Kendra Williams
Houston
Summary
Organized team leader builds positive rapport, inspires trust and guides teams toward achievement of organizational goals. Strong facilitator adept at working cross-departmentally with co-management and top-level leadership. Excellent trainer and mentor. Talented Team Leader experienced and dedicated to enhancing employee satisfaction and business success. Diplomatic and friendly with proven commitment to employee training. Hardworking team player bringing necessary experience and knowledge to tackle any operational demand.
Overview
23
23
years of professional experience
Work History
Utilization Review Coordinator
Kingwood Pines Hospital
10.2023 - Current
- Enhanced patient care quality by conducting thorough utilization reviews and coordinating with healthcare providers.
- Reduced hospital readmissions by implementing effective discharge planning and ensuring appropriate post-acute care.
- Increased efficiency of the utilization review process through regular communication with insurance companies for timely authorizations.
- Ensured compliance with regulatory guidelines by maintaining accurate documentation and records for all utilization review activities.
- Facilitated interdisciplinary team meetings to discuss patient progress, treatment plans, and coordination of care for improved outcomes.
- Supported positive working relationships between physicians, nursing staff, and other healthcare professionals through clear communication and collaboration on patient-centered goals.
- Evaluated medical necessity criteria using evidence-based guidelines to ensure that services provided were both clinically appropriate and costeffective.
- Served as a trusted resource for clinical staff seeking guidance on appropriate levels of care, alternate treatment options, or clarification on insurance coverage requirements.
- Particpates in unit staffing regularly to expedite discharge planning
- Performs reviews for appropriateness of admission and continued stays.
- Appeals inappropriate reimbursement denials with representatives of third-party payers in light of patient diagnosis, treatment and progress.
Utilization Management
Texas Childrens Health Plan
10.2022 - Current
- Utilization Management
- Texas Children’s Health Plan
- Utilization Management Evaluated medical guidelines and benefit coverage to determine appropriateness of services
- Performed prior authorization review of services requiring notification
- Obtained authorizations from multiple insurance carriers for various levels of care
- Supervised and maintained all utilization review documentation through Epic, Vital, OnBase, Macess and QNTX
- Recruited, hired and trained all staff, providing direct supervision, ongoing staff development and continuing education to employees
- Designed and introduced leadership development, coaching and team management model, resulting in promotion of employees into increased levels of responsibility
- Cross-trained existing employees to maximize team agility and performance
- Maximized performance by monitoring daily activities and mentoring team members
- Evaluated employees' strengths and assigned tasks based upon experience and training
- Established and updated work schedules to account for changing staff levels and expected workloads.
- Recruited, hired and trained all staff, providing direct supervision, ongoing staff development and continuing education to employees.
Team Lead
05.2018 - 09.2020
- Legacy Community Health
- Training all new associates for the MSO I work Chase Brexton
- Insurance Verification, Billing out new claims, Claim Status, Follow Up on Appeals and Unpaid claims
- I Medicare, Medicaid, All Commercial Payers, Self-pay, FQHC, Sliding Scale and Workers
- Comp Claims .
MSO Supervisor
Houston Eye Associates
06.2011 - 11.2016
- MSO division (Multi Specialty Organization) I oversee the Emergency Room, Cardiology, Urology and Family Practice groups with the A/R, Payments and Charge Posting
- Follow-Up Expertise includes verifying insurance coverage, records reviews and schedule maintenance
- Inpatient and outpatient records coding specialist with ICD-9, ICD-10 and ASC coding expertise
- Familiar with commercial and private insurance carriers Seeks a position of increased responsibility and authority Handled claims for Cardio
- Vascular Program (CVCP) for CHI St Luke’s Texas Childrens / Baylor handled claims for the Transplant
- Embassy/International Team Recall accounts from the collections agency Setting up payment plans for patients Handled A/R appeals for all carriers Medicare, Medicaid, Aetna, Humana, Medicare Hmo's, BC/BS, UHC , CHIP plans and Self Pay accounts
- Handled Charity Accounts for Texas Children.
Patient Accounts
05.2001 - 11.2016
- Radiology Management Incorporation
- Insurance Verification, Billing out new claims, Claim Status, Follow Up on Appeals and Unpaid claims
Education
Bachelor of Science - Healthcare Administration
University of Phoenix
04.2021
Notary - Notary
National Notary Association
Chatsworth, CA04.2021
Skills
- HIPAA Compliance
- Obtaining Authorizations
- Project Implementation
- Verbal and Written Communication
- Strategic Planning
- Schedule Preparation
- Staff Training
- Team Leadership
- Staff Motivation
- Team Mentoring
- Job Assignments
- Team Meetings
- Status Updates
- Issue and Conflict Resolution
- Staff Management
- Utilization Management
Timeline
Utilization Review Coordinator
Kingwood Pines Hospital
10.2023 - Current
Utilization Management
Texas Childrens Health Plan
10.2022 - Current
Team Lead
05.2018 - 09.2020
MSO Supervisor
Houston Eye Associates
06.2011 - 11.2016
Patient Accounts
05.2001 - 11.2016
Bachelor of Science - Healthcare Administration
University of Phoenix
Notary - Notary
National Notary Association
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