Case management /Discharge PLANNER Resume Washington, DC - Hire IT People

SUMMARY:

Knowledgeable, trustworthy, and dependable professional, seeking growth in Health Services environment where I can utilize my energy, creativeness and multi - tasking skills.

TECHNICAL SKILLS:

Windows XP and Windows Vista
Excel, Outlook, PowerPoint, Word
Acrobat
Adobe Reader
Internet Explorer / Web Navigation / Internet Research

PROFESSIONAL EXPERIENCE:

Confidential, Washington, DC

Case management /Discharge PLANNER

Responsibilities:

Uses “Softmed” to update hospital departments re: post hospital care referrals, provider contacts, and other related information
Coordinates patient care activities in collaboration with other hospital departments, physicians, staff, patients, and visitors
Assesses patients’ insurance/financial status to facilitate appropriate discharge planning
Participates in quality improvement and risk management activities in order to provide effective and efficient patient care
Serves as communication liaison between clinical case managers, social workers, and on-site reviewers
Interacts daily with healthcare payers, pre-cert, PT/OT, and social worker/clinical case managers
Updates several commercial insurance logs daily and interact with insurance providers
Attends multi-disciplinary and hospitalist rounds on the nursing unit floors as scheduled
Places orders for post hospital care and verifies that care is secured prior to discharge and obtains medical records for patient referrals
Monitors utilization review line daily to communicate with insurance companies’ requests
Calls in clinical information to insurance companies for authorizations, as requested
Coordinates patient denials, claims, and discharge planning
Involved in designing new systems/processes to prevent Medicare beneficiaries’ 30-day readmissions and bed status changes
Audits the department’s direct and indirect patient care providers files to ensure it meets the Joint Commission standards of human resources definition
Train the department staff on the use of new performance technology software and systems implemented
Identify potential issues that will delay progress and recommend corrective action strategies
Prepares reports, documenting relevant information and statistics as directed
Guides patients and their families toward and facilitate interaction with resources appropriate for the care and well-being of patients

Confidential, Alexandria, VA

Intern

Responsibilities:

Provided general administrative support to Physicians, Nurse Practitioner, RN’s, and patients in a high volume urgent care clinic
Attended staff meetings and responded to issues raised, responsible for prioritizing between patient demand and services/providers, and coordinating appropriate health services assistance
Performed clerical duties including filing patients charts, removing terminated employees files from active files, and calling medical assistant externs to schedule appointments for interview
Contacted insurance companies for patients verification & eligibility, and called patients to verify their medical results
Oversaw patient satisfaction surveys and evaluated waiting times experienced by patients; documented, analyzed, and reported findings to clinical services team members in order to reduce patient waiting time periods in the clinic
Updated current process of the clinics referral system to local hospitals for patients in need of special assistance
Retrieved, reconciled, and conducted daily log of monetary funds from co-payment and self-pay patients

Confidential, Alexandria, VA

Assistant Manager/Host

Responsibilities:

Provide superior customer service in order to increase customer satisfaction while providing a restaurant-quality dining experience
Recruit, train and monitor staff
Plan work schedules for individuals and teams
Deal with customer complaints and comments
Address problems and troubleshooting
Attend meetings with heads of department to coordinate and monitor the progress of business strategies
Set and achieve sales and profit targets
Maintain statistical and financial records
Set tables according to type of event and service standards
Record transaction in system at time of order
Complete closing duties, including restocking items and inventory management
Train new staff members on system, processing payment, and adhering to quality standards
Develop and maintain positive and professional working relationships within a team setting

Confidential, Washington, DC

Server/ Host

Responsibilities:

Provide superior customer service in order to increase customer satisfaction while providing a restaurant-quality dining experience
Receive orders from guests and process orders as necessary
Collect payment using cash register and enter order in system
Demonstrate a cordial attitude towards all guests and staff members
Possess a strong knowledge of wines and food pairings
Ensure cleanliness and professional atmosphere of quality rated restaurant environment

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Case Management /discharge Planner Resume

Washington, DC

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