Dynamic healthcare professional with a proven track record at Children Hospital of Philadelphia, enhancing patient satisfaction and care quality. Excelled in customer relations and documentation management, achieving significant improvements in complex case handling. Skilled in Microsoft Office, adept at fostering inter-departmental collaboration for strategic program development.
Overview
24
24
years of professional experience
Work History
Case Management Support Specialist
Children Hospital Of Philadelphia
Philadelphia, US
12.2021 - Current
Implemented strategies to improve accuracy, quality, and patient satisfaction for complex, high-volume assignments
Provided complex care planning, and case management to clients
Worked closely with managers and team members, evaluating for improving performance of direct services, contributing to strategic program planning and development
Referred clients to appropriate team members, community agencies and organizations to meet treatment needs
Communicated with supervisor regarding issues related to case management, resourcing, service collaboration and development of new resources
Analyzed complex cases involving multiple family members or special circumstances such as disabilities or long-term care needs
Identified discrepancies or inconsistencies in documents submitted by clients and requested additional evidence as needed
Lead Patient Service Coordinator
University of Pennsylvania
Philadelphia, US
05.2016 - 11.2021
Verified patients' eligibility and claims status with insurance agencies
Determined prior authorizations for medication and outpatient procedures
Examined patients' insurance coverage, deductibles, possible insurance carrier payments and remaining balances not covered under their policies when applicable
Processed invoices, credit memos, and payment requests in accordance with company policies
Maintained records of customer payments, refunds, and credits
Collaborated with other departments to resolve billing errors and discrepancies
Conducted detailed interviews with applicants to assess their needs and provided assistance in completing application forms
Verified income levels, assets and other pertinent information from a variety of sources including tax returns, pay stubs, bank statements and Social Security documents
Health Unit Coordinator
Einstein Medical Center Philadelphia
Philadelphia, US
09.2000 - 10.2014
Worked medical/surgical units, Intensive care, Telemetry, Mother/baby unit, Oncology, Emergency Department
Performed billing and coding procedures for ambulance, emergency room, impatient and outpatient services
Provided care for 50-patient unit, coordinating day-to-day hygiene, feeding and quality of life functions
Prepared patient charts for patient transfers by copying and organizing required documents according to specific criteria
Collaborated with several interdisciplinary departments to coordinate care of inpatients
Served as a liaison between physicians, nursing staffs, insurance companies and other healthcare providers to ensure timely processing of claims