Nadine Cabaong
Waianae,HI
Summary
Highly-motivated employee with desire to take on new challenges towards a different career path. Strong worth ethic, adaptability and exceptional interpersonal skills. Adept at working effectively unsupervised and quickly mastering new skills. Adds value to any organization in need of great collaboration and multitasking abilities.
Overview
13
13
years of professional experience
Work History
Patient Care Manager Assistant
Malama Ola Health Services
Honolulu, HI
06.2023 - Current
- Provide customer service for inbound and outbound calls
- Forward Faxes to designated areas
- Generate On Call Log and email to all staff
- Post after hours calls to patient threads
- Enter refills and new orders into Rxnt
- Update active census tracker
- Notify Physician of admission and death
- Enter data in EMR database to record payer & authorization.
- Update patient and insurance data and input changes into company computer system.
- Communicate with insurance carrier or employer to verify patient insurance benefits.
- Research patient accounts due to invalid and/or missing authorization information and correspond with insurance company to obtain the necessary information.
- Verify insurance, commercial & medicaid coverage and medicaid room and board.
- & board and Supportive care.
- Submit Room & Board notification to facility.
- Verify monthly eligibility for all payers.
- Submit and maintain current 1147 for Medicaid patients who are in a facility.
- Contacted pharmacies to submit and refill patients' prescriptions.
- Collaborated with local pharmacies to resolve and clarify issues with patient medication.
Payor Verification Specialist
Bristol Hospice
Honolulu, HI
09.2017 - 05.2023
- Enter data in EMR database to record payer & authorization.
- Update patient and insurance data and input changes into company computer system.
- Retain strong medical terminology understanding in effort to better comprehend.
- Communicate with insurance carrier or employer to verify patient insurance benefits.
- Research patient accounts due to invalid and/or missing authorization information and correspond with insurance company to obtain the necessary information.
- Communicate and work effectively with colleagues from other departments.
- Navigate through multiple online systems to obtain documentation.
- Complete, timely, and accurate identification and submission of prior and retro authorization requests to the payors.
- Submit re-authorization and eligibility checks in a timely manner.
- Submit appeals for denials.
- Verify insurance, commercial & medicaid coverage and medicaid room and board.
- Initiate authorizations for home hospice care, hospice room & board and Supportive care.
- Submit Room & Board notification to facility.
- Audit all hospice and supportive care admissions.
- Verify monthly eligibility for all payers.
- Submit and maintain current 1147 for Medicaid patients who are in a facility.
Medical Assistant/Prior Authorization Specialist
Molokai Family Health Center
Kaunakakai, HI
08.2010 - 06.2017
- Obtain vital signs and took medical histories to prepare patients for examination.
- Prepared treatment rooms for patients by cleaning surfaces and restocking supplies.
- Administered immunizations and injections (ensured proper charge).
- Maintained inventory, vaccination and product expiration logs to record updated documentation for tracking purposes.
- Sterilized and maintained medical equipment/instruments following procedures.
- Followed principles of asepsis and infection control to meet patient safety guidelines.
- Performed EKG & pulmonary function test.
- Assist with eye & ear irrigation.
- Entered completed test results and ensure proper charges: strep test, urinalysis, hemoglobin A1c, & hemoccult test.
- Labeled and completed lab requisitions using ICD and CPT coding.
- Input proper coding to designate the diagnosis and procedure.
- Adequate knowledge of workers compensation claims.
- Scheduled appointments for patients via phone and in person.
- Arrange off island appointments for specialty clinics.
- Coordinate air, ground and lodging with insurance company.
- Generate referrals and submit to healthcare insurance.
- Contacted pharmacies to submit and refill patients' prescriptions.
- Collaborated with local pharmacies to resolve and clarify issues with patient medication.
- Organized charts, documents and supplies to maintain team productivity.
- Relayed messages from patients to physicians about concerns, condition updates or refill requests to facilitate treatment.
Education
Associate of Applied Science - Clinical Medical Assisting
Education America
Honolulu, HI07.2002
High School Diploma -
Molokai High School
Hoʻolehua, HI05.1999
Skills
- Customer Service
- Data Entry
- Attention To Detail
- Documentation and Correspondence
- Communication and Interpersonal Skills
- Verbal and Written Communication
- MS Office
- Computer Skills
- Medical Terminology
- Solid Understanding Of ICD-10 and CPT Codes
- Strong Knowledge Of Commercial and Medicaid Coverage
- Electronic Authorization Processing
Timeline
Patient Care Manager Assistant
Malama Ola Health Services
06.2023 - Current
Payor Verification Specialist
Bristol Hospice
09.2017 - 05.2023
Medical Assistant/Prior Authorization Specialist
Molokai Family Health Center
08.2010 - 06.2017
Associate of Applied Science - Clinical Medical Assisting
Education America
High School Diploma -
Molokai High School
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