S. Bianca Whyte
Haiku,Hi
Summary
Healthcare Administrator with proven to deliver exemplary level of healthcare service delivery to patients. Coordinate admission and discharge of patients. Plan and implement strategies for developing improved health care management. Proven problem solver and excellent communicator. Strong organizational skills, superb understanding of data collection and performance metrics.
Overview
10
10
years of professional experience
Work History
Clinic Administrator/Testing Site Manager
Minit Medical Urgent Care
10.2020 - Current
- Manage data related to testing operations, generate reports, and present daily reports to the Department of Health, Medical Directors, and other stakeholders
- Responsible for managing the clinic's billing and insurance processes, including submitting claims to insurance companies, tracking payments, and resolving billing issues
- Process Workers Compensation, Insurance, and patient payments, including processing credit card payments and reconciling cash accounts
- Manage correspondence with patients, insurance companies, and other payers
- Ensure smooth and efficient testing operations by coordinating with testing technicians to maintain testing supplies and equipment
- Supervise testing site personnel, including testing technicians and administrative staff
- Conduct telephone interviews with COVID positive patients for contact tracing, monitoring symptoms, or providing guidance on self-isolation and care
- Managed mail and document tasks through digital medical record system.
Provider Services Representative
AlohaCare
09.2016 - 10.2020
- Conduct provider contracting, including contract language negotiation, rate exception negotiation, and provider utilization reporting
- Provide provider education on AlohaCare Medical policies, state and federal Fraud, Waste and Abuse guidelines, provider due diligence, and other contractual provider responsibilities
- Recruit providers and coordinate provider network development
- Serve as the main point of contact for provider concerns, provider grievances, member benefits, provider incentive programs, and other areas of provider concern for 80% of AlohaCare Maui County Providers
- Participate in AlohaCare interdepartmental special projects related to CMS, Med-Quest, and internal initiatives
- Coordinate and represent AlohaCare at external provider and community events.
Customer Service Representative
10.2015 - 09.2016
- Answered inbound calls for all AlohaCare lines of business
- Facilitated provider escalations to AlohaCare Claims Department regarding provider issues such as Claim Call Tracks, Claim Adjustments, and Member enrollment/Third Party Liability Coverage
- Assisted Sr
- Call Center Specialist in training and mentoring of new hires
- Aided AlohaCare members in PCP selections and reassignments in accordance with QUEST and AlohaCare policies
- Responded to all incoming inquiries relating to member benefits, eligibility, access to care.
Customer Service Agent
Haleakala Bike Company
02.2015 - 09.2015
- Responded to communications from customers, travel agents, and referral networks concerning reservations by telephone, fax, or through a central reservation system
- Created and maintained reservation records, prepared letters of confirmation, and processed any cancellations and modifications
- Handled sales, returns, and credit card transactions, including operating cash registers and POS systems
- Ensured that all customers filled out appropriate waivers and other forms prior to embarking on the tour.
Customer Service Representative
Maximus-Linium Staffing
06.2013 - 08.2014
- Provided assistance to consumers seeking health care coverage, including providing information on financial assistance and public health programs
- Processed applications for health care coverage via the telephone, including building tax household, household income, eligibility determinations, and interpreting determinations made by the D.C and Ct
- HBE system
- Processed enrollments into QHPs, plan changes, and disenrollments
- Assisted brokers and navigators with inquiries and eligibility and enrollment issues as appropriate.
Education
Associates Degree - Biology
Hunter College of CUNY
2002
Skills
- Operational Efficiency
- Code Compliance
- Healthcare Regulations
- Resource Monitoring
- Accounts Payable and Accounts Receivable
- Facility Policies and Procedures
- Training Junior Team Members
- Health Information Systems (HIS)
- Customer Relationship Management
- Inventory Control Processes
Timeline
Clinic Administrator/Testing Site Manager
Minit Medical Urgent Care
10.2020 - Current
Provider Services Representative
AlohaCare
09.2016 - 10.2020
Customer Service Representative
10.2015 - 09.2016
Customer Service Agent
Haleakala Bike Company
02.2015 - 09.2015
Customer Service Representative
Maximus-Linium Staffing
06.2013 - 08.2014
Associates Degree - Biology
Hunter College of CUNY
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