Kandi Miles

• Assists organizations to achieve greater efficiency and solve organizational problems
• Ensuring that the services are delivered according to the Alight Solutions description
• Develop strategies to improve organizational performance via process-based management; oversee the implementation of process improvements
• Escalation management: being a focal point for communicating, coordinating, and managing escalations
• Main point of contact for managing multiple client queues
• Having hands-on experience developing Powerpoint scripts, implementing, and supporting multiple clients
• Ensuring that reports are correct and provided to each client base
• Provide advice to internal senior management on the technical and business strategy within active deals
• Leading and participating in proposal presentations for new implementations

• Created and introduced the referral coordinator position within the department

• Developed excel spreadsheets and flow charts to navigate the process of the role

• Implemented insurance portals to help process authorizations and medical records

• Coordinated all aspects of the outpatient/impatient referral and precertification process including medical necessity review, benefits eligibility review, data entry and provider correspondence

• Responsible for the coordination of all aspects of the referral process of new patients to (sub)specialty services of The Emory Clinic, starting from the point at which the TEC registration function si complete (Global Patient Registration)

• Identified, tracked, and resolved on-going problems with the authorization process

• Answered referral questions and inquiries by phone and in person regarding referrals to a specialist or treatment facility

• Contacted patients to inform them of referral or precertification appointment; answered patients' referral billing questions

• Met team goals regarding number of patient referrals processed in a timely manner

• Processed legal documents pertaining to each patient

• Submitted images/specimens/etc. as applicable for review by an Emory Clinic expert (e.g. Pathology)

• Coordinated and reviewed emergency and nonemergency appointments and scheduled procedures and/or surgeries with patient, physician and/or facility prior to appointment or procedure

• Requested and tracked patient records and prepared charts for review by a nurse (navigator) or other knowledgeable clinician. Distributes charts/clinical data per departmental procedures

• Increased employee recognition through selective hiring practices and benefits negotiations

• Created user friendly application forms and questionnaires to be used during staff recruitment and interviewing

• Initiated the employment verification/reference checks for applicants

• Entered data into system for registration, billing, patient tracking, charge capture, and reconciliation in a fast, efficient way ot minimize patient wait times

• Led recall project to reduce the number of follow up visits within the department by 20%/400 patients

• Served as liaison between patient and department staff by informing patients and families of procedures and delays, answering questions, offering assistance, relaying messages, and other services that patients and families may require

• Explained regulatory financial requirements to patient or responsible party and collected/posted deposits or deductible amounts as required

• Interviewed patients and families to obtain complete and accurate demographic and financial information and ensured all necessary questionnaires and forms were completed according to pre-determined requirements by government or regulatory agencies

• Handled fax folder duties to ensure doctors received timely documentations that included prescriptions, referrals, and legal documents

• Managed cash duties, secured cash in safe, managed cash pickups with Dunbar, and balanced daily cash drawer in epic

• Scheduled patient appointments when needed, including referrals from faxes, phones, or other instructions and contacted physician offices when needed

• Responsible for performing a wide variety of clerical procedures that require independent judgment, ingenuity, and initiative in the utilization of computers and other equipment.

• Knew the existing lines of communication and authority, handled communication properly and was always dependable and cooperative

• Assisted physician's office staff with scheduling appointments in a timely manner

• Contacted referring physicians and or/patients to discuss rescheduling of procedures due to incomplete/partial authorizations

• Acted as liaison between clinical staff, patients, referring physician's office and insurance payers by informing patients and families of procedures authorization delays/denials, answering questions, offering assistance, relaying messages, pertaining ot the authorization of procedure/service

• Trained new hires on how to use the Epic system and scheduling

• Kept records and submitted billing and claims to insurance companies
• Other related clerical duties such as photocopying, faxing, data entry, and collation
• Verified patient insurance and demographics before proceeding with each exam
• Operated an OCT machine

• Verified patient's insurance coverage

• Specialized in Medicaid and Medicare documents

• Collected co-payments and other monetary transactions for each visit

• Maintained patient records by updating, obtaining, and recording personal and financial information Completed the registration process by scheduling and confirming patient appointments and demographics

• Posted and updated patient financial charges and services for each patient

• Completed patient registration process at the arrival of each patient's appointment by reviewing pre- registration information with patients and families to ensure accuracy of personal information

• Verified insurance and eligibility for future appointments to check eligibility and secure authorizations prior to patient's appointment

• Greeted patients and visitors in person or over the phone

• Submitted claims and billing to the appropriate insurance company

• Displayed exceptional customer service
• Exceeded sales goals within the department
• Unloaded and loaded shipments from delivery trucks to stocking shelves
• Organized and built displays