Summary
Overview
Work History
Education
Skills
Activities
Timeline
Generic

MICHELE Rauch

Port Orchard,United States

Summary

Dynamic Revenue Specialist at DaVita, with a proven track record in insurance verification and account resolution. Skilled at fostering strong professional relationships. Consistently exceeding KPIs and driving performance improvements. Proficient in Microsoft Excel and company specific applications, I leverage strong problem-solving abilities to enhance operational performance and service excellence.

Overview

17
17
years of professional experience

Work History

Revenue Specialist

DaVita
Federal Way, WA
06.2022 - Current
  • Verified insurance coverage for incoming patients and ensured that all documents were accurate and up-to-date.
  • Maintained confidentiality of all protected health information as required by HIPAA regulations.
  • Communicating with insurance payers regarding coverage and contracts.
  • Ensuring accurate payer and patient information in the billing system
  • Performed additional duties as assigned by management team.
  • Responding promptly to inquiries from staff members concerning patient accounts or payment issues.
  • Performed audits on patient accounts to ensure accuracy of demographic information and other data.
  • Attended meetings and training sessions as requested by supervisors.
  • Communicating and collaborating cross-departmentally
  • Cross-training teammates as needed
  • Training partner for new teammates
  • Partnering with training team to assist in coaching new employees
  • Ability to coach teammates through complicated account resolution.
  • Proficient in COB
  • Identified areas where improvements could be made, and worked with management on implementing changes.
  • Contacted insurance carriers to verify coverage, copays and deductible information for patients.
  • Resolving complex collection issues, registration denials, and overpayments.
  • Analyze revenue cycle data to identify trends, patterns, and areas for improvement, and communicate findings.
  • Meeting or exceeding Key Performance Indicators
  • Actively prepare for 1:1 to discuss trends and growth opportunities
  • Understanding and application of complex process changes, with the ability to coach others through changes.
  • Understanding and resolution of e-denials.
  • Communicate with insurance payers to understand network coverage, relationships, and contract terms to ensure timely and accurate reimbursement for dialysis services rendered at our clinics.
  • Process payer, partner, and customer requests to ensure center and payer information is loaded into the billing system for accurate billing, including single patient agreements.
  • Resource for teammates regarding payers, payer trends, and internal processes.
  • Ability to manage multiple priorities and project work outside of traditional system work, while meeting or exceeding deadlines.
  • Creating and maintaining positive relationships outside of, and within, the team.
  • User Acceptance Testing.
  • Assisting in the planning and facilitation of team homeroom meetings.
  • High-risk denial, buddy.
  • Proficiency in regional payer knowledge.
  • Consistent demonstration of service excellence.
  • Completion of DaVita Spark! leadership program
  • Completion of Davita DSSL leadership program

Health Unit Coordinator

Stafford Healthcare at Ridgemont
Port Orchard, United States
01.2016 - Current
  • Observe and document patient status and report patient complaints to the case manager.
  • Complete and submit clinical documentation.
  • MDS charting
  • Ordering DME, oxygen, and other home medical supplies
  • Schedule care conferences
  • Attend weekly patient status meetings, facilitate
  • Compile weekly updates for various insurances
  • Compile admission and discharge forms as required by various insurances
  • Attend monthly Quality Assurance and Performance Improvement meetings
  • Initiate patient discharge summary forms
  • Send discharge summaries to patient's primary care physicians

Transportation Coordinator

Stafford Healthcare at Ridgemont
Port Orchard, United States
10.2015 - 01.2016
  • Scheduling medical appointments for 95 patient facility
  • Arrange transportation to and from medical appointments
  • Coordinate referrals for specialists
  • Coordinate with patient, family, and staff regarding appointment (ex. appointment date, time, mode of transportation, special limitations, pre-op orders)
  • Knowledge of policies and procedures for various situations
  • Obtain pertinent documentation for appointments
  • Create driver and attendant schedules, approve leave, communicate changes in schedule
  • Coordinate activity transportation for facility and sister facility
  • Approve invoices related to specialized transportation
  • Maintain patient confidentiality

Central Supply Specialist

Stafford Healthcare at Ridgemont
Port Orchard, United States
10.2015 - 01.2016
  • Fill requisitions for routine supplies
  • Ensure routine dressings, OTC medications, and oxygen supplies are maintained
  • Follow established policies and procedures regarding infection control
  • Check and approve invoices, purchase orders, packing slips with incoming merchandise
  • Maintain organization and cleanliness of storage rooms
  • Clean, check, and send for servicing medical equipment
  • Deliver emergency supplies as needed
  • Ensure purchase orders are prepared, signed, and submitted as required by policy and procedure
  • Maintain patient confidentiality

Certified Nursing Assistant

Stafford Healthcare at Ridgemont
Port Orchard, United States
09.2008 - 10.2013
  • Observed and documented patient status and reported patient complaints to the case manager.
  • Read and recorded temperature, pulse and respiration.
  • Completed and submitted clinical documentation in accordance with agency guidelines.
  • Prepared patient rooms prior to their arrival.
  • Collected urine and fecal samples.
  • Support duties for diagnostic and technical treatment procedures
  • Assisted with adequate nutrition and fluid intake.
  • Cleaned and organized patients' living quarters.
  • Positioned residents for comfort and to prevent skin pressure problems.
  • Assisted with transferring residents in and out of wheelchairs and adaptive equipment.
  • Provided personal nursing care in pre- and post-operative situations.
  • Provided necessary supplies, support and assistance to medical staff and patients for unit specific procedures.
  • Charted daily information on the residents such as mood changes, mobility activity, eating percentages, and daily inputs and outputs.
  • Recognized and reported abnormalities and/or changes in patients' health status to nursing staff.
  • Documented resident records on daily flow sheets.
  • Exhibited compassionate care and communication with regard to issues of death and dying.
  • Promoted continuity of care by accurately and completely communicating to other caregivers the status of patients for which care is provided.
  • Promoted personal and co-worker safety.

Education

General Studies -

Eastern Washington University
Cheney, WA, United States
01.2008

Associate of Arts -

Olympic College
Bremerton, WA, United States

Certificate - Certified Nursing Assistant

Stafford Healthcare at Ridgemont
Port Orchard, WA, United States

Skills

  • Appointment scheduling
  • Computer skills to maintain patient's records
  • Completes admission and discharge forms
  • Attends to telephones and transfers calls
  • Ability to obtain necessary authorization or approval for outside services when required
  • Knowledge of case management policies and procedures
  • Patient charting
  • Organization and efficiency
  • Coordinate patient care with specialty clinics
  • Communicate/coordinate with interdisciplinary teams
  • Multitasking and prioritization
  • Insurance verification
  • Payer communication
  • E-denial resolution
  • HIPAA compliance
  • Team collaboration
  • Conflict resolution
  • Microsoft Excel
  • Interpersonal communication skills
  • Reliability
  • Problem-solving abilities
  • Multitasking Abilities
  • Communication skills-verbal and non-verbal
  • Interpersonal communication
  • Team building
  • Adaptability
  • Self motivation
  • Flexibility
  • Meets or exceeds performance expectations
  • Resilient
  • Ability to escalate complex issues
  • Root cause analysis
  • Team-oriented
  • Active listening
  • Empathetic
  • Collaborative
  • Drives professional and personal growth
  • Ability to pivot from task or goal as needed to fit the team, and provide the best service to our patients
  • Microsoft Office proficient

Activities

  • Employee of the Month, Stafford Healthcare at Ridgemont, 08/2010
  • Employee of the Quarter, Stafford Healthcare at Ridgemont, 04/2016
  • Team Leader, Stafford Healthcare at Ridgemont, 2014

Timeline

Revenue Specialist

DaVita
06.2022 - Current

Health Unit Coordinator

Stafford Healthcare at Ridgemont
01.2016 - Current

Transportation Coordinator

Stafford Healthcare at Ridgemont
10.2015 - 01.2016

Central Supply Specialist

Stafford Healthcare at Ridgemont
10.2015 - 01.2016

Certified Nursing Assistant

Stafford Healthcare at Ridgemont
09.2008 - 10.2013

General Studies -

Eastern Washington University

Associate of Arts -

Olympic College

Certificate - Certified Nursing Assistant

Stafford Healthcare at Ridgemont

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MICHELE Rauch