Louise Charles
Dumfries,VA
Summary
To use my professional experience and academic training to assist an organization in achieving its goals and objectives.
Overview
13
13
years of professional experience
Work History
Case Management Associate
NYU Langone Hospital - Long Island
08.2017 - 03.2020
- Provided discharge notices and Important Message from Medicare to patients with explanation of patient s rights as directed by case management supervisors
- Support department with executing policies and procedure to support the organization's compliance with regulatory requirements
- Communicate with departmental staff, patient families, vendors, facilities and payers, Ensure HIPPA is maintained
- Informally mentored new case managers and service coordinators, answering questions, offering opportunities to shadow and observe and explaining basic information about company procedures.
- Made appropriate referrals, monitored client services in appropriate time frames, sought supervisory guidance as required, documented services provided and completed departmental billing procedures.
- Communicated with supervisor regarding issues related to case management, resourcing, service collaboration and development of new resources.
Clinical Coordinator
Health Care Partners
02.2011 - 08.2017
- Ensured compliance with regulatory standards and best practices through diligent oversight of clinical procedures, documentation, and staff training.
- Create correspondence letters to provide health care providers with information regarding the status of their appeals and claims
- Developed and updated policies and procedures, maintaining compliance with guidelines relating to HIPAA, benefits administration and general liability.
- Forward appeals to third party reviewers such as Maximus, Create denial letters using CMS approved templates to provide facilities with information regarding the reasons for the denial of their claims. Use ICD Codes, InterQual, St.Anthony’s, CMS Guidelines to produce Touchstone, Liberty and HIP Denial letters.
Bank Teller Supervisor/Vault Custodian
JP Morgan Chase
10.2006 - 08.2010
- Promoted cross-selling efforts by educating staff on bank products and services, resulting in increased sales.
- Maintained cash drawer accuracy by conducting regular audits and implementing effective cash handling practices. Counted, verified and handled bank deposits and armored car transactions. Assisted customers with banking needs and inquiries.
- Provided training to new tellers on bank procedures, systems, and customer service best practices.
- Managed risk effectively by monitoring teller activities, ensuring compliance with banking regulations and policies.
Education
Bachelor of Science - Business Administration
York College-CUNY
Skills
- Microsoft Office (Word, Excel, Power Point, Outlook)
Timeline
Case Management Associate
NYU Langone Hospital - Long Island
08.2017 - 03.2020
Clinical Coordinator
Health Care Partners
02.2011 - 08.2017
Bank Teller Supervisor/Vault Custodian
JP Morgan Chase
10.2006 - 08.2010
Bachelor of Science - Business Administration
York College-CUNY
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