LANESHA ADAMS

• Centrally receive inbound calls from multiple clinics and make outbound calls on behalf of clinics
• Update patient information and manage information in our electronic medical records system
• Schedule appointments for patients with their Oak Street provider
• Manage patient referrals by obtaining authorizations and faxing requested information to specialists
• Perform service recovery address patient concerns and de-escalate callers when needed
• Ability to multi-task prioritize and manage time effectively
• Work closely with care team members to provide the highest level of customer service and act as an extension of the clinics
• Partner with colleagues to reach and maintain call center target metrics to ensure delivery of a positive patient experience

• Delivered service excellence through all points of contact
• Transported client to doctor's office and essential errands
• Assisted residents in and out of bed and wheelchairs using safe lifting and transferring techniques
• Updated job knowledge by participating in educational opportunities and maintaining certification or licensure
• Protected health information according to HIPAA policies and procedures
• Assisted residents in activities of daily living to maintain health and dignity
• Offered safety guidance protection to increase mobility for clients with impaired judgment
• Fostered resident comfort by answering requests and reporting observations to nursing supervisor
• Responded to resident dining needs and assisted with feeding
• Engaged clients through conversation and companionship promoting independence and social requirements
• Reported health changes and provided proper documentation to appropriate staff

• Verified insurance of patients to determine eligibility.
• Communicated with insurance providers to resolve denied claims and resubmitted.
• Managed appeals process for denied claims, resulting in successful reimbursements from insurance companies.
• Filed and updated patient information and medical records.
• Ensured timely payments from insurance providers through submission of accurate and complete claims.
• Utilized specialized software to assign patients to diagnosis-related groups, ensuring precise classification and billing.
• Maintained detailed patient records to enhance data availability for care improvement.
• Ensured accurate documentation for appeals by conducting detailed reviews of denial accounts and overseeing clinical appeal processes.
• Evaluated denial reports to identify root causes and trends, providing insights to stakeholders to enhance processes and minimize future denials.
• Managed processing of initial and second-level appeals, ensuring timely collaboration with physician advisors and fiscal attorney consultants.

• Managed high volume of patient accounts, resolving over 90% of billing issues within 24 hours.

• Verified claims to ensure timely reimbursement.

• Negotiated payment arrangements with patients to reduce outstanding debts.

• Processed and delivered claims efficiently to various insurance providers.

• Managed appeals process for denied claims, achieving 20% increase in successful outcomes.

• Employed multiple billing and claims management platforms, including EPIC.

• Coordinated with insurers and cross-functional teams to streamline resolution of billing challenges.

• Ensured compliance by maintaining precise records and reports.

Conducted training sessions for new team members on billing and appeals procedures.

• Worked in cooperation with family and outside providers to meet physical and emotional needs of patient
• Read and contributed to shift reports and care notes
• Followed universal precautions and established policies minimizing exposure to blood or bodily fluids
• Provided proper care and observation of patient's skin to prevent breakdown
• Maintained secure environment for staff and residents following established safety standards
• Administered bedside and personal care such as ambulation and personal hygiene assistance
• Entertained conversed with and read aloud to patients to keep mentally healthy and alert
• Participated in case reviews consulted with team caring for client to evaluate client's needs and plan for continuing services
• Performed healthcare-related tasks such as monitoring vital signs and medication under direction of registered nurses and physiotherapists
• Directed patients in simple prescribed exercises or in use of braces or artificial limbs
• Checked patients' pulse temperature and respiration
• Prepared and maintained records of client progress and services performed reporting changes in client condition to manager and supervisor
• Massaged patients or applied preparations or treatments to body
• Cleaned and organized client's living quarters to make living conditions more hospitable
• Established personal relationships with clients to maintain patient comfort and care
• Coordinated with doctors and registered nurses to develop care plans for clients
• Provided clients with communication assistance typing correspondence and obtaining information for them
• Helped patients move in and out of beds baths and wheelchairs
• Served clients regular balanced meals for breakfast lunch and dinner
• Completed and submitted clinical documentation in accordance with agency guidelines
• Drove motor vehicles to transport clients to physicians' offices or outings
• Evaluated client's needs to plan for continuing services
• Responded appropriately to physical emotional and developmental needs of residents

• Clarified inaccurate ineffective or contraindicated orders or treatment regimens by consulting with licensed nurse
• Managed medication cart for complete up-to-date supplies and quality control
• Assisted physicians with special tests and procedures within scope of nursing standards
• Liaised with clinical staff members to coordinate and administer medication to nursing home residents
• Followed standards of hygiene safety and infection control when handling and disposing of medications
• Removed discontinued outdated or deteriorated drugs from inventory
• Recognized and reported unsafe conditions for medication provision
• Reviewed patient dietary restrictions and food allergies to verify appropriate diet
• Reminded patients to take medications and nutritional supplements
• Observed and examined patients to detect symptoms that required medical attention such as bruises open wounds and blood in urine
• Collected specimens such as urine feces and sputum

• Reduced errors in claims submissions through meticulous attention to detail and thorough review processes.
• Improved claim processing efficiency by streamlining workflows and implementing best practices.
• Submitted electronic/paper claims documentation for timely filing.
• Skillfully navigated Medicare/Medicaid regulations in order to secure maximum reimbursement rates for qualifying services provided.
• Negotiated payment plans for patients facing financial hardships, minimizing revenue loss while maintaining empathetic customer service.
• Maintained accurate patient records by diligently updating databases and following strict documentation guidelines.

• Addressed customers courteously using suitable methods and problem-solving skills
• Responded to telephone inquiries and complaints following standard operating procedures
• Remained open to feedback from supervisor and peers to build and improve skills set
• Developed and maintained working knowledge of internal policies procedures and services to appropriately address customer issues
• Maintained knowledge of company products to provide helpful suggestions and recommendations to customers
• Utilized automated systems to log and retrieve call information
• Complied with corporate and regulatory policies regarding information confidentiality and privacy
• Maintained logs and documentation to detail key information regarding incoming and outgoing calls
• Followed up with customers regarding product functionality and overall satisfaction

• Lifted and assisted others to lift patients to move them on and off beds examination tables surgical tables and stretchers
• Followed doctor's treatment plans to schedule follow-up appointments
• Disposed of waste and hazardous materials
• Interviewed patients and families to identify problems relating to care
• Sterilized medical equipment to prevent microbial contamination
• Coordinated patient care with other healthcare and support professionals
• Communicated well with patients to identify and attend to needs
• Anticipated patients' anxieties and answered relevant questions to comfort patients

• Coordinated diagnostic tests and procedures for streamlined care delivery enhancing the overall quality of services provided.
• Contributed to practice growth by providing excellent customer service resulting in numerous positive reviews and referrals from satisfied patients.
• Improved office efficiency by managing inventory supplies anticipating shortages and placing timely orders.
• Developed a system to track follow-up appointments effectively leading to improved continuity of care for patients.