Summary
Overview
Work History
Education
Skills
Certification
Timeline
Generic

NALANI MACHAIN

Bullhead City,AZ

Summary

Professional with strong background in healthcare management, adept at optimizing practice operations and improving patient care. Demonstrates keen focus on team collaboration and achieving measurable results, showing adaptability to changing needs. Skilled in strategic planning, staff development, and process improvement, with reliable and results-driven approach. Recognized for effective communication, leadership, and problem-solving abilities.

Overview

21
21
years of professional experience
1
1
Certification

Work History

Practice Manager

MOHTASEB CANCER CENTER AND BLOOD DISORDERS
09.2022 - Current
  • Effective and efficient management of 2 practice locations concurrently; Daily On site assessment of administrative staff performance, laboratory staff performance, and examining on site clinical staff scheduling to achieve the most efficient and thorough patient care available through simulation techniques;
  • Clinical and non clinical staff management of 15-25 persons including interviews, onboarding, coordination of training, consistent follow up with employee to retain employees and set job satisfaction standards;
  • Lead and schedule monthly staff meetings; implement and schedule post probation reviews, annual reviews and continuously maintain an open door policy for all employees as well as providers.
  • Monitoring and ensuring CME requirements are met by clinical staff and facilitate new training opportunities;
  • Adhering to safety and administration policies and procedures;
  • Organize and ensure monthly accounts receivable and payable accounts are satisfied, recorded and deposited weekly.
  • Creation of Profit and Loss practice reporting in QuickBooks;
  • Gathering monthly analytical data representing practice strengths, areas of opportunity, and marketing strategies and presenting to Owner, CEO and agencies interested in joining our patient centered approach to oncology;
  • Monthly bank reconciliation for four business accounts;
  • Target and cut expense costs by 45% in 9 months, increase practice revenue by 75% plus in first 9 months by increasing clinical research income, reducing employee overtime, spearheading billing queries and inconsistencies and providing turnaround of same day responses;
  • Coding accuracy coaching for providers; drug, biosimilar and injectables price comparisons to reduce drug expenses and reduce patient financial burdens.
  • Complete and update quarterly credentialing requirements with insurance agencies, management and instigation of insurance contract negotiations that include supportive analytical data;
  • Payroll for two practice locations, creating monthly patient balance statements, returning patient concern phone calls and setting high standards for patient interaction;
  • Coordination of patient services including medical services, equipment, transportation, hospice and at home care, consistency in follow up with patient to ensure their needs are more than adequately met.
  • Providing resources as needed to patients, counseling patients on possible financial responsibilities associated with chemotherapy or hematology treatments; assisting with foundation and non profit agencies available.
  • Meeting weekly with drug sales representatives, distributors, laboratory representatives and coordination of medical convention schedules.
  • Providing guidance to four physicians to effectively maintain a positive schedule flow.
  • Supervised team of 25 office personnel.
  • Coordinated with physicians to optimize appointment schedules and maximize daily patient flow.

Independent Contractor

Mental Health Billing Services and Practice Consult
09.2017 - 11.2022
  • Coordination of insurance claim billing submissions including recoding for higher reimbursement rates, insurance contract negotiations to achieve highest fee schedule in area of practice, management of administrative and clinical staff of 6, coordination of therapists monthly treatment schedule, supervision of payroll biweekly.
  • Negotiated contracts with clients, ensuring clear communication of project scope and expectations for both parties.
  • Offered creative problem-solving techniques when faced with unexpected obstacles during the course of a project.
  • Trained new team members to apply best coding best practices and proper use of development tools.
  • Conducted regular reviews of operations and identified areas for improvement.

Senior Client Services Representative

LABORATORY CORPORATION OF AMERICA
02.2018 - 09.2022
  • Mastering 120 -150 inbound client and patient calls while problem solving with extreme accuracy, phenomenal demeanor and acting as a valuable liaison between doctor, hospital, urgent care staff, nursing staff, surgical staff and patients.
  • In depth work with physician offices, hospital staff, patients and internal customers to ensure that all client needs are addressed accurately and efficiently.
  • Providing product education to client and patient while handling a wide variety of highly technical questions while ensuring a world class customer experience.
  • Motivating and training colleagues to work with a customer centric team in an innovative company.
  • Resolve complex and routine customer requests with products or services via inbound, outbound calls, internet, email or fax.
  • Speak with patients in a courteous, friendly, knowledgeable and professional manner using protocol procedures.
  • Ensure teams are meeting required metric levels and presenting reports to Vice President of Client Services.
  • Inquire, clarify, and confirm patient requirements and understanding of the solution and provide additional patient education as needed.
  • Qualify and establish inbound new patients requesting LabCorp products and services.
  • Participate in activities designed to improve customer satisfaction and business performance.
  • Support field operations in maintaining support services for improved patient access to the LabCorp portfolio of tests.
  • Perform administrative support for additional departments and medical record management, data maintenance, and internal records to assure HIPAA compliance.
  • Seeking alternative solutions to challenging testing, doctor consult and insurance based issues.
  • Answer and complete with utmost accuracy 120-150 inbound calls per day from patients, doctor's office, private insurance carriers.
  • Talking and typing, utilization of multiple computer screens simultaneously.
  • Routinely and efficiently utilize multiple resources to resolve client or patient inquiries and issues while completing and following specimen testing add-ons, specimen traces and searches and advanced troubleshooting.

Executive Coordinator - Contractual Management and Communications

DIANA R. CONKLIN, LCSW
04.2005 - 09.2017
  • Supervision and negotiation of insurance contract acquisitions, sales coordination and reporting;
  • Providing complete office support for practice including phones, scheduling, correspondence, fax, email, scan, proofreading, meeting preparation and file management including daily update of files;
  • Cash handling, bank deposits, audit preparation;
  • Scheduling clients and accounting; daily initial follow up contact with clients and insurance providers.
  • Managing personal and business schedules for therapist, coordinating multiple deadlines for promotions and addition of new services;
  • Completion of required quarterly practice attestations and promotion of mental health practices
  • Obtaining authorizations and referrals, billing medical claims utilizing portals and CMS 1500 forms when required;
  • ICD 9/10 implementation and coding, daily coordination of all communications between clients, insurance companies and physician referrals.

Table Games, 21 Dealer

BLUEWATER CASINO & RESORT
01.2005 - 04.2005
  • Game protection, providing high energy customer service at all times, promotion of special events and entertainment, certified dealer/instructor of table games.
  • Maintained fast, smooth game pace by efficiently handling dice, chips, money, and cards.
  • Greeted guests warmly, fostering a positive atmosphere conducive to repeat patronage and customer loyalty.
  • Created enjoyable atmosphere for players by engaging patrons in positive and entertaining conversation.
  • Adhered to company and game policies as well as state and federal regulations.

Education

Bachelor of Arts - Anthropology, Forensic Laboratory in Anthropologic studies

San Diego State University
San Diego, CA
05.2000

Associate of Arts - General Education

Cuyamaca College
Cuyamaca, CA
12.1996

Skills

  • Practice management
  • Staff management
  • Workflow management
  • Policy and procedure development
  • Strategic planning
  • Payroll administration
  • Budget oversight
  • Regulatory compliance
  • Performance metrics
  • Process improvement
  • Critical thinking
  • Patient relations
  • Financial reporting coordination
  • Profit improvements

Certification

  • Sales and Negotiation Skills, 2022-02-01
  • Transformational Leadership, 2020-09-01

Timeline

Practice Manager

MOHTASEB CANCER CENTER AND BLOOD DISORDERS
09.2022 - Current

Senior Client Services Representative

LABORATORY CORPORATION OF AMERICA
02.2018 - 09.2022

Independent Contractor

Mental Health Billing Services and Practice Consult
09.2017 - 11.2022

Executive Coordinator - Contractual Management and Communications

DIANA R. CONKLIN, LCSW
04.2005 - 09.2017

Table Games, 21 Dealer

BLUEWATER CASINO & RESORT
01.2005 - 04.2005

Bachelor of Arts - Anthropology, Forensic Laboratory in Anthropologic studies

San Diego State University

Associate of Arts - General Education

Cuyamaca College

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