Loraine Roncone
Canfield
Summary
Dedicated healthcare professional with expertise in interdisciplinary collaboration and critical thinking. Coordinated patient care plans and trained staff on case review procedures, enhancing patient outcomes and departmental efficiency. Strong background in customer service, multitasking, and time management.
Overview
17
17
years of professional experience
Work History
UM Case Reviewer
Anthem/Elevance Health
Indianapolis
10.2013 - 04.2026
- Reviewed case files to ensure compliance with health regulations and policies, contributing to regulatory adherence.
- Analyzed medical records to determine eligibility for claims processing.
- Evaluated documentation for accuracy and completeness in case assessments.
- Coordinated with internal teams to resolve discrepancies in case information, enhancing data accuracy and reliability.
- Provided training to new staff on case review procedures and systems.
- Ensured that all deadlines were met while conducting case reviews.
- Participated in training sessions related to new or updated policies and procedures associated with casework.
- Identified and recommended improvements in departmental processes to streamline case review operations.
Case Manager
Grace Hospice
Boardman
12.2008 - 03.2013
- Delivered case management services encompassing intake, assessment, crisis intervention, advocacy, referral, and monitoring to address family needs.
- Assessed patient needs and developed personalized service strategies.
- Coordinated patient care plans with interdisciplinary teams to ensure comprehensive and effective treatment.
- Facilitated communication among patients, families, and healthcare providers to enhance understanding and support.
- Monitored patient progress and adjusted care plans.
- Documented case notes and maintained accurate patient records.
- Provided emotional support and counseling to patients and families.
- Educated families on hospice services and available resources.
- Advocated for patients' rights and ensured quality of care standards.
Education
Bachelor of Science -
Youngstown State University
Youngstown, OH06-1988
Skills
- case review
- claim processing
- policy compliance
- documentation accuracy
- training facilitation
- patient advocacy
- interdisciplinary collaboration
- care coordination
- problem solving
- critical thinking
- time management
- Professionalism and integrity
- Client confidentiality
- Records management
Timeline
UM Case Reviewer
Anthem/Elevance Health
10.2013 - 04.2026
Case Manager
Grace Hospice
12.2008 - 03.2013
Bachelor of Science -
Youngstown State University