Kia Jones
Marrero,LA
Summary
Enthusiastic healthcare medical support analyst eager to contribute to team success through hard work, attention to detail and excellent organizational skills. Clear understanding of scheduling and training in patient care. Motivated to learn, grow and excel in New Orleans VA Medical center
Overview
14
14
years of professional experience
1
1
Certification
Work History
Eligibility Representative 40hrs
Accredo Specialty Pharmacy
Warrendale, PA
12.2020 - 04.2022
- Educated patients on eligibility and affordability options by offering insightful information.
- Followed guidelines when reviewing applicant data to determine eligibility for economic assistance.
- Actively listened to customers, handled concerns quickly and escalated major issues to supervisor.
- Resolved problems, improved operations and provided exceptional service.
- Documented all communication with applicants and inputted information into system using TMW & Smart Tab.
- Input gathered information and researched data on applicants into computer system using Coverage 360.
Complex Authorization Specialist 40hrs
TriWest Healthcare Alliance
Phoenix, AZ
01.2016 - 04.2020
- Schedules 70% appropriate level of care and document pertinent information regarding community care scheduled appointment.
- Verifies patient attended appointment and request/obtain medical documentation from community providers, document properly utilizing consult toolbox to alert Care Coordinating nurse and VA provider for continuity of care.
- Performs administrative duties, scheduling, customer service and other duties as assigned for proper and timely care coordination of veterans.
- Contacting veterans for desired community care provider and preference date/time of community care appointment.
- Maintains appointment schedules for Community Care.
- Requested and prepared documentation required to support medical necessity for services being authorized.
- Completed 85% referrals and prior authorizations according to department guidelines and workflows.
Health Information Analyst 40hrs
West Jefferson Medical Center
Marrero, LA
03.2012 - 07.2015
- Processed records quickly to avoid delays and keep workflows running smoothly.
- Ability to independently set priorities and organize work to meet deadlines, ensuring compliance with established processes, policies, and regulations.
- Located, retrieved, sent and scanned medical record data.
- Organized medical record copy and chart requests to complete EHR quality maintenance procedures.
- Worked with professionals on scanning, coding and releasing information to departments.
- Used medical center hardware and software to produce required reports.
- Copied 75% medical records and performed various clerical tasks as required.
- Processed 75% records efficiently and oversaw timely project completion.
- Collected 65% of overdue payments
Patient Service Representative 40hrs
Oschner Foundation Hospital
New Orleans, LA
10.2003 - 11.2008
- Performs 80% administrative duties, scheduling, customer service and other duties as assigned from clinicians in psychology department
- Maintains appointment schedules for child psychologist and LCSW for testing for ADD and ADHD
- Helped address client complaints through timely corrective actions and appropriate referrals.
- Facilitated communication between patients and various departments and staff.
- Ability to collaborate and communicate [with wide range of medical clinicians across multiple disciplines (e.g. medical doctors, nurse practitioners, physician assistants, psychologists, psychiatrists, social workers, clinical pharmacists, and nursing staff) to accomplish team goal setting to ensure medical care to patients is met.
- Applied administrative knowledge and courtesy to explain procedures and services to patients.
- Handled 100+ calls per day to address customer inquiries and concerns
Education
Some College (No Degree) - Accounting
University of Louisiana At Monroe
Monroe, LA03.
Some College (No Degree) - Business Administration
Delgado Community College
New Orleans, LASkills
- Multitasking Abilities
- Good Telephone Etiquette
- Teamwork and Collaboration
- MS Office
- Written Communication
- Organization and Time Management
- Proficient in written and spoken English
- Appointment Scheduling
- Clerical Support
- Proficiency in excel, power point & outlook
- Insurance verification
- Creating authorizations
Certification
- Coding ICD-9, Allied Prep - 10/2015
Timeline
Eligibility Representative 40hrs
Accredo Specialty Pharmacy
12.2020 - 04.2022
Complex Authorization Specialist 40hrs
TriWest Healthcare Alliance
01.2016 - 04.2020
Health Information Analyst 40hrs
West Jefferson Medical Center
03.2012 - 07.2015
Patient Service Representative 40hrs
Oschner Foundation Hospital
10.2003 - 11.2008
Some College (No Degree) - Accounting
University of Louisiana At Monroe
Some College (No Degree) - Business Administration
Delgado Community College