TONI L. TAYLOR

• Year 1 - Build consumer centricity by serving in-role in multiple consumer-facing areas during first year of program
• Year 1 - Understands priorities and performance metrics such as Quality, Schedule Adherence, After Call Work, Service Levels, Customer Satisfaction, and other performance metrics
• Year 1 - Analyze consumer experience; gather, document and present findings to enterprise leadership
• Year 1 & 2 - Work in cohort teams to develop and propose solutions to enhance the member experience
• Year 1 & 2 - Participate in leadership and professional development curriculum, including technical skills training, speaker series, networking opportunities and additional enrichment activities
• Year 2 - Understands operational problems using defined processes, expertise, and judgment
• Implements strategies to improve operational performance including call management, call back rate, transfer rate, quality, and United Experience Survey
• As needed, prepares, delivers, and manages remediation plans
• Year 2 - Assist with ad-hoc projects that impact the consumer experience for leaders in each area

Additional Information Regarding this Program:

• · Rotation 1-CSGP

-Initiate and process authorizations for cancer related diagnosis for Providers

-Provide status of existing claims

• Mock Project-123 call Center

-Improve Employee satisfaction results from previous year

• Claims Specialty Group

-Improve current process to get claims paid sooner by implementing new workflow process that excludes judgement-based tasks from Intake department.

• Proactive engagement

-Identify opportunities across the health care professional’s journey and communicate them effectively and efficiently in the right way, at the right time, via the right channel before they need to utilize our services in a reactive fashion.

• Deliver quality care according to facility policy with full knowledge of Resident’s rights
• Kept digital records of patient details, medications, billing and other activities.
• Document care
• Take and record vital signs as ordered
• Assist residents with ambulation
• Assist with lifting using proper body mechanics and /or mechanical assistance
• Offered support for client mental and emotional needs to enhance physical outcomes and overall happiness.
• Participate in activities with residents
• Accompany residents on outings
• Assisted patients with dressing, grooming and feeding needs, helping to overcome and adapt to mobility restrictions.

• Schedule ICT Meetings between Care Coordinator and Provider
• Take inbound calls
• Research records to obtain current contact information
• Assist Care Coordinators to ensure Members concerns and/or questions are answered and/or resolved
• Process all fax requests
• Preceptor for new hires
• Initiate requests for ID cards and mailing materials
• Check daily reminders for Care Coordinators
• Selected participant for EMS audit

• Maintain inventory and replenish central supplies
• Maintain all office supplies for Nursing and Administrative Staff
• Evaluates and develops/recommends appropriate health information forms to meet federal requirements and corporate compliance
• Created effective auditing system including all active and discharge charts
• Created 48-hour audit on all new admissions as plan of correction for CMS
• File medical records and maintain organized filing system for active and discharge charts
• Process all medical record requests
• Responsible for medical record storage and destruction of records
• Coordinate chart activity between medical offices, clinics, labs, hospitals, and facility
• Analyze documentation omissions and obtains compliance from responsible staff
• Assist DON with attendance and payroll editing
• Assist DON with follow up of quarterly deficiencies found upon review
• Conduct interviews when tasked, check employment references
• Maintain credentials from Physicians and Service Providers
• Prepare and maintain all medical records and documentation according to policy
• Collaborate with office staff to ensure chart compliance
• Code invoices for payment
• Maintain Resident admission and discharge register
• Maintain adequate staffing to ensure quality patient care
• Complete daily as works and monthly schedule
• Ensure Physicians conduct visits as required by CMS
• Prepare reports for deficient practices
• Assist Compliance Officer and Clinical Director with amendments made to assessment tools and audits
• Check UB-04’s for billing accuracy at end of month
• Coordinate annual inspection of equipment utilized
• Negotiated policies and contracts with vendors to achieve optimal pricing and consistent availability