
Healthcare coordination and operations professional with 14+ years of healthcare experience, including 2+ years in remote healthcare member support. Experienced in health insurance and benefits navigation, patient/member outreach, healthcare resource coordination, referrals, scheduling, patient education, health coaching, motivational interviewing, and clinical/administrative operations. Proven ability to communicate with patients, members, providers, and internal teams while maintaining accuracy, confidentiality, regulatory compliance, and service quality.
• Support physicians with patient intake, vital signs, histories, examinations, injections, medications, treatments, and clinical documentation.
• Communicate patient concerns, condition updates, and refill requests to providers to support timely follow-up and continuity of care.
• Maintain medical equipment, clinical supplies, inventory logs, and exam room readiness while following established procedures and standards.
• Process insurance claim forms in accordance with applicable regulations and organizational requirements.
• Supported 30+ members, providers, and vendors through inbound calls and chats, providing empathetic, accurate assistance across healthcare needs and services.
• Verified member account, insurance, benefits, and coverage information and helped members understand available healthcare resources.
• Completed outbound outreach projects for high-opportunity members and engaged members regarding health goals, barriers, and available programs.
• Used motivational interviewing and health coaching techniques to connect members with quality programs and appropriate healthcare resources.
• Navigated members through healthcare services and benefits while maintaining compliance with organizational guidelines and healthcare laws and regulations.
• Participated in ongoing training and professional development to maintain knowledge of healthcare programs, services, and processes.
• Coordinated staff scheduling and collaborated with practice leadership to support daily clinical and administrative operations.
• Triaged incoming patient calls, assessed caller needs, and coordinated appropriate appointments or provider followup.
• Served as a liaison between patients, physicians, outside practices, and hospitals to coordinate appointments and care needs.
• Coordinated charts, insurance forms, patient education, diagnostic testing, and clinical workflows while supporting office efficiency.
• Coordinated the work of junior staff and helped maintain team performance while supporting the needs of 50+ patients per day.
• Educated patients on procedures, medications, and physician instructions to promote understanding and continuity of care.
• Coordinated patient scheduling, check in/check out, payments, billing support, and communication through phone, patient portals, and email.
• Scheduled surgeries for multiple surgeons, coordinated operating rooms, and supported pre-procedure preparation.
• Entered procedure and diagnosis codes into medical billing software and audited patient files for medical necessity and coverage criteria.
• Coordinated referrals with insurance companies and medical specialists and documented referral details in patient charts.
• Provided patient onboarding and preparation for appointments and procedures, ensuring patients understood required next steps.
• Recruited, hired, trained, supervised, and developed clinical staff, including direct supervision of 8 Medical Assistants and providers.
• Developed and updated policies and procedures while supporting compliance with HIPAA and applicable benefits, regulatory, and operational requirements.
• Prepared staff schedules, assisted with payroll, coordinated new hire orientation and employment documentation, and supported employee separation processes.
• Managed patient complaints and grievance procedures and assisted with corrective actions and performance related processes.
• Coordinated surgeries, managed pre-certifications, and verified insurance coverage to support timely patient care.
• Served as a hands on mentor to clinical staff and supported consistent delivery of quality patient care.
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Care Coordination | Member Services | Health Insurance Navigation | Benefits Verification | Patient/Member Outreach | Health Coaching | Motivational Interviewing | Referral Coordination | Prior Authorization Support | Patient Scheduling | Telehealth | EHR/EMR | Claims Processing | Patient Education | Healthcare Operations | Team Leadership | Staff Training | Process Improvement | HIPAA & Regulatory Compliance
Electronic Health Records (EHR/EMR) | Health Information Systems | Medical Billing Software | Patient Portals | Telehealth | Insurance & Benefits Systems