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Case Management /discharge Planner Resume

Washington, DC

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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