Verona Blossom
Owyhee,NV
Summary
Dedicated with professional experience gained through my employment with the federal and tribal governments. Dependable candidate successful at managing multiple priorities with a positive attitude. Willingness to take on added responsibilities to meet organizational goals. Ready to help achieve goals in any position.
Overview
22
22
years of professional experience
Work History
Purchased/Referred Care Manager
Shoshone-Paiute Tribes
07.2013 - 01.2024
- Established and maintained effective communication with PRC staff, physicians and beneficiaries to promote high quality patient care.
- Developed strong rapport with patients and families through empathetic listening and compassionate communication techniques. Followup with patient outcomes.
- Facilitated family meetings to address concerns, establish goals of care, and provide PRC financial support and understanding of utilizing alternate resources, Medicare, Private Insurance, and Medicaid.
- Managed PRC filing system, vendor and patient care financial records.
- Streamlined care coordination processes in coordination with PRC staff, resulting in timely referrals and access to appropriate resources.
- Handled sensitive financial information with discretion, adhering to strict confidentiality policies at all times.
- Improved patient satisfaction through effective communication and collaboration with interdisciplinary healthcare teams, including non-tribal providers.
- Resolved outstanding account issues through effective communication strategies toward each unique situation.
- Recruited, hired and trained PRC staff, providing direct supervision, ongoing staff development and training needs of employees.
- Completed forms, reports, and records to handle documentation to assist Clinical Director with funding requests.
- Optimized office workflows by organizing files, managing databases, and updating essential documents as needed or requested by colleagues or management team members.
- Served as a liaison between patients, families, physicians, insurance providers, and other healthcare professionals for care coordination efforts.
- Managed accounts payable and receivable, ensuring timely payments and accurate processing of payable transactions. Receivable payments received from providers for reimbursements from primary payor updates and Catastrophic Health Insurance Fund payments.
- Utilized electronic health records systems proficiently for efficient retrieval of provider documentation of clinical information according to regulatory standards.
- Enhanced financial accuracy with thorough record keeping and data tracking.
- Participated in PRC committee meetings and trainings to stay updated on best practices and new developments in care management.
- Reduced budget discrepancies by conducting regular audits prior to payment requests being processed by Financial Management staff.
- Established and maintained relationships with clients, families and community partners to coordinate services to meet client's needs.
- Purchased new accounting software to calculate Medicare Like Rate on all PRC medical claims processed.
- Developed Provider Contract for Medicare Like Rate software.
- Prepared PRC Fiscal Year Budget for Patient Care and Administrative projections.
- Routinely reviewed expenditures and funding status of PRC Accounts.
- Modified Revenue Expenditure Spreadsheet when necessary to stay within budget.
- PRC financial functions; Accounts Payable and Receivable, Time and Attendance, Inventory management, reports and financial documents, record keeping, compliance with financial controls.
- Monitoring PRC financial system; PRC utilized RPMS/ Contract Health system to initiate purchase orders from each individual claim received which tied directly to a PRC authorized referral.
- PRC workflow for medical claims consisted of internal controls; authorization to initiate PRC purchase order, prepare spreadsheet identifying each PO, amounts for payment, the MLR savings and amount paid by third party. Data entry of same information to Microix, figures balanced with payment request for authorized approval and submission to Financial Management for payment to each vendor identified.
- Developed Accounting Codes to utilize in the PRC payment process. Codes identified in the Microix financial system for accurately identifying appropriate funding codes for each specific medical procedure, accordingly.
- Files Management of financial records in vendor and individual patient files in preparation of audits and retrieval of documents when necessary.
- Monitored the positing of each transaction to the RPMS/CHS system.
- Prepared financial documents; purchase order requests, payment requests, requisitions, travel, travel reimbursements, vendor contracts, justifications to support requests, etc.
- Coordinated referrals to specialists, hospitalizations, ER visits, ancillary testing, and other enabling services for patients.
- Established excellent rapport with various non-tribal patient financial offices in coordinating benefits on behalf of patients.
- Coordinated case management with other healthcare professionals to develop comprehensive patient care plans and provide highest quality of care.
- Collaborated with insurance providers to secure authorization for necessary services, maximizing patients'' benefits coverage.
- Worked closely with Tribal Financial Accounts Payable staff member to clarify documents in question.
- Arranged transportation and documented details of discharge transition plans.
- Communicated with healthcare providers to facilitate continuity of care.
- Maintained strict adherence to professional ethics and confidentiality guidelines, safeguarding sensitive information and promoting trust.
- Successfully negotiated provider contracts and renewals to create effective patient care.
- Learned and adapted quickly to new software applications; Microix (Financial), Nextgen (EHR) and Nivonyx (PRC Accounts Payable).
Legal Administrative Specialist
DOI, Bureau Of Indian Affairs
01.2002 - 05.2013
- Managed the Real Estate/Probate Estate Services Program for the Department of Interior,Bureau of Indian Affairs at the Western Nevada Agency Carson City, Nevada from November, 2011 to May, 2013. Puget Sound Agency, Everett, Washington from December, 2009 to November, 2011. Eastern Nevada Agency, Elko, Nevada from, 2002 - 2009.
- Prepared and processed all probate transactions; Pre-Case Preparation; identify assets/resources of an identified decedent. Case Preparation; identify family history of all potential heirs with supporting legal documents. Case Adjudication; submit case documents to Administrative Law Judge for Probate Hearing. Case Closing; transfer ownership of landownership to legal heirs and estate distribution of any funds identified to legal heirs.
- Case Preparation document collected consisted of birth certificate, death certificate, assets, property inventory, individual Indian monies account data, last will and testaments, claims filed against an estate, marriage, divorce and other family history information.
- Attended probate hearings.
- Worked closely with the Office of Special Trustee and Office of Land Titles and Records.
- Managed sensitive client information with discretion and confidentiality, maintaining trust between clients and the federal organizations handling each probate case.
- Prioritized and handled multiple assignments and maintained agency commitment to deadlines.
- Probate Backlog was a priority and each agency was provided their caseload deadlines.
- Coordinated extensive geneology research by contacting federal, state, tribal and family contacts in search of heirs.
- Probate cases were assigned from the Probate Caseload Reduction Project of the BIA and OST agencies.
- Accurate and timely filing of case closing documents was imperative.
- Reduced errors in legal documents by meticulously proofreading and editing drafts before submission.
- Produced and filed various legal documents and electronically preserved updated case record system.
- Streamlined legal document processing by implementing efficient filing and organizational systems.
- Arranged for delivery of legal correspondence to clients, witnesses, and court officials.
- Developed and maintained positive relationships with clients and colleagues.
- Conducted research on legal cases and prepared summaries for Administrative Law Judge assistant.
Education
Various Certificates -
Great Basin College
Elko, NVCertificate of Accomplishment - Business
Lamson Business College
Phoenix, AZ06.1977
High School Diploma -
Owyhee Combined Schools
Owyhee, Nevada06.1974
Skills
- Records Management, retrieval of documents
- Resource Utilization, third party insurance payors
- Staff Supervision, five employees
- Financial Operations in coordination with Financial staff
- PRC Process Implementation, Referrals and Claims
- Personnel Recruitment
- Discharge Planning in coordination with case manager
- Referral management in coordination with PRC staff
- Budget Development
- HIPAA Guidelines and Compliance
- Health Information System, Electronic Health Records and NextGen
- Records Maintenance
- Clinical Documentation by Providers to effectively initiate referral process
- Human Resource, providing documents for hiring employees
- Resource Monitoring, third party utilization by providers
- Budget Planning, Patient Care and Administrative
- Employee Work Scheduling, Time and Attendance tracking
- Workflow Coordination
- Medical Terminology
- Insurance Verification
Additional Information
Various Certificates received: Security Awareness, Medicare Like Rate Training, AIPRA training, Privacy Act & FOIA training, Records Management, Discrimination and whistleblowing in the workplace, Federal Information Systems Security Awareness, TAAMS Realty training, Wills and Trust Reform Training, Travel Regulations Training.
Awards; Cash, 2012, 2011, 2009, 2007, Time Off Award, 2006, Group Cash Award and Time Off, 2004, Letter of Appreciation, Administrative Law Judge, 2010 & 2004.
Detailed Work Assignment to assist with special probate project/backlog, 2006.
Timeline
Purchased/Referred Care Manager
Shoshone-Paiute Tribes
07.2013 - 01.2024
Legal Administrative Specialist
DOI, Bureau Of Indian Affairs
01.2002 - 05.2013
Various Certificates -
Great Basin College
Certificate of Accomplishment - Business
Lamson Business College
High School Diploma -
Owyhee Combined Schools
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