Kinsley Bradshaw

Patient Care Coordinator (04/2018)

*Check in/out patients for scheduled and walk in appointments.

• Verify medical insurance eligibility
• Input patients demographic information in chart along with prescription and referrals.
• Fax medical records request and forms for insurance approval.
• Answer telephone calls, schedule patients for in office appointments and satellite clinic locations.
• Communication with physician offices/ and hospitals.
• Experience with ADOBE and EXCEL.

Insurance Specialist (started in May 2023)

Calls insurance companies to verify eligibility and benefits.

Review and submission for RAC audits for Medicare and Medicare replacements.

Reviewing medical documentations for insurance approval. (Verifying it meets all criteria for quality for reimbursement purposes.)

Submit prior authorizations by phone, fax and direct submission on insurance website.

Communication with medical providers for patient care.

Verifying the coding/ services are valid and billable .

Verifying if prior authorization/ predeterminations are required and or recommended prior to rendering services.

Filing some medicaid secondary claims.

• Provided compassionate personal care, assisting residents with daily living activities and enhancing overall well-being.
• Monitored and documented vital signs, ensuring accurate health assessments for resident care plans.
• Assisted with medication management, promoting adherence and safety in medication administration.
• Presents medication to patient and observes ingestion or other application using specified procedures.
• Collaborated with healthcare team to develop individualized care strategies tailored to resident needs.

* Documents reasons prescribed drugs are not administered.

• Assisted clients with daily living activities, fostering independence and dignity.
• Administered medication and monitored health conditions to ensure client safety.
• Developed personalized care plans in collaboration with healthcare professionals.
• Coordinated transportation for medical appointments, enhancing client access to healthcare services.
• Updates job knowledge by participating in educational opportunities.
• Records patient information by making entries in the patient journal; notifying nursing supervisor of changing or unusual conditions.
• Protects the home care agency by adhering to professional standards, home care policies and procedures, federal, state and local requirements.