Kaelah Haynes
Oakland,CA
Summary
To secure a position with a reputable hospital or competitive medical facility to effectively collaborate with physicians and health care teams. Organized and dedicated with proven track record of providing exceptional customer service in fast-paced environments. Offering keen attention to detail and strong decision-making skills to manage multiple, concurrent tasks. Self-motivated work ethic to perform effectively in independent or team environments.
Overview
4
4
years of professional experience
1
1
Certification
Work History
In Home Health Care Provider
IHSS
09.2022 - 11.2023
- Provided assistance to clients by handling household cleaning duties, managing schedules, and transporting to and from medical appointments.
- Cooked tasty, nourishing meals for patients to promote better nutrition.
- Administered medication as directed by physician.
- Administered wound care and cleaning
- Monitored changes in clients' conditions to report concerns to medical care teams.
- Communicated regularly with clients' families to provide updates on health and wellbeing.
- Developed and implemented care plans for clients.
- Interacted kindly with patients and families and displayed positive, outgoing attitude, resulting in establishment of long-term, professional relationships
Referral Specialist/Authorization Coordinator
John Muir Health/ UCSF Medical Center
12.2020 - 01.2021
- Obtain authorizations for multiple specialty departments
- Knowledgeable in fundamentals of Healthcare plans and insurance coverages
- Knowledgeable in Medical CPT Codes and ICD-10 codes
- Schedule patient appointments and procedures
- Obtain authorization for patient office visits, hospital procedures and testing
- Maintained consistent follow-up on status of prior authorization requests.
- Reviewed authorizations from payer to determine approved or denied items
- Scanned approved and denied authorization into patient charts
- Faxed referrals and provider orders to internal and external specialty facilities for servicing
- Healthcare liaison for incoming and outgoing specialty referrals
- Work closely with providers to expedite scheduling for patient consults and procedures.
- Skilled at working independently and collaboratively in team environment
Administrative Assistant Insurance Management OB/GYN (Level 3)
UCSF Medical Center
11.2019 - 05.2020
- Knowledgeable in fundamentals of Healthcare Plans and Insurance Coverages
- Familiar with variety of Healthcare Payer Plans (Medi-Care/Medi-Cal, HMO, PPO and Fee for Service Providers)
- Verify per web or via phone insurance eligibility and benefits for all incoming patients
- POS payment collection in Epic System
- Obtain pricing points for rendered hospital services
- Medical referral coordinator between contracted insurance payers within UCSF Medical Group
- Obtain Medical Insurance Authorizations for patient hospital procedures, office visit consults, and ultrasounds
- Scan approved and denied authorization letters and/or referrals into patient charts
- Healthcare liaison between patient and payer plan to overcome potential insurance coverage contract barriers.
In Home Health Care Provider
IHSS
08.2019 - 11.2019
- Provided assistance to clients by handling household cleaning duties, managing schedules, and transporting to and from medical appointments.
- Cooked tasty, nourishing meals for patients to promote better nutrition.
- Administered medication as directed by physician.
- Monitored changes in clients' conditions to report concerns to medical care teams.
- Communicated regularly with clients' families to provide updates on health and wellbeing.
- Developed and implemented care plans for clients.
Education
Some College (No Degree) -
Merritt College
Oakland, CABachelor of Science in Public Health -
California State University Northridge
Northridge, CA05.2018
Skills
- HIPAA Regulations
- Epic Systems
- CPT Coding
- Medical Terminology
- Pre-Authorizations
- Appointment Scheduling
- Patient Referral
- Time Management
- Collaboration and Teamwork
- Customer Service
Related Skills And Qualifications
- Proficient in Microsoft Word, Excel, Power Point, Outlook, Epic & APEX
- Awareness of important code of ethics in Healthcare provision and HIPAA Certified
- Proficient in Medical Terminology
- Clinical Clerical Medical Experience
- Excellent interpersonal skills and highly adaptable to new challenges and situations
- Successful in assisting patients in overcoming barriers of identified goal
- Works well independently with little to no direction or in a team setting
Certification
- HCA - Home Care Aide
- Wound Care , Sutter Care at Home
Timeline
In Home Health Care Provider
IHSS
09.2022 - 11.2023
Referral Specialist/Authorization Coordinator
John Muir Health/ UCSF Medical Center
12.2020 - 01.2021
Administrative Assistant Insurance Management OB/GYN (Level 3)
UCSF Medical Center
11.2019 - 05.2020
In Home Health Care Provider
IHSS
08.2019 - 11.2019
Some College (No Degree) -
Merritt College
Bachelor of Science in Public Health -
California State University Northridge
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