Keiara M Hollis

• Overseeing West Coast WC administration duties • Experience with CA WC is a plus but not a must (Multi-State WC support approx. 14 states including CA)

• Knowledge working in Workday, AIC & CAREMC is a plus but not a must as they can train.

• Ensure all claims are being documented and tracked in all systems

• Follow up with hiring managers to upload documents when needed

• Download documents from all databases and email to 3rd party Admin for WC benefits (Corvel)

• Document communication from HC providers in database (based on the documentation the associate provides)

• Offer Transitional Duty Offer Letters

• Tracking associates that are on medical restrictions

• Creating reports, dashboards, presentations

• Claims will be managed by this person to a certain level before it is passed on to the Director of Workers’ Compensation

• Texas Workers’ Compensation Act, DWC rules and regulations, and internal procedures
• Initiates contact with employees, supervisors, and doctor's office regarding workers' compensation claims.
• Establishes and maintains case files, logs, and indexes; reviews documentation and records.
• Verifies job-related accidents with claimants and supervisors.
• Initiates appropriate notices as needed; monitors claimant's case history, noting any prior workers' compensation claims filed.
• Addresses suspicious claims and delays cases when necessary.
• Authorizes any and all medically necessary treatment; authorizes payments.
• Monitors payments for permanent disability.

• Reviews and processes medical claims based on policy provisions and established guidelines

• Documents fully claims referred to senior staff for review and determination

• Maintains company production and quality standards

• Participates in training

• Checking patient insurance coverage and eligibility before billing.

• Handling patient inquiries about bills

• Navigating and maintaining electronic health records (EHR) and billing software, posting payments to patient accounts.

• Calling insurance companies for updates on claim status and to clarify billing details.

• Adhering to HIPAA regulations, ensuring patient confidentiality at all times.

• Staying updated on healthcare regulations, medical terminology, and coding practices.

• Tracking, reviewing, and reporting on billing metrics, trends, and periodic audits to ensure compliance and accuracy

• Collecting information such as patient details, medical history, billing, and insurance information, etc.
• Preparing patient admission and discharge documentation.
• Entering information into databases and maintaining accurate records.
• Relaying information to relevant staff members.
• Informing patients and their caregivers of hospital procedures, policies, and protocols.
• Providing patients with billing and payment information.
• Ensured compliance with HIPAA regulations to maintain confidentiality of sensitive patient information during all interactions.

• Obtain client health history through the use of client intake forms, assessing problems and conditions, and consulting with clients about recommended treatments.

• Perform a wide range of massage and body therapies following milk + honey protocols.

• Deliver exceptional, high-end customer service to ensure a memorable experience for every client.

• Record detailed notes for all clients including contraindications, allergies, medications, formulations, and treatment preferences.