Kalana Jackson

Work History

Veterans Service Representative

Veterans Benefit Administration

05.2023 - Current

Reviewed and requested medical records, military personnel records and service verification records to determine eligibility status.
Analyzed claims to determine percentage of disability, permanent and total disability and entitlement to compensation.
Utilized VBMS CORE & VBMS A to compose correspondence letters to explain current status of applications and request additional documentation.
Approached issues proactively to best meet current and future community needs.
Supported clients through development of new life skills, obtaining resources and transitioning back to society.
Kept case files updated, accurate and aligned with requirements.
Helped clients navigate social services system and access needed resources.
Assisted veterans and dependents in preparing forms and documents to present claims for benefits.

Advanced Medical Support Assistant

Department of Veterans Affairs

08.2021 - 05.2023

Coordinates with the patient care team to review the clinic utilization by using various reports (e.g., Clinic Utilization Statistical Summary)
Utilizes multiple software programs and Internet search engines concurrently along with critical, creative thinking to locate imminently suicidal Veterans
Locates Veterans using various Internet resources as well as VA databases
Educates local law enforcement and dispatch on telecommunication procedures to locate those in crisis
Conducts follow-up chart checks to ensure Veterans' consults are provided to the appropriate VAMC
Participates in team huddles and team meetings to manage and plan patient care
Participating in and independently following up on team huddles by sharing information and collaborating with the medical team to assure continuity of care
Performing administrative follow up actions
Evaluating patient information and clinic schedule lists to determine whether patient is vested
Participating and providing input in problem solving on operational issues or procedures in team meetings
Ensures that the SPCs (from over 152 VAMCs nationwide) follow-up has been completed by reviewing consult documentation in Crisis Line/Call Center Web-Application and CPRS
Schedule consults
Complete and update registrations for new veterans
Answer inbound and make outbound calls
Monitoring pre-appointment requirements to assure readiness for patient visit/procedure (e.g., X-ray, lab work)
Adjusting the flow and sequencing of the work to meet team and patient needs
Setting priorities and deadlines
Maintains effective and efficient communication with the patient, interdisciplinary team, VA Medical Centers, and other agencies (e.g., assist with communications during the inpatient to outpatient discharge; communicates with non-VA medical facilities; facilitate/process secure messaging with the patient and team; notify patients of appointments; manage a tracking system for follow up care such as Return to Clinic Orders, Recall, consults, tests, etc.)
Provides the necessary recommendations to ensure compliance or corrective actions and the appropriate level of access
Ensures that the clinic setup is closely monitored to effectively support the needs of the clinic
Contact respondents to serve charges, explain respondent's rights and obligations under the law, and conduct interviews to obtain evidence
Ensuring that current, accurate, and complete data is entered into electronic data systems.
Performed medical records management, including filing, organizing and scanning documents.
Collaborated with medical and administrative personnel to maintain patient-focused, engaging and compassionate environment.
Verified patient insurance coverage and collected required co-payments.

Advanced Medical Support Assistant

Department of Veterans Affairs

04.2021 - 08.2021

Updated outdated patient information to maintain current records
Relayed messages from patients to physicians about concerns, condition updates or refill requests to facilitate treatment
Scheduled appointments for patients via phone and in person
Organized charts, documents and supplies to maintain team productivity
Contacted pharmacies to submit and refill patients' prescriptions
Secured patient information and maintained patient confidence by completing and safeguarding medical records
Maintained inventory, vaccination and product expiration logs to record updated documentation for tracking purposes
Efficiently performed insurance verification and pre-certification and pre-authorization functions
Coordinates with the patient care team to review the clinic utilization by using various reports (e.g., Clinic Utilization Statistical Summary)
Identifies software, hardware operational problems, and forwards recommendations for improvements on the system
Knowledge of pertinent laws, regulations, and policies.

Lead Medical Assistant

Drug Rehabilitation Metro Health Medical Center

11.2015 - 04.2021

Supervised, trained and coached team of medical assistants
Guided patients to room, recorded vital signs, discussed patient medical history and entered information for physician or other clinical staff to review
Set up, cleaned and stocked examination rooms with medical supplies
Prepared daily charts by creating and updating electronic health records system data prior to patient visits
Assisted patients with registration, new patient paperwork and check-out process
Communicates with 911 dispatchers, emergency responders, and Mental Health mobile units to get emergency services to imminently suicidal individuals
Utilizes multiple software programs and Internet search engines concurrently along with critical, creative thinking to locate imminently suicidal Veterans
Conduct follow up chart checks to ensure Mental Health Patients consults are provided
Scheduled patients by collecting screening information or presented nurse with clinical information to triage urgent patient needs
Closed and submitted patient insurance claims at end of shift
Performed preliminary physical tests to accurately record results in patient history summary
Scheduled appointments for patients via phone and in person
Relayed messages from patients to physicians about concerns, condition updates or refill requests to facilitate treatment
Interviewed and engaged patients to obtain medical history, chief complaints and vital signs
Educated patients about medications, procedures and physician's instructions
Organized charts, documents and supplies to maintain team productivity
Contacted pharmacies to submit and refill patients' prescriptions
Secured patient information and maintained patient confidence by completing and safeguarding medical records
Maintained inventory, vaccination and product expiration logs to record updated documentation for tracking purposes
Efficiently performed insurance verification and pre-certification and pre-authorization functions
Followed principles of asepsis and infection control to meet patient safety guidelines
Assessed, documented and monitored vital signs for patients within outpatient setting.

Human Resources Assistant

University Hospital and Medical Center

01.2011 - 10.2015

Created, organized and maintained employee personnel files to keep sensitive data secure
Guided new hires through orientation and on-boarding and explained documentation requirements to facilitate HR process
Developed job postings, recruited candidates and scheduled interviews to fill vacant positions
Conducted employment verification and background investigation to facilitate hiring process
Developed and maintained training materials and benefits packets for new hires
Reviewed and processed payroll-related actions to drive data accuracy and comply with company policy and federal and state regulations
Reviewing, analyzing, and providing information to computer systems
Prepared and submitted final payment and benefits allocations for employees upon termination
Assisted with employee termination process to drive consistency and reduce discrimination claims
Worked with HR department to devise and update policies as needed for corporate accountability and workplace health
Handled sensitive and confidential employee information with complete discretion
Processed onboarding paperwork for new hires and rehires
Conducted job applicant background checks in accordance with policy and procedures
Process and approve personnel actions following the guide to processing personnel actions in automated system
Intake/Assess, investigate, conciliate, and/or resolve complex, highly sensitive and difficult allegations of discrimination related to housing, and employment
Knowledge of the major issues, Program goals and objectives, work processes, and administrative operations of a federal health plan
Negotiating some aspects of awards in accordance with applicable regulation
Analyzing applications including making assessments of a prospective awardee's eligibility
Development and implementation of administrative contracts, including all policies and requirements to support major agency organizations.

Claims Representative

Menorah Center for Rehabilitation and Nursing Care

02.2013 - 04.2014

Provided quality customer service to assigned, insured and claimants throughout claims process to deliver timely service to customers
Delivered quality customer service to assigned, insured and claimants throughout entire claims lifecycle to promote service times
Verified details with policyholders and requested additional information
Assessed policy coverage and pulled contracts for review
Consulted with field support team, claim manager and other entities to receive support specific to assigned claim
Supported efficient handling of complex claims and followed up on open, denied or suspended claims to complete required line items
Researched and reviewed information to determine validity of insurance claims and contacted companies and customers about decisions
Determined liability, compensability and benefits due on each claim
Maintained knowledge of policies and procedures and insurance coverage benefit levels, eligibility systems and verification processes
Investigated and analyzed requirements to improve timeliness of reports to customers
Tracked and reported on patterns of claims and repeat offenders to help eliminate system abuse
Making critical decisions to determine the amount of benefits paid to individuals
Identifying operational problems and recommending corrective actions
Skill in applying analytical and evaluative methods and techniques
Providing advice on the mechanisms to develop agreements.

Summary

Overview

Work History

Veterans Service Representative

Advanced Medical Support Assistant

Advanced Medical Support Assistant

Lead Medical Assistant

Human Resources Assistant

Claims Representative

Education

Some College (No Degree) - Medical Assisting

College Degree - Human Services

Skills

Timeline

Similar Profiles

Melissa DiazMelissa Diaz

ZAIRA GUERRAZAIRA GUERRA

Kenneth WeiskergerKenneth Weiskerger