Luis Jaime
Miami,FL
Summary
Compassionate LPN Case Manager with experience in coordinating patient care and managing healthcare services. Strong skills include creating individualized patient plans, collaborating with interdisciplinary teams, and advocating for patient needs. Demonstrated impact in improving patient outcomes through diligent monitoring and timely response to changes in patient status.
Overview
23
23
years of professional experience
1
1
Certification
Work History
Dispatcher
DispatchHealth
Miami, FL
11.2021 - Current
- Received and dispatched calls for emergency services.
- Prepared daily work and run schedules.
- Take patients' symptoms over the phone to dispatch the appropriate medical team.
- Kept detailed and updated records of calls in physical and electronic databases.
- Utilized various software systems to facilitate movement, planning and scheduling.
- Maintained logs of all incoming calls and assigned tasks.
- Performed administrative duties such as filing paperwork, updating databases, and preparing documents for review by management staff.
- Ensured compliance with safety regulations and company policies.
- Participated in team meetings discussing changes in procedures or processes.
- Monitored dispatch board and adjusted call priorities regularly based on caller needs.
Patient Access Registrar
Mount Sinai Medical Center Of Florida
Miami Beach, FL
09.2004 - 06.2020
- Patient Access Registration / Bed control.
- Work under the guidance of the Patient Access Supervisor.
- Perform patient pre-admission, admission, transfer, and discharge activities.
- Collect and validate patient demographic and insurance information.
- Obtain health, financial, and religious information from patients at the time of admission.
- Prepare patient identification band and complete admission papers.
- Obtain signatures for financial responsibility and treatment procedures from patients or guardians.
- Work in compliance with hospital policies and procedures, and adhere to government regulations.
- Contact insurance companies for patient medical billing operations.
- Mentoring New Employees.
- Advocate for members.
Pre-Certification Coordinator
professional response incorporation
Miami, FL
10.2001 - 08.2004
- Reviewed and evaluated incoming requests for medical services in accordance with insurance requirements.
- Created authorization numbers to ensure correct pre-certification of services.
- Maintained records of all precertified services and related information.
- Researched patient's medical history, insurance coverage, and other relevant data.
- Provided customer service by responding promptly to inquiries from patients and providers.
- Initiated prior authorizations using electronic systems or paper forms as required by third party payers.
- Ensured compliance with applicable regulations such as HIPAA Privacy Standards and CMS guidelines.
- Verified patient eligibility status through various sources including but not limited to telephone calls, faxes, emails .
- Conducted quality assurance reviews for accuracy of completed pre-certifications.
- Participated in training sessions regarding new procedures or changes in policies related to precertification activities.
- Navigated through multiple online systems to obtain documentation.
- Contacted patients to confirm demographic information and communicate financial responsibilities.
- Entered data in EMR database to record payer, authorization requirements and coverage limitations.
Education
LPN - Nursing
Genesis Vocational Institute
Miami, FL12-2016
Skills
- Care plans
- Hospital experience
- Medical terminology
- Medical scheduling
- Management
- Nursing
- Training new hires
- Customer Relations
- Database Management
- Database updates
- Prioritizing calls
- Customer Relationship Management
- Verifying coverage
- Critical thinker
- [Software] Proficiency
Certification
- LPN
- LVN
- CPR Certification
Languages
English
Native/ Bilingual
Spanish
Native/ Bilingual
Timeline
Dispatcher
DispatchHealth
11.2021 - Current
Patient Access Registrar
Mount Sinai Medical Center Of Florida
09.2004 - 06.2020
Pre-Certification Coordinator
professional response incorporation
10.2001 - 08.2004
LPN - Nursing
Genesis Vocational Institute
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