KAREN PARKER
SPRING,US
Summary
Over 20 years in healthcare billing and financial counseling, with a strong focus on program coordination and enhancing patient engagement. Proven ability to streamline processes, promote compliance, and improve member satisfaction in remote settings.
Overview
17
17
years of professional experience
Work History
PROGRAM COORDINATOR I
Centene
03.2023 - 05.2025
- 100% remote based. Responsible for making proactive phone calls to Centene (Medicare and Medicaid) members to inform them about a program, encourage participation, gather information, schedule appointments and follow up on progress. Initiate authorization requests for output or input services in keeping with the prior authorization list. Research claims inquiry specific to the department and responsibility. Perform tasks necessary to promote member compliance such as verifying appointments, obtaining lab results. Assess and monitor inpatient census. Screen for eligibility and benefits. Identify members without a PCP and refer to Member Services. Screen members by priority for case management (CM) assessment. Perform transition of care duties co include but not limited to contact the member's attending physician, member or medical power of attorney, other medical providers (home health agencies, equipment vendors) for information pertaining to special needs. Provide backup coverage for the program coordinator team.
- Experience in TruCare. Assist with special projects, help work glitches in Virtual Health. Coordinate services with community-based organizations. Attend marketing and outreach meetings as directed to represent the plan. Produces and mails routine CM letters and program educational material.
- Data enter assessments and authorizations into the system.
CARE COORDINATOR
Verustat, Inc.
08.2022 - 12.2022
- 100% remote based. Provided the technical monitoring and oversight of a designated patient panel. Provide day-co-day technical monitoring of individual patient activity. Initiate outbound calls to patients, caregivers, and providers as needed. Handled high volume of inbound calls for general inquiries and redirect as appropriate. Document all actions and interactions in electronic portal. Train and support individuals regarding equipment, web portal, and application. Assist with equipment order follow up as needed. Able to react to change productively and manage all other duties/ essential tasks as assigned.
- Systems and Programs: Call Shaper, Sure MDM Console, Verustat Portal
REMOTE PROGRAM COORDINATOR
Medasource (Centene/WellCare)
11.2021 - 05.2022
- 100% remote based. Responsible for making proactive phone calls to Centene and Wellcare (Medicare and Medicaid) members to inform them about a program, encourage participation, gather information, schedule appointments and follow up on progress. Initiated authorization requests for output and input service in keeping with the prior authorization list. Research claim inquiries specific to the department and responsibility. Perform tasks necessary to promote member compliance such as verifying appointments, obtaining lab results, etc. Assess and monitor inpatient census. Screen for eligibility and benefits. Coordinate services with community-based organizations. Attend marketing and outreach meetings as directed to represent the plan.
- Systems and Programs: WC Citrix, Pins One, Virtual Health, and IBM Infosphere.
FINANCIAL COUNSELOR/REMOTE INSURANCE VERIFICATION/REMOTE REFERRAL COORDINATOR
Woodlands Specialty Hospital
12.2016 - 07.2020
- Served as support co patients and their family members co assure customers have access to all available funding. Verifies and assures all accounts are ready for billing with adequate supporting documentation within the established period. Follows policy and procedures in regard to financial screening, arrangements, and third-party demands. Determines patient's ability to pay and secure repayment arrangement with patients. Provides comprehensive audit and analysis.
- Assisting verifications and referrals with scheduling appointments and all clerical functions in the centralized scheduling division. Responsible for reviewing patient's cases and insurance coverage information to personalize the contents to the patient. Responsible for precertification and authorization. Authorize/verified prescriptions. Heavy phone contact with managed care companies. Maintain strict confidentiality of patient and center related business. Schedule, problem solve, communicate, and coordinate referral appointments with outside specialize, family practice and all physicians.
- Systems and Programs: Smart Sheet, Athena Health and Availity.
INTAKE COORDINATOR (WEEKENDS REMOTE)
Kindred Healthcare
01.2008 - 08.2013
- Oversaw the centralized intake process for conversion of referrals into actual admissions. Staffed the department and at times will carry the responsibility of an admissions coordinator. The admissions coordinator monitors turnaround times for completing initial screening, verification of insurance benefits and secures all necessary approvals prior to admission. Verified/authorized prescriptions.
Education
1 YEAR COLLEGE, TECHNICAL OR VOCATIONAL SCHOOL -
Champions School of Real Estate
1 YEAR COLLEGE, TECHNICAL OR VOCATIONAL SCHOOL -
Texas School of Business
Skills
- Healthcare Billing
- Financial Counseling
- Customer Service
- Verifications
- Referrals
- Claims Examination
- Authorization Requests
- Eligibility Screening
- Case Management
- Data Entry
- Technical Monitoring
- Patient Support
- Scheduling
- Precertification
- Confidentiality
- Leadership
- Organization
- Adaptability
- Communication
- Problem Solving
- Claims research
- Program coordination
- HIPAA compliance
- authorization processing
- patient engagement
Technical Skills
True, 60wpm
Timeline
PROGRAM COORDINATOR I
Centene
03.2023 - 05.2025
CARE COORDINATOR
Verustat, Inc.
08.2022 - 12.2022
REMOTE PROGRAM COORDINATOR
Medasource (Centene/WellCare)
11.2021 - 05.2022
FINANCIAL COUNSELOR/REMOTE INSURANCE VERIFICATION/REMOTE REFERRAL COORDINATOR
Woodlands Specialty Hospital
12.2016 - 07.2020
INTAKE COORDINATOR (WEEKENDS REMOTE)
Kindred Healthcare
01.2008 - 08.2013
1 YEAR COLLEGE, TECHNICAL OR VOCATIONAL SCHOOL -
Champions School of Real Estate
1 YEAR COLLEGE, TECHNICAL OR VOCATIONAL SCHOOL -
Texas School of Business