Kayla Chaddock
Las Vegas
Summary
Utilization Review Coordinator with extensive experience in authorization management and patient advocacy at Mountainview Hospital. Demonstrated expertise in navigating complex insurance processes and conducting peer-to-peer reviews to ensure compliance and enhance patient outcomes. Strong communication skills and attention to detail contribute to effective care planning and discharge coordination.
Overview
27
27
years of professional experience
Work History
NICU/Hospital Denials - Utilization Review Coordinator
Mountainview Hospital
Las Vegas
03.2019 - 10.2025
- Maintain and manage authorizations for all NICU patients admitted into the facility
- Maintain and manage authorizations for all Labor & Delivery and Antepartum patients admitted into the facility
- Maintain, submit and manage all authorizations for self-pay patients who were applied for and received Medicaid after their stay had ended
- Monitor all NICU faxes received, make notes in each account as needed and scan into a shared system for patient documents
- Document any NICU denials and denial detail received from insurance companies and schedule peer to peer reviews with the insurance companies Medical Director and the Neonatologist based on both of their availability
- Assist Neonatologist Doctors with understanding the Peer to Peer Process for any/all denials the hospital receives on a NICU baby stay
- Provide discharge dates and disposition as requested to providers at the patients insurance
- Assist Case Managers/Social Workers with various insurance questions to help better understand the payer, both adults and NICU babies
- Assisted with Hospital Visitors when it is restricted due to COVID-19 Hospital Policy, overtime as requested
- Work various reports assigned to the Case Management team, mostly regarding insurance questions or overlapping stays
- Assist with reviewing hospital account denials on previous admissions documenting reason(s) for denial
- Assist with overturning hospital account denials on previous admissions if able, inform Billing Department of the outcome for a re-bill to be generated and sent out
Utilization Review Coordinator
FarWest Division
Las Vegas
02.2018 - 03.2019
- Maintain and manage authorizations for all patients admitted into the facility as inpatient or observation; including assisting with all 8 hospitals within the FarWest Division
- Monitor all faxes received, make notes in each account as needed; pass information along to case manager for follow up
- Enter in denials and denial detail received from various insurance companies
- Provide discharge dates and disposition as requested to providers at the patients insurance
- Assist case manager with various insurance questions to help better understand the payer
- Monitor Authorizations In House and Discharge Report, update/notate all on the daily list, provide detailed information to management in regards to certain patients/payers
- Assist with faxing in clinical documentation when requested
- Document all denials received for in house and discharged patients, manage follow up if received via phone call or fax in Midas Avoidable Days Entry
- Assist with training the new hires for both NV and CA Markets
Authorization Coordinator
Mountainview Hospital
Las Vegas
09.2014 - 02.2018
- Maintain and manage authorizations for all patients admitted into the facility as inpatient or observation
- Monitor all faxes received, make notes in each account as needed; pass information along to case manager for follow up
- Enter in denials and denial detail received from various insurance companies
- Provide discharge dates and disposition as requested to providers at the patients insurance
- Assist case manager with various insurance questions to help better understand the payer
- Monitor Authorizations In House and Discharge Report, update/notate all on the daily list, provide detailed information to management in regards to certain patients/payers
- Assist with faxing in clinical documentation when requested
- Document all denials received for in house and discharged patients, manage follow up if received via phone call or fax in Midas Avoidable Days Entry
- Assist with Southern Hills Hospital authorization coordinator position when current person is out on vacation/sick leave
- Trained new hires for Southern Hills and Good Samaritan Hospital authorization coordinator positions
Insurance Verification/Authorizations Representative
HCA-Parallon Business Office
Las Vegas
07.2003 - 09.2014
- Create and obtain authorizations for all inpatient and observation admissions from the emergency room for 2 HCA Northern California hospitals; Good Samaritan Hospital and Regional Medical Center
- Assist with the NV Market: Sunrise, Southern Hills and Mountainview Hospital for authorizations and insurance verification as needed
- Maintain and manage all provider websites for the department and hospital needs, issuing any individual log ins if required by the provider website
- Assist doctors offices with any billing questions they may have from an ER admission; ie. Limited information provided by physician to staff, I provide the insurance information
- Assist with verification of insurance if help is needed
- Maintain the insurance company list for the department that includes private insurances and Medicare Replacement insurances
- Train select individuals on new job roles, including assisting with the coverage of another persons job duties if they’re similar to my own or new hires that will be working in the same area of the department as myself
- Maintaining and organizing the department listing for a vast majority if BC/BS provider services phone numbers and fax numbers
Business Office Clerk
Sunrise Hospital
Las Vegas
06.2002 - 07.2003
- Request medical records for business office insurance collectors
- Assisting Customer Service with phone calls and patient questions
- Assisting Cashiering post/receive payments from patients and other departments throughout the hospital
- Assisting Insurance Verification with calling insurance companies when short on staff, scanning important insurance information into patients accounts, calling insurance companies for co-pay/deductible information
Business Office Clerk for Sunrise Hospital
Onstaff Temp Agency
Las Vegas
02.2002 - 06.2002
- Opening and Sorting insurance/patient mail in Business Office Mail Room
- Copying insurance/patient checks for hospital records
- Transferred over to requesting medical records after a week
- Requesting medical records for the business office and insurance companies
Receptionist/Data Entry Clerk
Career Connectors Temp Agency
Las Vegas
06.2001 - 08.2001
- Data Entry for business that requested extra assistance for a short period of time
- Receptionist – answering up to 10 line phones and taking messages
- Filing away important documents for businesses that were short of staff
- Distributing mail to proper mail boxes of employees
Sales/Cashier
Things Remembered
Las Vegas
11.2000 - 01.2001
- Greeting customers and assisting in any way possible
- Answering a 1 line phone
- Taking orders for personal engravings on items bought – Give customers gift ideas for a personalized gift
- Pick-up engraved merchandise and making sure everything is done perfectly
- Pick-up store and make sure everything is stocked at end of night
- Christmas Season Worker
Cashier
Service Merchandise
Las Vegas
11.1999 - 08.2000
- Customer Service
- Checking/Cashiering customers out
- Assisting all customers in any way possible to make their shopping experience easier
- Straightening assigned sections/departments of store each night
- Participated in sales transactions
- Answering phones – assisting customers with complaints/questions on merchandise in store
- Helping customers carry bulk items to their vehicles
- Picking up customers merchandise from the warehouse
- Assisted in dock pick-ups from warehouse
Hostess
The Tillerman Restaurant
Las Vegas
04.1999 - 05.1999
- Greeted customers as they entered the restaurant
- Booked phone reservations for future dates
Education
Associates Degree - Applied Science for Criminal Justice Law Enforcement Emphasis
Community College of Southern Nevada
Las Vegas, NV01.2006
Diploma - Received Diploma
Western High School
Las Vegas, NV01.2001
Skills
- Utilization review and management
- Authorization and insurance verification
- Clinical documentation and compliance
- Patient advocacy and care planning
- Case management and review expertise
- Regulatory knowledge and healthcare regulations
- Effective communication and interpersonal skills
- Attention to detail and problem solving
- Team collaboration and mentorship
- Peer-to-peer reviews and physician consultations
- Documentation, reporting, and discharge planning coordination
- Patient transfers and transitions
- Inpatient care and managed care strategies
- Medicare and Medicaid knowledge
Hobbies and Interests
- Traveling
- Learning about different cultures
- Cooking
- Hiking
- Snowboarding
- Improving on learning Italian as a second language
- Quality time with boyfriend & our 2 dogs
- Quality time with my mom, home & traveling
Languages
Italian
Limited
Timeline
NICU/Hospital Denials - Utilization Review Coordinator
Mountainview Hospital
03.2019 - 10.2025
Utilization Review Coordinator
FarWest Division
02.2018 - 03.2019
Authorization Coordinator
Mountainview Hospital
09.2014 - 02.2018
Insurance Verification/Authorizations Representative
HCA-Parallon Business Office
07.2003 - 09.2014
Business Office Clerk
Sunrise Hospital
06.2002 - 07.2003
Business Office Clerk for Sunrise Hospital
Onstaff Temp Agency
02.2002 - 06.2002
Receptionist/Data Entry Clerk
Career Connectors Temp Agency
06.2001 - 08.2001
Sales/Cashier
Things Remembered
11.2000 - 01.2001
Cashier
Service Merchandise
11.1999 - 08.2000
Hostess
The Tillerman Restaurant
04.1999 - 05.1999
Associates Degree - Applied Science for Criminal Justice Law Enforcement Emphasis
Community College of Southern Nevada
Diploma - Received Diploma
Western High School
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