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Firm - Patient Service Representative Onsite Eligibilit Resume Example

XXXX XXXXXXXXX XX, CANA, VA 24317
Ph: XXXXXXXXXXXX
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Daniel Thomas
Summary
Innovator Result-Oriented Team Player Innovative, autonomous, bilingual healthcare professional, proficient in assessing business and client needs, and implementing business processes and protocol to maximize productivity and profitability. 

Accomplished and energetic within my experience 15 plus years  of employment with a solid history of achievement in fast pace medical settings. Motivated leader with strong organizational and prioritization abilities in areas of expertise include Case Manager, Transition Manager Liaison, and  Supervisor Outreach Worker. Core competencies include Technical skills Benefit Eligibility & Determination Emergency Response System/ In-home Services Medical Billing & Transcription Financial Management Congregate Housing Patient & Quality Care Assisted Living Housing Client Needs Assessment Short- and Long-term Care with a high degree of autonomy, efficiency and effectiveness. 

Skills
  • Microsoft Office (Word, Excel, PowerPoint, and O
    Systems Evaluation
  • Computers and Electronics
  • Time Management
  • Negotiation
  • Judgment and Decision Making
  • Active Learning
  • Complex Problem Solving
  • Coordination
  • Social Perceptiveness
  • Monitoring
  • Critical Thinking
  • Customer and Personal Service
Experience
Patient Service Representative Onsite Eligibilit Jan 2014Present FIRM/ REVENUE CYCLE MANAGEMENT SERVICE INC
  • The Patient Service Representative Onsite eligibility is responsible to screen patients on-site for eligibility assistance programs by providing information, guidance, advocacy to all clientele. 
  • Coordinate communication between patients, family members, medical staff, administrative staff, or regulatory agencies.
  • Developed and delivered in-services for hospital staff and managerial personnel to maximize the effectiveness of the Patient Service representative Onsite Eligibility role.
  • Review financial statements, sales and activity reports, and other performance data to measure productivity and goal achievement. 
Medical Social Worker, and Outreach Coordinator Oct 2006Dec 2013 Home Care Of Rochester Rochester, NY
  • Provides outreach in the form of education, coordination, and assistance both clientele  and medical staff, helping bridge cultural gaps and language barriers in navigating the healthcare system.
  • Assesses the psychosocial functioning of patients and families, intervenes as necessary.
  • Established a system to support the Homecare Coordinators and Care Transition Managers to maximize the holistic care of clients.
  • Developed detailed guidelines to ensure the consistent application and implementation of common protocol across like positions.
  • Through the assessment of patient needs, secured Medicaid insurance by providing guidance with the process, resolved complex issues related to eligibility process, and provided follow-up to both staff and clients as they transition to care by HCR.
  • Manages 15+ concurrent social work cases on an ongoing basis.
  • Serves as coordinator for Nursing Home and Transition Diversion Medicaid Waiver Program, helping clients maintain independence in their daily lives.
  • Advocate for clients or patients to resolve crises.
  • Collaborate with other professionals to evaluate patients' medical or physical condition and to assess client needs.
  • Refer patient, client, or family to community resources to assist in recovery from mental or physical illness and to provide access to services such as financial assistance, legal aid, housing, job placement or education.
  • Utilize consultation data and social work experience to plan and coordinate client or patient care and rehabilitation, following through to ensure service efficacy.
  • Organize support groups or counsel family members to assist them in understanding, dealing with, and supporting the client or patient.
  • Plan discharge from care facility to home or other care facility.
  • Monitor, evaluate, and record client progress according to measurable goals described in treatment and care plan.
  • Oversee Medicaid- and Medicare-related paperwork and recordkeeping in hospitals.
Hispanic Liaison Outreach Coordinator Jan 2009Jan 2013 Home Care Of Rochester Rochester, NY Hispanic Liaison to Homecare & Program Outreach Coordinator                        2009 – 2013 Responsibilities span three capacities: Hispanic Liaison, Medical Social Worker, and Outreach Coordinator.  Provides outreach in the form of education, coordination, and assistance to both Hispanic clients and medical staff, helping bridge cultural gaps and language barriers in navigating the healthcare system. Assesses the psychosocial functioning of patients and families, intervenes as necessary. ·    Established a system to support the Homecare Coordinators and Care Transition Managers to maximize the holistic care of clients.  ·    Developed detailed guidelines to ensure the consistent application and implementation of common protocol across like positions. ·    Through the assessment of patient needs, secured Medicaid insurance by providing guidance with the process, resolved complex issues related to eligibility process, and provided follow-up to both staff and clients as they transition to care by HCR. ·    Manages 15+ concurrent social work cases on an ongoing basis. ·    Serves as coordinator for Nursing Home and Transition Diversion Medicaid Waiver Program, helping clients maintain independence in their daily lives.  
Jan 2006Jan 2013 Home Care of Rochester HCR Rochester, New York
  • In-home health care services company serving the greater Rochester area since 1976.
  • Provides patients, physicians, and other health care professionals with superior service - from referral to post-discharge follow-up.
  • OCS HomeCare Elite Top 500 Agency - one of 42 Certified Home Health Agencies nationwide.
Medicaid Outreach Worker Jan 2006Jan 2010 Anthony Jordan Health Center Rochester, New York
  • A not-for-profit comprehensive primary care center widely recognized for being one of the first true community health centers in the country.
  • In addition to providing high-quality healthcare, the organization's mission mandates wellness promotion and neighborhood outreach.
  • Responsible for the development, implementation, and execution of new Medicaid reimbursement program, as well as a community outreach wellness program.
  • Established business model to maximize the institution's ability to recoup Medicaid dollars.
  • Recovered upwards to $7,000 per month in years one through three; recouped $10,000 per month in years four and five.
  • Prior to the initiation of this program, organization's average recovery rate was close to nil.).
  • Developed business intelligence statistical reports to enable management regular visibility to the progress and success of Medicaid Reimbursement Program.
  • Developed and delivered in-services for hospital staff and managerial personnel to maximize the effectiveness of the Medicaid O.
Supervisor Medicaid Outreach Worker Jan 2005Jan 2006 Highland Hospital Rochester, New York
  • Full-service healthcare institution providing comprehensive orthopedics services and women's services, along with a nationally ranked geriatrics program, regional leading gastric bypass surgery center, and extensive network of primary care physicians.
  • Affiliated with the University of Rochester Medical Center.
Medicaid Outreach Worker Jan 1999Jan 2005
  • Established a systematic approach per newly created position; designed statistical reports; conducted in-services to familiarize hospital staff with the duties of the Medicaid Outreach worker; completed all paperwork for Federal insurances; acted as a liaison between the client and Department of Social Service; worked closely with the accounting department to track self-pay patients; referred patients to external agencies as needed.
  • Developed, implemented, and executed new Medicaid reimbursement program to recover of Medicaid dollars.
  • Acquired close to $1M in reimbursement from Medicaid for hospital in year one, and approximately $800K annually, thereafter.
Education
Bachelor of Science : Social Work Jan 2005 The College at Brockport - State University of N Brockport, New York
Associate of Science : Human Service Jan 1995 Monroe Community College - State University of N Rochester, New York
Additional Information
Home Care of RochesterPage | 2
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This is a real resume for a Patient Service Representative Onsite Eligibilit in CANA, Virginia with experience working for such companies as Firm, Revenue Cycle Management Service Inc, Home Care Of Rochester. This is one of the hundreds of Patient Service Representative Onsite Eligibilit resumes available on our site for free. Use these resumes as templates to get help creating the best Patient Service Representative Onsite Eligibilit resume.

Previous Companies:

  • FIRM
  • REVENUE CYCLE MANAGEMENT SERVICE INC
  • Home Care Of Rochester

Previous Job Positions:

  • Patient Service Representative Onsite Eligibilit
  • Medical Social Worker
  • and Outreach Coordinator
  • Hispanic Liaison Outreach Coordinator
  • Medicaid Outreach Worker

Schools:

  • The College at Brockport - State University of N
  • Monroe Community College - State University of N

Level of Education:

  • Bachelor of Science
  • Associate of Science

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