KEVINEISHA REED
Altamed Medical Group
Corona,CA
10
years of professional experience
Dynamic healthcare professional with over four years of patient care experience, adept at delivering timely and accurate data to secure reimbursement for services. Committed to upholding policies and guidelines that ensure quality care while maintaining patient privacy and confidentiality. Recognized for exceptional interpersonal communication skills, fostering trust and respect by consistently exceeding expectations. Dependable team player who collaborates effectively with staff to enhance customer service, with a strong foundation in utilization management and expertise in case management and process improvement.
Work History
Utilization Management Coordinator TEMP CONTRACT
2 Months- Coordinated prior authorization requests, referrals, and utilization review documentation for medical services.
- Reviewed eligibility, benefits, and plan requirements to support timely authorization decisions.
- Monitored pending requests and escalated urgent cases to prevent delays in patient care.
- Streamlined communication process between nursing staff and case managers, reducing delays in patient care plans.
- Streamlined communication process between nursing staff and case managers, reducing delays in patient care plans.
- Maintained confidentiality and security of patient data, adhering to all relevant privacy laws and regulations.
- Evaluated medical guidelines and benefit coverage to determine service eligibility.
Referral Coordinator
1 Year 7 Months- Demonstrated strong attention to detail and organizational skills in managing a high volume of referrals while maintaining exceptional levels of patient care.
- Scheduled appointments with specialists and surgeons on behalf of providers, enhancing referral management.
- Streamlined prior authorization submissions for surgical procedures by accurately utilizing CPT and DX codes, enhancing approval efficiency.
- Assisted with preparing pre-operative documents such as obtaining insurance authorizations, lab work, radiology tests and demographics to send to hospitals or facilities for surgical procedures.
- Responded to patient inquiries, providing timely updates on referral status to improve patient satisfaction.
- Established strong relationships with external providers, facilitating seamless communication and collaboration in patient care.
- Developed comprehensive knowledge of insurance requirements, advocating for patients when necessary to secure approval for needed services.
- Called insurance companies to get pre-certification and other benefits information on behalf of patients.
- Developed comprehensive knowledge of insurance requirements, advocating for patients to secure approval for needed services.
- Coordinated surgical procedures across four providers, streamlining scheduling and communication to enhance patient experience.
Medical Receptionist
2 Years 3 Months- Coordinated patient scheduling, check-in, check-out, and billing payments to streamline patient flow.
- Verified patient insurance, demographic, and health history information to ensure accuracy and compliance.
- Assisted patients in completing medical forms and documentation to facilitate efficient processing.
- Maintained strict confidentiality of patient information, adhering to HIPAA regulations and medical office policies.
- Handled high call volumes by directing calls to appropriate departments efficiently.
Residential Support Staff
1 Year 10 Months- Delivered compassionate customer service, fostering a welcoming atmosphere for patients and families.
- Fostered positive work environment through effective collaboration with colleagues and support of team initiatives.
- Observe, report, and document resident conditions and activities
- Ensured safe, clean, and organized environment for autistic children, enhancing their comfort and well-being.
- Followed company policies to ensure compliance with regulations. and procedures and abide by HIPAA guidelines to protect privacy
- Observed resident conditions and reported any changes to staff., and document resident conditions and activities
Direct Support Professional
1 Year 2 Months- Maintained a safe, supportive environment for individuals with intellectual and developmental disabilities which fostered growth and rehabilitation for the development of skills
- Maintained safe, supportive environment for individuals with intellectual and developmental disabilities, fostering growth and skill development
- Completed light housekeeping duties, prepared and served meals, and tailored support to individual needs to enhance personal well-being
- Participated in physical care, behavioral intervention, and activities of daily living – hygiene and mobility to promote independence and quality of life
- Protected private information by following strict confidentiality protocols
Security Guard
2 Years 2 Months- Patrolled property, monitored cameras, wrote reports, and investigated suspicious activity
- Monitored surroundings to ensure safety and security while presenting a professional demeanor and providing exceptional customer service
- Maintained detailed records of daily activities for review
Customer Service Agent LAX Airport G2
2 Years 3 Months- Thrived in fast-paced environments, ensuring seamless operations and quick service delivery.
- Demonstrated respect, friendliness and willingness to help wherever needed.
- Resolved customer complaints swiftly and professionally, restoring confidence and safeguarding business relationships.
- Fostered positive customer relations while coordinating with team members to address requests and inquiries efficiently.
- Greeted customers warmly at the entrance to create a positive first impression. to set tone of customer experience and provide welcoming and friendly atmosphere.
- Provided exceptional customer service, addressing passenger inquiries and resolving issues promptly.
- Improved passenger experience by assisting with boarding procedures and providing timely information.
- Assisted in reconciling end-of-day reports to ensure accuracy of financial records. end-of-day reports to maintain accurate records of operational activities within the facility efficiently.
- Actively participated in regular training sessions focused on workplace safety procedures or improvements in technology used within the aviation industry.
- Assisted passengers with special needs, ensuring their comfort and satisfaction throughout their journey.
- Discreetly observed behavior and demeanor of travelers and staff to screen for suspicious actions.
- Attended daily briefings with supervisors to discuss issues with security screening processes.
- Responded effectively to security incidents and provided guidance regarding security procedures.
Education
Certificate - Medical Billing and Coding
Certificate - Direct Support Professional (DSP)
Certified in CPR
High School Diploma
Skills
Insurance Verification
Insurance Claim Processing
Co-Pay
Deductibles
Managed Care (HMO
PPO
POS)
Government (Medicare & Medicaid)
Revenue Cycle Management
Medical Billing
CMS 1500
CMS 1450 (UB-04)
Electronic Health Records (EHR)
Medical Coding (ICD-10-CM
HCPCS
CPT)
Patient Advocacy
Posting Payments
Third Party Payers
Scheduling
Medical Terminology
HIPAA Compliance
Electronic health records
Multitasking efficiency
HIPAA compliance awareness
ADDITIONAL INFORMATION
Current job title as medical receptionist / referral coordinator, I also was trained and gained skills in how to room and vital patients.
Timeline
Utilization Management Coordinator TEMP CONTRACT
Altamed Medical Group
07.2026 - 09.2026Read More
Referral Coordinator
Edward A Mena Inc
09.2024 - 04.2026Read More
Medical Receptionist
Edward A Mena Inc
01.2024 - 04.2026Read More
Residential Support Staff
RozHome Care
03.2022 - 01.2024Read More
Direct Support Professional
BMW Loved Ones
03.2021 - 05.2022Read More
Security Guard
G4S Secure Solutions
01.2019 - 03.2021Read More
Customer Service Agent LAX Airport G2
Secured Staff
01.2017 - 04.2019Read More
California Department of Education
Certificate from Direct Support Professional (DSP)
Read More
Ultimate Medical Academy
Certificate from Medical Billing and Coding
Read More
Soledad Enrichment Charter Action
High School Diploma
Read More