Mai Kollie
OHIO
Summary
Dedicated and adaptable professional with a proactive attitude and the ability to learn quickly. Strong work ethic and effective communication skills. Eager to contribute to a dynamic team and support organizational goals.
Overview
12
12
years of professional experience
Work History
Community Health Worker
Caresource Health Plan
12.2023 - Current
- Maintain appropriate documentation within protocols and guidelines of care management program
- Documented customer interactions and transactions, maintaining accurate records of all dealings.
- Educate members on health resources and available services within the health plan.
- Assessed community health needs through surveys and direct outreach efforts.
Claims Adjudicator
Molina Healthcare
11.2021 - 11.2023
- Processed medical claims using claims management software efficiently and effectively.
- Communicated with providers to clarify claim details and resolve discrepancies.
- Collaborated with team members to streamline claim processing workflows.
- Analyzed medical records to verify diagnosis codes and services rendered.
Medical Records Specialist
MT Carmel St. Anns Hospital
03.2018 - 05.2021
- Enhanced patient privacy protection through diligent maintenance of confidential records and adherence to HIPAA regulations.
- Reviewed medical charts for completeness and adherence to regulations.
- Scanned and validated medical records for upload.
- Tracked and processed release of information requests.
Care Coordinator
Management and Network Services
07.2014 - 09.2017
- Collaborated with healthcare teams to streamline referral workflows.
- Increased coding accuracy by diligently reviewing medical documentation and applying appropriate codes.
- Verified insurance eligibility and benefits for referred patients.
- Collaborated with admissions, discharge planning and clinical team to verify connection with key professionals involved in case upon release of client information.
Education
Mifflin High School
Skills
- Effective communication
- Active listening
- Team collaboration
- Organized and detail oriented
- Task prioritization
- HIPAA guidelines
- Customer documentation
- Researching
- Problem solving
- Time management
Timeline
Community Health Worker
Caresource Health Plan
12.2023 - Current
Claims Adjudicator
Molina Healthcare
11.2021 - 11.2023
Medical Records Specialist
MT Carmel St. Anns Hospital
03.2018 - 05.2021
Care Coordinator
Management and Network Services
07.2014 - 09.2017
Mifflin High School