Evette Hayes

• Provided backup support to office staff by completing filing tasks, answering phones and scheduling appointments.
• Organized patient records to research records, extract medical information and review records for completeness and accuracy.
• Directed patients to exam rooms, fielded questions and prepared for physician examinations.
• Used AHLTA and CHCS to compile and record medical charts, reports and correspondence.
• Determined nature and urgency of patient requests to refer patients to appropriate medical staff.
• Built positive rapport with patients to make patients feel comfortable during uncomfortable procedures.
• Performed clerical duties, such as word processing, data entry, answering over 100 phone calls a day and filing.

• Coordinated daily medicine schedules and administration to help clients address symptoms and enhance quality of life.
• Helped patients safely transition between sleeping surfaces and mobility assistance such as wheelchairs by providing consistent support.
• Cooked tasty, nourishing meals for patients to promote better nutrition.
• Assisted patients with dressing, grooming and feeding needs, helping to overcome and adapt to mobility restrictions.
• Followed nutritional plans to prepare optimal meals.
• Took patient vital signs, height and weight measurements and monitored glucose and patient wellbeing.
• Checked vital signs on daily basis and contacted supervisor regarding patient health concerns or behavioral changes.
• Kept close eye on behavior and emotional responses of clients to address concerns and protect each person from harm.
• Provided patients with assistance in completing daily tasks, reducing daily burden on family members.
• Interacted kindly with patients and families and displayed positive, outgoing attitude, resulting in establishment of long-term, professional relationships.
• Maintained best-in-class standards for individualized care in 6-bed unit by continuously checking in with patients and families and quickly providing care.
• Cared for clients with diagnoses such as respiratory failure, diabetes, Parkinson's disease and muscular dystrophy.
• Facilitated personal hygiene management, feeding and ambulation.

• Responsible for the adjudication and payment of Medi-Cal claims with a high level of production and accuracy using the EZ-Cap program.

• Assisted in running claims reject reports and handled electronic claims intakes on weekly basis with high degree of success.

• Handled claims correspondence on a daily basis and maintained a daily quota of 250-350 claims per day in a timely manner.

• Analyzed and processed a variety health claim forms; UB-04, CMS-1500 or ADA to ensure timely submission of claims.

• Reviewed and checked claims adjudication process to assure that all claims are adjudicated in accordance with CMS rules and regulations.

• Inspected and reviewed Medicare, Medicaid and commercial services for accurate charges.

• Authorized claim payments under my jurisdictions and within establish guidelines.

• Processed refunds and letters of dual coverage (when applicable) to customers.

• Resolved medical claims by approving or denying documentation; calculating due benefits, initiating payment or composing denial letter.

• Protected and maintained clientele privacy protocols and business operations by keeping claims information confidential.

• Ensured legal compliance by following company policies, procedures, guidelines, confidentiality protocols, as well as state and federal insurance regulations.

• Prepared and submitted reports by collecting, analyzing, and summarizing information.