Care Specialist Resume Samples

Description :

1. Assistant to the care management team to provide care management services for the WI Family care program.
2. Coordination, tracking, and reconciliation of authorizations for transportation services for family care members.
3. Data entry of prior authorizations as requested by care managers Liaison between the care management team and nursing homes to ensure correct authorizations.
4. Maintained excel spreadsheets to assist with the tracking of changing rates due to Nursing home assessments.
5. Gather updated medical records from Medical facilities Print updated assessment data for the care managers to review prior to completing.
6. Gathering data and completing a variety of reports for the team, on a monthly basis or as requested.
7. Work with the care manager supervisor completing reports to track and ensure that time contractual timelines are being met.
8. Liaison between Care management, providers, and provider network regarding prior authorizations and billing questions.

Experience

5-7 Years

Level

Executive

Education

Diploma

Description :

1. Checked department messages and send email co-workers.
2. Printed outpatient face sheets for all Sharp Reese-Stealy patients.
3. Generated all admissions and discharges for all Sharp Reese-Stealy for patients in all of the Sharp hospitals checked for urgent on-line referral requests.
4. Generated denial referrals per the medical director and emailed the denial letters to the providers and patients.
5. Generated referrals for admission and discharges to Sharp Rady Hospital and provider offices.
6. Generated all retroactive referrals and assign them to the case managers.
7. Check the patient's vital signs, such as pulse, temperature, and respiration.
8. Provide patients with personal care services including medication and bathroom needs Turn and change beds Insert and empty catheter bags Feed.

Experience

5-7 Years

Level

Executive

Education

Horticulture

Description :

1. Maintained records of patient care, condition, progress, or problems to report and discuss observations with supervisor or case manager.
2. Checked patients' pulse, temperature, and respiration. Provided patients with help moving in and out of beds, baths, wheelchairs.
3. Cared for patients by changing bed linens, washing and ironing laundry, cleaning, or assisting with their personal care.
4. Entertained, conversed with, or read aloud to patients to keep them mentally healthy and alert.
5. Administered oral medications, under the written direction of a physician or as directed by home care nurse or aide, and ensure patients take their medicine.
6. Planned, purchased, prepared, or served meals to patients or other family members, according to prescribed diets.
7. Accompanied clients to doctors' offices or on other trips outside the home, providing transportation, assistance, and companionship.

Experience

5-7 Years

Level

Executive

Education

Diploma

Description :

1. Present Responsibilities Respond to email inquiries, as well as phone calls.
2. Track shipments, Contact the driver that's in charge of an order to be delivered.
3. Place Big Ticket Item orders for the customer as well as canceling orders.
4. Dealing with delicate situations and escalated customers. Help residents with every day living.
5. Received a promotion and now a care specialist Skills Used have great time management skills.
6. Provide support by answering phone lines, scheduling appointments for surgeries, grooming, and exams, greeting/Checking in clients and their pets.
7. Accepting payment for services, providing administrative support to the doctors, maintaining patient records & filing, cleaning as needed.
8. Received meds pass training, and other certificates Skills Used Cooking Clean, assist residents to use bathroom.

Experience

7-10 Years

Level

Management

Education

Diploma

Description :

1. Screened incoming calls, obtained appropriate information from subscribers, providers.
2. Investigated, validated subscriber primary insurer; if questionable, provided referral inquiry to designated Care Managers.
3. Interacted with providers and subscribers in the coordination of healthcare services.
4. Maintained logs providing data for the monthly department, corporate reporting.
5. Provided confidential administrative support and assistance to various departments.
6. Collaborated with physicians, providers, vendors, and medical facilities to collect pertinent data validating subscriber benefit plans based upon requested services.
7. Materials went out in a timely manner to members, providers within regulatory CMS guidelines.
8. Communicated determinations of QIO appeal requests to respective parties.

Experience

10+ Years

Level

Senior

Education

Business Administration

Description :

1. Handled inbound calls regarding troubleshooting, Billing.
2. General questions regarding their accts, status, and understanding their needs even when they donor.
3. Thanked profusely for help, information, patience, and disposition.
4. Above and beyond in situations that felt warranted it.
5. Personally dealt with a store on customer's behalf as they were elderly, medically limited, and unfamiliar with the processes.
6. Calmed the unhappy, explained the confusing clearly, and ultimately gave them an educational base to allow them the comforts and peace of understanding.
7. Proven skill as customer satisfaction surveys generally remained above.

Experience

2-5 Years

Level

Junior

Education

Interior Design

Description :

1. Cared for up to clients without a supervisor on-site while working at a retirement home in Lynnwood WA.
2. Some needed assistance with all of their ADL's. A catheter and did some light ROM.
3. Client in which did bed baths, catheter care and used a Hoyer lift daily.
4. Stopped working in that home started caring for clients in their own homes.
5. Clients had ALS with a feeding tube, and another client had, had a stroke and was bed-bound.
6. Medication reminders, walking assistance, transportation, healthy meal preparation, bathing assistance, hospice care, memory care.
7. Assisted residents with activities of daily living, hygiene, and nutrition.

Experience

5-7 Years

Level

Executive

Education

CNA Licence

Description :

1. Answer incoming calls regarding scheduling appointments.
2. Transfer incoming calls to the appropriate department. Verify insurance is active, authorizations on file, and orders are signed.
3. Schedule and reschedule appointments in a timely, correct, and well-organized manner.
4. Review referral forms for the patient's health status and sleep issues.
5. Track the number of referrals received and the status of patients scheduled.
6. Obtain additional information to clarify patient health issues that may impact the sleep study.
7. Deal with various systems such as NexGen, Practice Management, EHR, Allscripts, Clearwave.

Experience

7-10 Years

Level

Management

Education

Psychology

Description :

1. Check department messages first thing and send email co-workers.
2. Face sheets- Generate all referrals for patients that are not in IDX.
3. Checks for urgent on-line referral requests. Send medical records to other physicians.
4. Denials-priority-check and deny referrals in the IDX per the medical director and send out denial letters.
5. Approvals-priority Pediatric referrals- Generating referrals for admission and discharges.
6. Retro referrals- Generate all retro referrals and assign them to the case managers.
7. Concurrent reports-all facilities for discharges and admissions for all sharp hospitals.

Experience

5-7 Years

Level

Executive

Education

Horticulture

Description :

1. E-mailed customers, and took payments, went over billing.
2. Adjusted their accounts based on their products and desires.
3. Set correct expectations, High standard customer service.
4. Gave customers accurate information when they asked questions about their accounts.
5. Gave helpful information to see them have success.
6. Learned more listening skills and softphone skills. Took inbound calls, Spanish outbound calls as well.
7. Learned a lot about following up with customers in regard to their concerns, whether it was Spanish or English.

Experience

2-5 Years

Level

Junior

Education

Diploma

Description :

1. Provide activities to seniors with Dementia-related diseases.
2. Assists with all activities of daily living. Improved clients well being.
3. Appreciated someone who they felt comfortable with being in their own homes.
4. Trained Medical Personnel can make the necessary recommendation for improving their quality of health.
5. Specialize in all areas of cognitive challenges.
6. Track dictation for four providers and make sure all dictation is completed and signed.
7. Assist patients and take payments over the phone. Fax over orders for radiology, labs, etc.

Experience

5-7 Years

Level

Executive

Education

Medical Assistant