Sarai Cruz
Kansas City,KS
Overview
4
4
years of professional experience
Work History
Care Coordinator
Ilumifin
02.2023 - Current
- Review 3+ medical records per claimant to determine benefit eligibility
- Complete clarification call 2-5x/day with external providers or power of attorney (POA) to obtain medical records and/or address discrepancies
- Monitor, track, and update aged claims (6+) daily to match benefits to insured care needs
- Educate power of attorney and/or insured of benefits and claim process 2x/day
Care Coordinator
Dedicated Senior Medical Center
02.2022 - 09.2022
- Reviewed and tracked internal and external referrals for two markets
- Verified patient insurance and produced insurance authorizations
- Uploaded patient results/progress reports to their profiles
- Advocated for patients while scheduling/rescheduling appointments on a daily basis
- Met with the care team every morning to discuss our works and determine future approach
Outreach Case Manager
Swope Health Services
10.2020 - 10.2021
- Introduced designating screening days for a team of 3, optimized team flexibility and efficiency
- Screened 1-3 patients a week to determine Hospital Diversion program eligibility; once enrolled, strategized a personalized course of action after patient initiation into Hospital Diversion program
- Coordinated care with internal and third-party health providers 1-4 times a day
- Guided participants with connecting to new community resource 1-5 a week
Community Support Specialist
Swope Health Services
08.2019 - 10.2020
- Managed caseload of 25 adult participants or more per month
- Developed 1-5 care plans per month with participants based on personal strengths/weakness
- Educated patients regarding resource options and provided consistent support to promote participant independence, 20% of caseload attained personal goals and no longer needed case management within 12 months
- Recorded 3-5 participant progress notes per day, evaluated patient progress and necessary action required to achieve care plan goals
- Networked 3-5 a week to access new resources suitable to participant needs
Education
Bachelors in Health Sciences -
University of Missouri Kansas City
Kansas City, MO05.2019
Associate of Arts -
Donnelly College
Kansas City, KS05.2016
Skills
- Communication
- Cross-functional teamwork
- Time management
- Organization
- Patient services
- Technologically proficient
- Problem-solving
- Hybrid/Remote work
- Medical terminology
- Self-management
- Multi-task
- Outreach
- Advocacy
Accomplishments
- Devised an 11 topic process document for the Hospital Diversion program to utilize for onboarding employees
- Managed the Hospital Diversion program while Supervisor was on leave on two separate occasions for one week each time
- Pulled St Louis, MO 15 rank to 3 within ChenMed markets
Timeline
Care Coordinator
Ilumifin
02.2023 - Current
Care Coordinator
Dedicated Senior Medical Center
02.2022 - 09.2022
Outreach Case Manager
Swope Health Services
10.2020 - 10.2021
Community Support Specialist
Swope Health Services
08.2019 - 10.2020
Bachelors in Health Sciences -
University of Missouri Kansas City
Associate of Arts -
Donnelly College
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