Talonya Abebe
Griffin,GA
Summary
Patient-focused Care Coordinator equipped with administrative and customer service expertise. Helps keep healthcare services proceeding smoothly by coordinating communications, referrals, and policy enforcement. Talented in finding balanced solutions and resolving conflicts.
Overview
29
29
years of professional experience
Work History
Care Coordinator
Optum Services
Minnetonka, MN
08.2022 - Current
- Assist MSCs with difficult questions they encounter on their calls
- Use contract resources to provide appropriate responses to questions from the front-line staff
- Handle and resolve escalated issues when appropriate
- Assist in inbound and outbound queues as needed to control work volume
- Report and assist with escalated issues as appropriate
- Assist RN in the Triage department with Military Families
- Follow Orders of operation
- Locate Military Treatment Facility
- Schedule appointments with PCM, ED or Urgent Cares
- Submit Referrals.
Member Engagement Coordinator
Signify Health
Dallas, Texas
10.2021 - 02.2022
- Assign and Schedule contracted provider for each confirmed evaluation
- Adjust and reset appointments scheduled as required
- Building strong connections to primary care providers and community resources
- Sales.
Outbound Contact Representative
Humana Healthcare
Deerfield Beach, Florida
05.2021 - 09.2021
- Making outbound calls to health plan members to coordinate and schedule in home one on one health assessments
- Follow up with members and ensure member inquiries are complete
- Sales.
Customer Service
Sutherland HealthCare Solutions (BlueCross BlueShield)
Pittsford-Victor, NY
07.2020 - 12.2020
- CSR Handling customers questions on Health Benefits
- Communicate with Providers on Claims and Benefits
- Research Pharmacy, Dental, Vision Plans and Referrals.
GI-Tech/ Registration/ Billing and Coding
Passavant Hospital
Allison Park, PA
01.2011 - 06.2012
- Front desk, administrative duties, billing and coding
- Scheduled follow-up appointments post procedure
- Contacted insurance carrier to verify coverage of insurance
- Assisted with billing and collections
- Created and maintain patient charts- filing
- Collected biopsies, assist with colonoscopy and endoscopy
- Perform vital signs and administered medication
- Review Medical Records
- Work closely with providers and ancillary staff to ensure that all aspects of patient care were addressed prior to patient discharge
- Follow up calls to patients post procedure as needed (wellness, courtesy, and business needs calls as needed.
Certified Nursing Assistant
John J. Kane Regional Hospitals
Allison Park, PA
01.2006 - 12.2010
- Perform Patient Care, vital signs
- Charting
- EKG, Phlebotomy
- Answered patient call lights
- Assisted nurses with minor procedures
- Assisted patients with activities of daily living
- Assisted receptionist with chart retrieval and maintenance
- Notified nurse of immediate changes and or needs of patient(s).
PCA
West Penn Hospital
Pittsburgh, PA
01.2002 - 01.2006
- Takes vital signs and records the information
- EKG
- Phlebotomy
- Helps assist patients with daily needs.
Customer Service Representative
Mellon Bank
Pittsburgh, PA
01.1995 - 06.1998
- Answered customer questions, by helping resolve problems, offered a variety of services that were listed
- Assisted customers with concerns regarding their accounts and redirected them to the appropriate financial representative or associate
- Answer phone calls.
Education
Bachelor's in HealthCare Administration -
Southern New Hampshire University
06.2019
Diploma in Medical Billing and Coding -
Penn Foster College
07.2012
Certified Nursing Assistant Training and Certification -
Vincentian Skilled Nursing Facility
Skills
- Microsoft Word
- Microsoft Excel
- Adobe Reader
- Outlook
- Facets
- Maces
- Genesis
- Billing and coding- ICD-9 and ICD-10/CPT II coding
- 10 key calculation
- Ledgers
- Data entry
- Charting
- Data monitoring
- Typing
References
References available upon request.
Timeline
Care Coordinator
Optum Services
08.2022 - Current
Member Engagement Coordinator
Signify Health
10.2021 - 02.2022
Outbound Contact Representative
Humana Healthcare
05.2021 - 09.2021
Customer Service
Sutherland HealthCare Solutions (BlueCross BlueShield)
07.2020 - 12.2020
GI-Tech/ Registration/ Billing and Coding
Passavant Hospital
01.2011 - 06.2012
Certified Nursing Assistant
John J. Kane Regional Hospitals
01.2006 - 12.2010
PCA
West Penn Hospital
01.2002 - 01.2006
Customer Service Representative
Mellon Bank
01.1995 - 06.1998
Bachelor's in HealthCare Administration -
Southern New Hampshire University
Diploma in Medical Billing and Coding -
Penn Foster College
Certified Nursing Assistant Training and Certification -
Vincentian Skilled Nursing Facility
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