Latasha Applewhite
Chicago,IL
Summary
Knowledgeable patient representative offers demonstrated skills in case management and service coordination. Expertly handles complaints, inquiries and service questions to meet patients' access needs and correct problems related to care. Well-versed in policies, procedures and standards.
Overview
11
11
years of professional experience
Work History
Utilization Review Assistant
United Healthcare
Chicago, IL
05.2024 - Current
- Collaborated with healthcare teams to ensure compliance with policies and regulations.
- Coordinated communication between providers, payers, and patients regarding care approvals.
- Developed training materials for staff on utilization review processes and best practices.
- Assessed the appropriateness of length of stay for inpatient admissions.
- Conducted utilization review activities including concurrent reviews, retrospective reviews, and discharge planning.
- Responded promptly to inquiries from internal and external customers regarding authorization status or payment issues.
- Developed clinical criteria for authorization decisions based on accepted standards of practice.
Clinical Administrative Supervisor/Quality Analyst
Optum
02.2023 - 04.2024
- Support management in driving strategic direction at the lead and staff levels.
- Perform regular audits of team members' work activities to ensure compliance, accuracy, and efficiency.
- Coordinated schedules and meetings for executive leadership teams.
- Implemented process improvements to enhance team collaboration and communication.
- Reviewed employee timesheets regularly to ensure hours worked were accurately recorded.
- Supervised a team of administrative professionals including hiring, training, scheduling, evaluating performance and providing feedback.
Clinical administrator coordinator
Optum
11.2018 - 02.2022
- Process the insurance authorization request.
- Screens incoming emails, mail, and telephone calls to assign priority and route them as needed.
- Support Managed Care member enrollment.
- Enter denials and request appeals into the information system.
- Monitor and report the status of credentialing providers; acts as a credentialing coordinator.
Patient Financial Specialist
Advocate Medical Group
Country Club Hills, USA
03.2015 - 11.2018
- Assist customers with billing/insurance/charge/referral questions.
- Work with Hospital/professional building teams when identifying trends that can lead to inappropriate billing for the customer.
- Identify uninsured customers and communicate financial assistance plan.
- Obtain prior AUTH’s for patient procedures.
- Appropriately refer customers to other payment sources i.e., Medicaid/ Medicare
Education
Health Care Administration -
Rasmussen College
Tinley Park10-2027
Skills
- Communication Skills
- Adaptability
- Adaptive Person
- Ability to Work Under Pressure
- Management Skills
- Medical billing
Timeline
Utilization Review Assistant
United Healthcare
05.2024 - Current
Clinical Administrative Supervisor/Quality Analyst
Optum
02.2023 - 04.2024
Clinical administrator coordinator
Optum
11.2018 - 02.2022
Patient Financial Specialist
Advocate Medical Group
03.2015 - 11.2018
Health Care Administration -
Rasmussen College