Designed and implemented sourcing and recruiting plan for support division; including reconstructing assessment protocol and thresholds, establishing realistic timeframes, and managing communication between all parties.

Source, screen, and identify qualified candidates within Service Level Agreements and Recruiting Metrics

Processed custom/specialized provider contracts including Group agreements, works with internal departments to facilitate new/re- contracting efforts for all networks in defined health service area.

As a recruiter, I am responsible for prospecting new candidates. This would include prospecting for newrecruits, building relationships with field associates, working on open job orders, ensuring facility and MSN compliance is maintained, and providing excellent customer service. I maintainprofessional follow-up and quality assurance consistent with MSN policies, procedures, and standards

Respond to a high volume of incoming calls from patients, clinics and insurance companies regarding claims discrepancies, policies, procedures, and payments. Process patient and clinic correspondence and research billing questions.Key Results:Accurately collect record and ensure distribution of patient information to appropriate staff. Coordinate internal and external phone communication among staff, patients and providers. Perform clerical, scheduling and record… Show more Respond to a high volume of incoming calls from patients, clinics and insurance companies regarding claims discrepancies, policies, procedures, and payments. Process patient and clinic correspondence and research billing questions.Key Results:Accurately collect record and ensure distribution of patient information to appropriate staff. Coordinate internal and external phone communication among staff, patients and providers. Perform clerical, scheduling and record keeping activities, often simultaneously, in support of patients and staff. Provide information regarding financial assistance policies, registration requirements and referral resources. Show less

The role of the Referral Coordinator is to process all medical and dental referrals, this may include referrals from teen health clinics if appropriate. Referral process will include all managed care referrals for clients enrolled in Healthy Options, the Basic Health Plan and CHIP, sliding scale client referrals and other third party payer referrals.Key Results: Process and prioritize referrals received from providers and provider teams. Ensure that referrals are… Show more The role of the Referral Coordinator is to process all medical and dental referrals, this may include referrals from teen health clinics if appropriate. Referral process will include all managed care referrals for clients enrolled in Healthy Options, the Basic Health Plan and CHIP, sliding scale client referrals and other third party payer referrals.Key Results: Process and prioritize referrals received from providers and provider teams. Ensure that referrals are addressed in a 48 to 72 hour time frame. Screen for eligibility and assist patients in completing required forms for Project Access of Northwest. Submit referral request to appropriate insurance plans for prior authorization. Assist clients when necessary in problem solving potential issues related to the health care system, i.e. may include language or transportation barriers/services. Show less

Ensured all clinician visit needs are appropriately scheduled, to meet the agency’s patient care and service needs and in accordance with physician orders, agency standards and regulatory requirements. Processed and maintained all inbound and outbound correspondences.Key Results: Coordinated the scheduling of clinical visits with physician approved orders. Processed spend down reports for all billing invoices and supply orders. Prepared reports for scheduling… Show more Ensured all clinician visit needs are appropriately scheduled, to meet the agency’s patient care and service needs and in accordance with physician orders, agency standards and regulatory requirements. Processed and maintained all inbound and outbound correspondences.Key Results: Coordinated the scheduling of clinical visits with physician approved orders. Processed spend down reports for all billing invoices and supply orders. Prepared reports for scheduling tracking and participated/lead agency meetings to ensure patients associate scheduling needs are met. Maintains employee personnel files, making sure all expireables documents, drivers’ license, car and professional licenses are current and up to date. Show less

Create and manage work schedules for internal medicine physicians. Received no instructions on routine work and general instructions on new projects. Daily use of Microsoft Outlook, Excel, OneNote and Amion.Key Results: Provide advance administrative support for medical chiefs and medical directors. Conduct routine schedule maintenance and yearly/quarterly audits for six medical clinics for a combined 99+ physicians. Manage payroll submissions, sick leave, vacation, jury… Show more Create and manage work schedules for internal medicine physicians. Received no instructions on routine work and general instructions on new projects. Daily use of Microsoft Outlook, Excel, OneNote and Amion.Key Results: Provide advance administrative support for medical chiefs and medical directors. Conduct routine schedule maintenance and yearly/quarterly audits for six medical clinics for a combined 99+ physicians. Manage payroll submissions, sick leave, vacation, jury duty, FCA and FMLA request Maintain a constant and open line of communication, via telephone and email with medical providers Travel to multiple medical facilities and locations Show less

Manage a high-volume workload within a deadline-driven environment. Resolved an average of 250 inquiries in any given week and consistently met performance benchmarks in all areas (attendance, speed, accuracy, productivity and compliance).Key Results: Answer questions from patients regarding, medical benefits, enrollment/disenrollment, billing, claims processing, referrals, Sales and complaints via letter, e-mail and phone correspondence. Review and interpret medical… Show more Manage a high-volume workload within a deadline-driven environment. Resolved an average of 250 inquiries in any given week and consistently met performance benchmarks in all areas (attendance, speed, accuracy, productivity and compliance).Key Results: Answer questions from patients regarding, medical benefits, enrollment/disenrollment, billing, claims processing, referrals, Sales and complaints via letter, e-mail and phone correspondence. Review and interpret medical contracts, CPT and ICD coding. Extensive knowledge of medical terminology and Medicare, HMO and Options lines of business Communicate with multiple departments regarding, sales, claims denials, prescription cost, authorizations and appeal inquiries. Show less

Fulfill a broad range of human resource functions including recruiting, new employee training, filing and managing employee records. Support sales representatives in opening new accounts, upgrading and deactivating services. Answered question directly related to website technical issues and navigational problems.Key Results: Awarded employee of the month and received, outstanding positive comments on employee reviews, as well as exceptional feedback from senior… Show more Fulfill a broad range of human resource functions including recruiting, new employee training, filing and managing employee records. Support sales representatives in opening new accounts, upgrading and deactivating services. Answered question directly related to website technical issues and navigational problems.Key Results: Awarded employee of the month and received, outstanding positive comments on employee reviews, as well as exceptional feedback from senior management. Manage front-end operations to ensure friendly and efficient membership enrollment and disenrollment Answer question for members via, letter, e-mail and live chat sessions Adapted to diverse work styles and consistently provided friendly, personable service. Show less