure timely resolution.
- Adapt to fluctuating workloads by adjusting priorities and offering support where needed. Encourage a good and collaborative team atmosphere by actively participating in team meetings, providing feedback, and sharing best practices which drives a culture of continuous improvement and problem-solving.
- Ensure all appeals/grievances process comply with relevant industry regulations, such as HIPAA, and adhere to internal polices and timelines for processing.
Customer Service Representative II - MSCC
Kaiser Permanente
10.2017 - 12.2021
- Experienced customer service professional in researching and resolving member issues by utilizing strong problem-solving and communication skills to deliver customer service satisfaction.
- Communicated daily with providers in high volume call center in regard to claims, authorization, or coding issues by assuring issue resolution and exceeding departmental requirements.
- Handled customer benefit and eligibility inquiry, web support, general complaint, premium billing inquiry and new member experience.
- Handled 45+ customer/provider interactions per day, giving detailed, personalized, friendly, and polite service to ensure customer retention and satisfaction.
- Primarily responsible for working specifically with customers who request to cancel, non-renew, or are looking for lower rates on their insurance policy.
Medical Secretary
Mount Sinai Beth Israel Medical Center
11.2014 - 09.2017
- Served as medical secretary for four Internal Medicine Attending Physicians and 13 Medical Residents.
- Represented physicians by screening incoming calls, recording and transmitting messages.
- Handled complex insurance pre-authorization processes accurately, enabling timely delivery of necessary medical services.
- Organize forms, make photocopies, file records, prepare correspondence and reports.
- Reduced wait times for patients by effectively coordinating lab tests, imaging studies, and consultations with other healthcare providers.
- Contributed to the reduction of no-shows by sending appointment reminders via phone or email as per patient preferences.
- Supported healthcare professionals by efficiently managing high volume of patient calls and inquiries, ensuring timely responses.
Patient Service Representative
Mount Sinai Beth Israel Medical Center
09.2011 - 11.2014
- Registered patients and collected required documentation; created medical record for new patients including all necessary forms.
- Facilitated patient registration by accurately entering demographic and insurance information into electronic health record systems.
- Collected co-payments at each visit at the time of registration.
- Provided patient education for radiological and referral procedures.
- Handled sensitive patient concerns with professionalism and empathy, fostering an atmosphere of trust within the clinic.
- Improved patient satisfaction by providing exceptional customer service during check-in and check-out processes.
Unit Secretary Associate
Mount Sinai Beth Israel Medical Center
07.2008 - 09.2011
- Assisted nursing staff with patient care, ensuring timely completion of tasks and improved patient satisfaction.
- Ensured that accurate protocol was executed for admissions and discharges; coordinated transportation for patients, as needed.
- Managed inventory levels of office supplies, ensuring adequate stock was available at all times for efficient unit operations.
- Contributed to positive patient experiences by greeting visitors, providing directions, and addressing inquiries professionally.
- Supported hospital compliance efforts by adhering to privacy policies and HIPAA regulations when handling sensitive patient information.
- Maintained rapport with physicians, nurse,s and other healthcare personnel.
- Assisted with the training and onboarding of new unit secretaries, sharing expertise and best practices to ensure their success in the role.
Education
Bachelor of Applied Science - Healthcare Management/Health Informatics
Colorado Technical University
06.2021
Associate of Applied Science - Health Information Technology
Plaza College
06.2017
High School Diploma - Virtual Enterprise Sales and Marketing
Business Computer, Applications & Entrepreneurship Magnet H.S
06.2004
Skills
- Office administration
- Data management
- Medical documentation
- Customer service skills
- Team Collaboration
- Insurance claims
- Insurance verification
- METRS
- Tapestry
- Custom medical database software programs
- Medical Terminology
- Microsoft Office proficiency
Timeline
Appeals Assistance / Intake Coordinator
Kaiser Permanente
12.2021 - Current
Customer Service Representative II - MSCC
Kaiser Permanente
10.2017 - 12.2021
Medical Secretary
Mount Sinai Beth Israel Medical Center
11.2014 - 09.2017
Patient Service Representative
Mount Sinai Beth Israel Medical Center
09.2011 - 11.2014
Unit Secretary Associate
Mount Sinai Beth Israel Medical Center
07.2008 - 09.2011
Bachelor of Applied Science - Healthcare Management/Health Informatics
Colorado Technical University
Associate of Applied Science - Health Information Technology
Plaza College
High School Diploma - Virtual Enterprise Sales and Marketing
Business Computer, Applications & Entrepreneurship Magnet H.S