KIMBERLY NADEAU
LLANO,US
Summary
Referral Coordinator with a strong record in optimizing multi-state admission processes. Skilled in managing patient data, facilitating effective communication among healthcare providers, and leading teams to improve service delivery. Committed to enhancing healthcare compliance and innovation through strategic policy updates and teamwork.
Overview
1
1
Certification
25
25
years of professional experience
Work History
Referral Coordinator
Compassus
08.2021 - Current
- Streamlined multi-state referral processes, significantly enhancing service delivery and accelerating admission timelines.
- Coordinated multi-state referrals, optimizing admission processes to improve service delivery.
- Coordinated home health services and intake processes, strengthening communication among providers and enhancing patient care delivery.
- Managed patient data in ERM, ensuring accurate records and facilitating timely payor authorizations.
- Developed a comprehensive ERM documentation process, ensuring accuracy of medical records and expediting payor authorization for services.
- Led daily huddles for branches, ensuring accurate admission data and chart completion.
- Fostered a collaborative environment by leading daily huddles, promoting transparency and improving team communication for optimal referral management.
- Streamlined admission criteria by revising policies, resulting in clearer guidelines and improved compliance across multiple states.
- Analyzed admission criteria, implementing updates that led to measurable improvements in policy compliance and operational efficiency.
Research Assistant
FMC Science
02.2021 - 08.2021
- Research Assistant for 4 different Research Coordinators.
- Assisted in data collection and analysis for scientific studies.
- Collected and organized charts for onsite research projects to support monitors in data verification.
- Entered data into multiple systems to ensure accurate logging of research results.
- Systematically organized and maintained research documentation and records to facilitate easy access and review.
- Participated in team meetings to discuss research progress and findings.
- Engaged in training sessions to learn new research techniques and tools.
Charge Analyst
Ascension
Lampasas, Tx
02.2021 - 08.2021
- Processed charge entries for patient services, ensuring accurate billing and timely reimbursement.
- Work with all managed care, commercial and private insurance as well as Medicare and Medicaid for processing and verifying claims.
- Claims corrections for all payors for specialty providers, RIIC clinics and SNF.
- Hospital billing for multiple sites.
- Nursing Home/AI. billing for multiple sites.
- Time of service collections.
- Assisted with referrals and prior authorizations for clinics, optimizing patient access to necessary procedures and specialty care.
- Supported medical assistants by preparing treatment areas and facilitating patient care, enhancing clinic workflow. up-front desk area for RHC and Specialty clinics by welcoming patients, answering phones, determining eligibility, scheduling appointments, updating demographics and insurance information.
- Assisting with entering outgoing orders, medication changes.
- Assisted physician (general surgery) with all procedures.
Scheduler
Texas Home Health
08.2020 - 02.2021
- Optimized caregiver shifts and availability using scheduling software.
- Scheduled patient appointments with scheduling software to enhance clinic operations.
- Scheduled patient load to individual staff for skilled nursing services, therapy services.
- Coordinated with healthcare professionals to facilitate timely patient care.
- Communicated with patients regarding appointment times and changes.
- Assisted in maintaining accurate records of scheduled services and staff hours.
- Collaborated with team members to address scheduling conflicts promptly.
PARI/PARII
Ascension
Burnet, Tx
08.2014 - 01.2018
- Managing a surgical clinic with all daily operations to include - scheduling, obtaining authorization for procedures in clinic and outpatient hospital, scheduling with the OR for 3 providers.
- Executed claim corrections to resolve billing discrepancies and enhance revenue recovery.
- Processed clinic billing records to ensure financial accuracy and compliance.
- Entered charges into billing system to support timely and accurate patient invoicing.
- Entered procedure and diagnosis codes into billing software to streamline invoicing and account management.
- Proficient in ICD 10, CPI and HCPCS II coding.
- Provided backup support for medical assistants in PCP and specialty clinics.
- Preparing patient rooms for visits and procedures.
- Assisting with entering outgoing orders and medication changes.
- Supported physicians during in-clinic procedures to ensure efficient workflow.
CNA/Business Office Representative
Seton/Ascension
Burnet, Tx
04.2001 - 08.2014
- Scheduled and managed daily home visits, providing timely updates and maintaining accurate patient records.
- Daily home visits for assisting patients with ADLs-bathing, grooming, changing bedding and safety checks.
- Vital signs and patient monitoring.
- Patient Advocacy and Support.
- Provided quality end of life care to patients in facilities as well as their personal homes.
- Achieved certification in CPR to provide immediate assistance in emergencies.
- Coordinated delivery of medical supplies to healthcare facilities and patients, ensuring uninterrupted patient care.
- Maintained dignity of the dying patient.
- Ensured compliance with privacy and HIPAA regulations to protect patient information.
- Protect the security of all medical records to ensure that confidentiality is maintained.
- Create, maintain and enter information in various applications, database management or word processing.
- Adhere to local, state and federal laws, regulations and statutes.
- Assigned DRGs with computer software.
Education
General Study Program -
Central Texas College
Killeen, TX01-1996
Skills
- Referral management
- Claims management
- Billing practices
- Insurance processing
- Precertification processes
- Electronic patient charts
- Healthcare systems
- Data management
- Referral tracking
- Follow-up management
- Scheduling software
- Appointment scheduling
- Communication
- Organization
- Attention to detail
- Customer service
- Interpersonal Skills
- Interpersonal Skills
- Compliance adherence
- Microsoft Excel
- Microsoft Word
- Database administration
- Healthcare analytics
- Healthcare analytics
Certification
- Good Clinical Practice - Human Research, CITI Program
- Transporting Dangerous Goods, Mayo Clinic, Mayo Medical Laboratories
- Security Training Certification, HIPAA Now
- Certified Nurse Aide Training Network
Timeline
Referral Coordinator
Compassus
08.2021 - Current
Research Assistant
FMC Science
02.2021 - 08.2021
Charge Analyst
Ascension
02.2021 - 08.2021
Scheduler
Texas Home Health
08.2020 - 02.2021
PARI/PARII
Ascension
08.2014 - 01.2018
CNA/Business Office Representative
Seton/Ascension
04.2001 - 08.2014
General Study Program -
Central Texas College