Kayla Tunstall
Winthrop,MA
Summary
Professional with significant experience in clinical intake processes, adept at assessing patient needs, and coordinating care. Known for strong team collaboration and adaptability in dynamic environments, ensuring efficient and comprehensive patient intake. Skilled in patient communication, data management, and maintaining compliance with healthcare regulations. Reliable and results-driven, consistently contributing to team success and patient satisfaction.
Overview
12
12
years of professional experience
Work History
Clinical Intake Specialist (Remote)
Blue Cross Blue Shield of Massachusetts
Quincy, MA
10.2021 - Current
- Maintain high-volume provider calls.
- Organized prior authorizations for medical and radiological procedures, adhering to appropriate coding standards (ICD-10 and CPT codes).
- Responded promptly to inquiries from patients or physicians regarding clinical services provided.
- Assessed sensitive medical documents, and managed processing.
- Adhere to department goals, standards of performance, and objectives.
- Provides assistance to physician office staff and patients to access the web portal and submit the necessary documentation.
- Ensured patient confidentiality by adhering to HIPAA requirements.
- Monitored incoming faxes for completed referral forms and other documents related to patient intake process.
Member Service Representative (Remote)
Tufts Health Plan
Watertown, MA
06.2020 - 07.2021
- Delivered clear information to members about the company's services and products.
- Demonstrating an in-depth understanding of diverse products and materials.
- Provide information on claims, benefits, pharmacy services, enrollment, and referrals/authorizations.
- Handled customer disputes and complex situations by maintaining composure.
- Assisted members in resolving account issues and navigating internal systems.
- Maintained comprehensive records of inquiries in a structured manner.
- Executed outreach initiatives to providers and pharmacies about medications.
- Answered incoming calls regarding membership benefits and services.
ED Registrar
Massachusetts Eye and Ear Infirmary
Boston, MA
10.2018 - 05.2020
- Adhered to HIPAA requirements to safeguard patient confidentiality.
- Demonstrated ability to handle difficult situations by using effective problem-solving skills.
- Ensure a positive and productive workspace by working independently or as a team in a fast-paced environment.
- Verified insurance coverage for services rendered by the ED department.
- Provided support in scheduling appointments for follow-up care after discharge from the ED.
- Maintained a database of all patients registered in the ED department.
- Analyzed patient charts to ensure accuracy of data entered into the system.
- Performed patient registration for ED visits, verifying insurance and demographic information.
- Managed front office customer service, appointment management, billing, and administration tasks to streamline workflow.
- Scheduled and confirmed patient appointments and consultations.
- Cross-trained to accommodate work coverage requests by rotating between the ED, Admitting, Ophthalmology, and ENT departments.
Sales Associate
Forever 21
Boston, MA
11.2016 - 04.2017
- Maintained the appearance of the sales floor, and the overall cleanliness of the store.
- Provided exceptional customer service by engaging customers in friendly, professional dialogue to determine their needs.
- Handled cash transactions efficiently while adhering to company cash-handling policies, ensuring accuracy in all financial exchanges.
- Managed returns, exchanges, and refunds in accordance with store policy.
- Rotated stock and restocked shelves to maintain product availability and store appearance.
- Organized racks and shelves to maintain the store's visual appeal, engage customers, and promote specific merchandise.
- Helped customers locate products, and checked the store system for merchandise at other sites.
- Collaborated with team members to improve overall store performance, sharing best practices, and offering support as needed.
Hostess
Battery Park Lounge
Boston, MA
05.2015 - 09.2015
- Maintained an inviting entrance area, and greeted all customers in a cheerful manner.
- Built positive relationships with other front-of-house and kitchen staff.
- Answered customer questions about hours, seating, and menu information.
- Demonstrated strong multitasking skills, balancing responsibilities such as answering phone calls, greeting guests, and updating reservation logs simultaneously.
- Supported servers, food runners, and bussers with keeping the dining area ready for every guest.
- Seated patrons based on guests' preferences and seating availability.
- Cross-trained to handle different restaurant roles, including bar, kitchen, and to-go stations.
Hostess
Mccormick & Schmick’s
08.2013 - 12.2013
- Trained new hostesses on customer service best practices and restaurant policies to maintain high standards of service.
- Stayed attentive to server availability and table turnover to quickly seat guests.
- Supported serving staff, food runners and bussers to keep dining room presentable and ready for guests.
- Scheduled reservations and notified servers and managers of large groups to prepare seating in advance.
- Accommodated guests with children and special needs to promote comfortable dining experience.
- Trained new hostesses on customer service best practices and restaurant policies to maintain high standards of service.
- Reduced wait times for guests by effectively coordinating with other team members during peak hours.
Education
Associate Of Arts - Health Sciences
North Shore Community College
Lynn05.2016
Skills
- Medical terminology
- Data entry
- Appointment scheduling
- Team player
- Critical thinking
- EPIC systems
- Problem-solving
- Communication
- Patient health information access
Timeline
Clinical Intake Specialist (Remote)
Blue Cross Blue Shield of Massachusetts
10.2021 - Current
Member Service Representative (Remote)
Tufts Health Plan
06.2020 - 07.2021
ED Registrar
Massachusetts Eye and Ear Infirmary
10.2018 - 05.2020
Sales Associate
Forever 21
11.2016 - 04.2017
Hostess
Battery Park Lounge
05.2015 - 09.2015
Hostess
Mccormick & Schmick’s
08.2013 - 12.2013
Associate Of Arts - Health Sciences
North Shore Community College
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