Highly organized, accomplished administrative professional with experience in the health care operations for over 27 years. I proactively approach business challenges, apply critical thinking skills and persistence teamwork with resourcefulness to achieve positive results. I can quickly cultivate relationship with very difficult members and influential decision makers. I have developed excellent time management skills with the ability to multi-task.
Overview
29
29
years of professional experience
1
1
Certification
Work History
Member Services Coordinator
Kaiser Permanente Camp Springs/Marlow Heights
Camp Springs/Marlow Heights
11.2015 - Current
Serve as primary contact for services for members and center leadership for escalations and direction regarding complex member Issues
Provide quality assurance through monitoring Member’s documentation for accuracy and compliance
Collaborates with manager on strategic department initiatives as well as provides input on individual Member Service Reps performance
Serves as the primary resource expert for information about all Kaiser Permanente products, benefits and policies
Partners with Patient Financial Service, Membership Administration, Claims and other regional business partners to quickly resolve member issues/concerns and improve patient satisfaction and retention
Assist members in resolving problems, including clarification of benefits, appointment access, medical referrals, payment of claims, and concerns about quality of care and service to ensure that service standards are met in compliance with applicable state and federal regulations
Facilitates resolution of member’s claims, including orienting members, communication with appropriate claims and external providers, track status of pending complaints and follow up as needed to expedite completion of a claim.
Position required me to lead, train and mentor Provider Management Schedulers
Ensured timely activation of provider schedules and make updates in the appropriate systems to satisfy access management initiatives
I performed and monitor quality checks and documentation in accordance with the PSMD Quality Program
Assist in the development and implementation of departmental process and procedures, focus on areas that needed improving, assist with training and retraining of staff
Give support to the Provider Schedulers by answering staff questions, resolving problems raised by providers and clinical staff
Also assist PSMD Schedulers with schedule management tasks as needed.
Collaborate regularly with leads, Clinic Coordinators and Service Chiefs to select appropriate provider profiles used to build, adjust and edit provider schedules into PASS system and ensure adequate appointments are activated to meet demands, and within specified time frame and deadlines
I was responsible for creating and maintaining provider planners and profiles and coordinating process for inputting Providers schedules.
SURGERY SCHEDULER COORDINATOR
Kaiser Permanente
Kensington, MD
06.2002 - 12.2005
Coordinates scheduling between members, surgeons, external providers, Kaiser Permanente and/or non-Kaiser Permanente Contracted facilities and vendors according to established surgery scheduling protocols and policies
Schedules surgeries utilizing established scheduling guidelines with consideration of factors such as historical procedure length and operating room availability
Collaborates and partners proactively with surgeons and departmental chiefs to ensure that surgeries are accurately scheduled in timely and effectively manner
Initiates and maintains contact with member throughout the scheduling process; conveys information concerning date of surgery and related appointments; refers medical related questions to the appropriate healthcare team or provider
Assures that durable medical equipment that will be needed by patient is available.
MEDICAL ASSISTANT-INTERNAL MEDICINE DEPARTMENT
Kaiser Permanente
Kensington/Camp Springs, MD
10.1998 - 06.2002
Job duties assigned were to check the patients into the Internal Medicine Department and collect co-payments, also to take Vital Signs and to assist with providers call backs and enter encounters for Providers
Make patients follow-up appointments as needed.
MEDICAL ASSISTANT-MEDICAL ACUTE CARE CLINIC
EMSA/National Naval Medical Center
Bethesda, MD
10.1994 - 10.1998
Worked with 3 staffs Physicians and 3 Interns to ensure orderly flow and care for over 100 patients per day, in the Emergency Room clinic area
Assist with the daily task of the clinical unit.
Education
Bachelor of Business Administration - Business Administration And Management
Colorado Technical University
Colorado Springs, CO
06-2024
Certification
Associate in Art in Business Administration since March 2017
Bachelor’s degree in Business Administration June 2024
Professional References
Dr. Thomas Chang, Kaiser Permanente, Thomas.chang@kp.org, 240-848-2296
Carolyne Mukabane Kaiser Permanente carolyne.k.mukabane@kp.org 240-619-6280
Martha Meade Kaiser Permanente martha.m.meade@kp.org 703-473-6237
Patient at Patient FinancialAdvisor, Kaiser Permanente Eligibility and FinancialServices, FinancialAdvisor, Kaiser PermanentePatient at Patient FinancialAdvisor, Kaiser Permanente Eligibility and FinancialServices, FinancialAdvisor, Kaiser Permanente