Kelli Pierce
Healthcare Management
Glenns Ferry,ID
Overview
7
7
years of professional experience
9
9
years of post-secondary education
Work History
Clinical Review Management
St. Luke's Health Systems
Boise , Idaho
03.2021 - Current
- Improved patient care quality by implementing effective utilization management processes and strategies.
- Enhanced team performance by providing training, guidance, and feedback to utilization management staff members.
- Streamlined communication between healthcare providers and insurance companies for efficient claims processing.
- Optimized resource allocation through data-driven decision-making in healthcare service delivery planning.
- Increased compliance with regulatory requirements by monitoring adherence to guidelines and protocols within the utilization management department.
- Built strong relationships with external stakeholders such as hospitals, clinics, provider networks, and insurance carriers to facilitate seamless coordination in service delivery.
- Presented findings from utilization reviews at interdisciplinary meetings, resulting in improved collaboration among healthcare professionals involved in patient care decisions.
- Mentored junior staff members on best practices within the field of utilization management, fostering a culture of continuous learning and professional growth among team members.
- Played a key role in the development and implementation of departmental policies and procedures aimed at maintaining high-quality care standards while adhering to regulatory guidelines within the scope of utilization management activities.
- Hired, managed, developed and trained staff, established and monitored goals, conducted performance reviews and administered salaries for staff.
- Coordinated individual duties after careful evaluation of each employee's skill level and knowledge.
- Delegated tasks to administrative support staff to organize and improve office efficiency.
- Monitored front areas so that questions could be promptly addressed.
- Kept high average of performance evaluations.
- Built highly-efficient administrative team through ongoing coaching and professional development opportunities.
Patient Access Specialist
St. Luke's Health Systems
Twin Falls , ID
08.2020 - 03.2021
- Enhanced patient satisfaction by providing efficient registration and scheduling services.
- Streamlined front-desk operations for improved patient flow and reduced wait times.
- Verified insurance coverage and obtained necessary authorizations to ensure timely billing and reimbursement.
- Maintained patient confidentiality by adhering to HIPAA guidelines and hospital policies.
- Increased accuracy in patient record-keeping through diligent data entry and regular database maintenance.
- Collaborated with clinical staff to ensure seamless coordination of care for patients.
- Assisted in revenue cycle management by timely collecting co-payments, deductibles, and other financial responsibilities from patients.
- Reduced billing errors by verifying demographic information and updating records as needed.
- Managed high call volume while maintaining a professional demeanor, ensuring accurate communication of information.
CNA
St. Luke's Health Systems
Twin Fals , ID
09.2017 - 09.2019
- Experience with various medical conditions including Parkinson's, Dementia, Diabetes, Cancer, and Alzheimer's
- Followed infection control procedures.
- Took and recorded patients' temperature, pulse and blood pressure.
- Assisted patients with daily functions.
- Ensured safety and well-being of patients.
- Monitored fluid intake and output levels.
- Assisted patients with bathing, dressing, hygiene and grooming.
- Helped residents with bathing, dressing, feeding, lifting and transferring.
- Worked effectively in fast-paced environments.
- Worked well in a team setting, providing support and guidance.
- Demonstrated respect, friendliness and willingness to help wherever needed.
- Excellent communication skills, both verbal and written.
- Passionate about learning and committed to continual improvement.
Education
High School Diploma -
Filer High School
08.1999 - 05.2003
Bachelor of Science - Healthcare Administration
Bryant And Stratton College
Buffalo, NY 11.2018 - 10.2023
Skills
- Professional bedside manner
- CPR certification
- Adept at prioritizing/managing deadlines
- Patient evaluation/intervention
- Diabetes, Hospice, and Stroke Patient Care
- Patient-focused care
- Electronic Filing System
- Utilization Management
- Employee Performance Evaluations
- Microsoft Office
- Conflict Resolution
- Staff Training
- Digital Filing
- Administrative Support
- Workflow Processes
- Staff Meetings
- Status Updates
- Corrective Actions
- Administrative Procedures
- Data Communications
- Leadership and Change Management
Timeline
Clinical Review Management
St. Luke's Health Systems
03.2021 - Current
Patient Access Specialist
St. Luke's Health Systems
08.2020 - 03.2021
Bachelor of Science - Healthcare Administration
Bryant And Stratton College
11.2018 - 10.2023
CNA
St. Luke's Health Systems
09.2017 - 09.2019
High School Diploma -
Filer High School
08.1999 - 05.2003
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