Summary
Overview
Work History
Education
Skills
Timeline
Generic

Keith Terrence Vaughn

Canyon Country,CA

Summary

Accomplished Program Coordinator offering experience implementing new and innovative programs aimed at meeting the needs of the consumer. Highly skilled at building lasting relationships with customers and business executives.

Overview

31
31
years of professional experience

Work History

Program Coordinator I

Health Net, Centene
10.2018 - Current
  • Perform task necessary to promote member compliance such as verifying appointments, member eligibility and Established care with Primary Care physician
  • Request Medical records for Case Management review for Member Care services
  • Produces and mail routine Case Management Letters and program educational materials, Welcome Letters, Unable to Reach Letter communication to member to reach out to assigned RN
  • Outbound call Outreach to members in discussing and educating on Care Management Services offers, help in assisting members with Dr Appointment scheduling, Meal on Wheels deliver to member's home and Transportation assistance

Pre-Authorization Specialist

Boston Scientific Corp
05.2018 - 07.2018
  • Preform Initial benefit verification and Pre-Surgical authorization for new Pre-Surgical case by working closely with all payers
  • Document Case Status, Actions and outcome in Pre-Authorization Support contact management database
  • Utilize Customer Service skills & Communication to PCP and Health Insurance companies for Patient verification Eligibility & reaching out to UM department for Prior Authorization and current approved cases.

Customer Service Representative

Providence Facey Medical Foundation - CBO
08.2012 - 05.2018
  • Handled internal & external patient calls under HMO, PPO Coordination of Benefits
  • Research electronic medical records & Insurance Explanation of Benefits to resolve patient concerns regarding billing & claims issues
  • Collect patient copayments & deductible payments via phone inquiries

Foreclosure Specialist

Bank Of America (Temp Agency)
12.2011 - 02.2012
  • Responsibilities included handling of Pre-Sale Foreclosure Accounts and understanding state laws to facilitate foreclosure steps
  • Worked closely with attorneys to verify documents of milestone dates
  • Handled average of 80 loans daily and exceeded quotas on documents.

Customer Care Associate

WellPoint-Anthem Blue Cross
07.2008 - 06.2011
  • Handled inbound calls with members & Large Group Employers with their policies & benefits
  • Research Claims & Billing inquires to provide complete and accurate information to members
  • Providing Follow ups on documents, Explanation of Benefits, faxes of Protected Health Information to IPA, Professional Physicians, Medical Groups, & members and followed HIPAA laws.

Foreclosure Specialist

GMAC Mortgage-(Temp Agency)
04.2007 - 05.2008
  • Processing non-judicial foreclosure for states of CA, NV, WA, AZ, OR, ID, portfolios
  • Prepared documents of default and Notice of Sale to Borrowers in timely manner
  • Managed portfolios and repayment options for borrowers while following policy guidelines

Customer Service Representative

Royce Ossur
08.2006 - 02.2007
  • Placing outbound calls to provider’s office promoting company product of Prosthetics & Orthotics
  • Developed rapport with customers through active listening skills, leading to higher retention rates and positive feedback from clients

Default Collections Specialist II

Washington Mutual Bank
08.2002 - 04.2006
  • Handled up to 300 loans each month that requires extensive research, problem solving techniques and managed high dollar account portfolios
  • Maintained a high level of professionalism & Customer Service while resolving all payment issues, preparing repayment plans to bring account to current status

Customer Service Representative

Enterprise Rent-A-Car
07.1993 - 07.2002
  • Greeted and helped Clientele and performed dispute settlement for customers
  • Responsible for A/R and collections, managed aged trail run & brought down 30/60/90 day receivables to an acceptable 3% level while maintaining professional level of customer rapport
  • Responsible for Branch Fleet of Vehicles, Inspecting all Rental vehicles for timely maintenance, services and cleanliness.

Education

Some College (No Degree) - Computer Software And Media Applications

Southwestern College
Chula Vista, CA

GED Diploma -

Chula Vista Adult School
Chula Vista, CA
11.1998

Skills

  • Ability to reach resolutions on Customer concerns and issues and handling of sensitive issues
  • Knowledge of and experience with Healthcare benefits and background
  • Computer skills in: MS Word, MS Excel, MS Outlook, EPIC, FileNet, OMNI, Workday, CVS CareMark Website
  • Typing Skills - 45-50 WPM
  • General Clerical/Office Duties
  • Medical Records Correspondence
  • Logging Sensitive Documents in company Database

Timeline

Program Coordinator I

Health Net, Centene
10.2018 - Current

Pre-Authorization Specialist

Boston Scientific Corp
05.2018 - 07.2018

Customer Service Representative

Providence Facey Medical Foundation - CBO
08.2012 - 05.2018

Foreclosure Specialist

Bank Of America (Temp Agency)
12.2011 - 02.2012

Customer Care Associate

WellPoint-Anthem Blue Cross
07.2008 - 06.2011

Foreclosure Specialist

GMAC Mortgage-(Temp Agency)
04.2007 - 05.2008

Customer Service Representative

Royce Ossur
08.2006 - 02.2007

Default Collections Specialist II

Washington Mutual Bank
08.2002 - 04.2006

Customer Service Representative

Enterprise Rent-A-Car
07.1993 - 07.2002

Some College (No Degree) - Computer Software And Media Applications

Southwestern College

GED Diploma -

Chula Vista Adult School

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Keith Terrence Vaughn