Patricia D. Lancaster

PL Skills Research Thoroughly Decision-Making Leadership Active Listening Responsible Punctual Resolution Strong Research Skills Customer Service 4+years Medicare Knowledge Written Communication Excel, word, outlook Positive Airway DME Jurisdiction Knowledge Answering Phones Dealing with doctors Handling Complaints/Escalation Completing Tasks in a timely manner References Kara Litteral: - Jarrod Clark: - Jackie Blackmer: - Tasha Mings:- Nita Chester: - Patricia Lancaster 7221 Timberlane Dr. Fairview, TN 37062 (615)-- Experience quality Patient Complaint Coordinator • verus healthcare • Dates October 2017-Current Worked directly with all company departments and patient to achieve a resolution to patient complaint. Responded to customer requests via telephone and email. Supported Chief Operating Officer with daily operational functions. Analyzed departmental documents for appropriate distribution and filing. Researched and updated all required materials needed for firm and partners. Copied, logged and scanned supporting documentation. Responsible for resolving and responding to all complaints issued by BBB, Medicare, client attorneys, etc. If requested, done the duties of a Quality Audit specialist where help is needed Only agent to respond to and handle a patient complaint once it reaches to the level patient making threats to contact lawyer, Medicare, BBB etc. In charge to respond to any interactions on Verus Healthcare’s Facebook page and Google Reviews Quality Audit coordinator •verus healthcare • Dates March 2016-October 2017 Prepared Audits Completed Audits  Submitted Audits to Medicare Responded to Medicare's requests in a timely manner Organized audits by due dates to prioritize  Communicated with Medicare via phone to check the status of audits submitted to see if they were paid/denied Worked in CGS and Noridian online portal to see if patient was in a payable status with Medicare Inserted audit information into department excel spreadsheet for informative purposes per supervisors’ requests If audit failed, appealed to Medicare second and third time to get paid Called doctor's offices and patients to obtain the documentation that may be missing prior to submitting audit Review and make sure all documentation is correct per Medicare's guidelines prior to submitting  Respond to supervisor's and coworkers regarding questions on Medicare's guidelines  Report changes from Medicare to Quality Supervisor to add to Verus Healthcare process Distributed work accordingly to Quality Specialists Spoke with patients who were under audit to explain what it meant for them until the audit was clear Quality Audit Specialist •verus healthcare • Dates Jan 2016-March 2016 Work audits Complete audits Submit audits to Quality Coordinator for review Call doctor offices, referrals and patients to obtain documents that may be needed prior to submitting to Medicare Work any project given per Supervisor from departments who may need assistance  Work in Athena to work machine orders for billing purposes  Work internal audits throughout Verus Healthcare on our machine and supply orders Check insurance, documentation and billing on orders internally to ensure all are correct according to guidelines and processes and to ensure agents are obtaining the correct information per Medicare Transfer all information on internal audits to a scorecard in Excel that is organized accordingly  Submit scorecards to Supervisor when completed Respond to any email from other employees or Supervisors at Verus Healthcare regarding Medicare's guidelines or processes Speak with patients who are under audit  Communicate with Medicare via phone  Work in online CGS and Noridian Portals to check same/similar and other Medicare information cUSTOMER SUPPORT COORDINATOR •verus healthcare • Dates sEPT 2015-JANUARY 2016 Continued to do all the duties of a Customer Support/Referral Specialist Created multiple manuals and simple "refer to guides" for the documentation team and customer support team  Answered any questions my coworkers had regarding working an order or handling a patient or referral account Handled all escalations within the customer support/referral team from patients, doctor's or referrals Monitored agents within our team to ensure that their work was being done efficiently Listened to calls weekly of agents to make sure they were including all the information required during phone calls  Checked the quality of documents verified by our agents weekly Composed score sheet of phone and quality check weekly and sent it to my supervisor Discussed mistake with agents and what should be done to correct it  Resolved patient, doctor or referral issues in a timely manner and prioritized them accordingly and made my supervisor aware of each situation Worked with our respiratory therapists to arrange set ups for patients with respiratory assist devices Worked with our warehouse agents to be sure that we had the respiratory assist device inhouse Trained new hires Worked projects assigned by supervisor Staff reviewed all machine orders to ensure correct documentation was obtain prior to shipping cUSTOMER SUPPORT/REFERRAL SPECIALIST •verus healthcare • Dates sEPTEMBER 2015-Jan 2016 Followed Medicare's guidelines for obtaining documentation to successfully provide our obstructive sleep apnea patients with the CPAP equipment needed per doctor's orders Called patients to update them accordingly in regards to their orders Worked specifically with our referral companies and customer support  Worked accounts specifically assigned to me to obtain documents, orders and other information from referral companies Received phone calls and emails from other agents within Verus to assist patient if their department could not Received phone calls from patients/doctors and assisted them with any issues, question or concern they had Booked orders for patients based on prescription or patients request Handled all Respiratory Assist Device patient orders and prioritized accordingly Staff reviewed all machine orders that were ready to go out to double check that insurance information and documentation was correct Worked in excel to organize and send informational spreadsheets to our referrals and my supervisor dOCUMENTATION SPECIALIST •verus healthcare • Dates mARCH 2015-sEPTEMBER 2015 Followed Medicare's guidelines for obtaining documentation to successfully provide our obstructive sleep apnea patients with the CPAP equipment needed per doctor's orders Staff reviewed all machine orders that were ready to go out to double check that insurance information and documentation was correct Called patients to update them accordingly in regards to their orders Called doctor's offices daily to obtain the documents Medicare requires  Assisted inbound calls from patients/doctor's  Faxed over request's for documentation required by Medicare Verified documents correctly into patients account Worked all order's for patients who needed Respiratory Assist Devices (patient's with diagnoses of COPD, central sleep apnea, different types of muscular dystrophy, hypoventilation, etc.) Completed different projects assigned by my supervisor efficiently and on time Trained new hires on the documentation process and what each document should include in order to be Staff reviewed all machine orders that were ready to go out to double check that insurance information and documentation was correct mEDICAL ASSISTANT •CUMBERLAND HEIGHTS • Dates mARCH 2013-MARCH 2015 Cared for patients in rehab struggling with addiction Recorded patients’ vitals ever two to three hours of as needed: Blood pressure, pulse and temperature. Recorded patients’ medical history and tests results in medical records Took blood samples from every patient and ran tests as part of admission process Took hair samples and sent it off to LabCorp Faxed and scanned in patients’ medical records into system Collected urine sample as part of the admissions process with every patient who came through  Maintained a safe and clean environment  2 years laboratory experience (drawing blood) CAREGIVER •MID-CUMBERLAND HUMAN RESOURCES• Dates fEB 2011-MARCH 2013 Assisted disabled clients in any way necessary to facilitate independence and well-being. Monitored progress and documented any status changes accordingly. Developed rapport with patients to create a safe and trusting environment for care. Transported individuals to medical appointments and other errands. Worked to improve and enhance patient lives through effective and compassionate care. Maintained a clean, safe and well-organized patient environment. Supervised daily activities and aided when needed. Administered medication as directed by physician. Ensured HIPAA compliance. Completed all daily living tasks to enhance the quality of life of elderly patients. Treated patients with strokes, head traumas, comas, and intracranial hematomas. Assisted patients with bathing, dressing, hygiene and grooming. Took and recorded patients' temperature, pulse and blood pressure. CARHOP •SONIC• Dates fEB 2009-JUNE 2013 Operated and sanitized all equipment in a safe and proper manner. Handled money, balanced tills, processed credit card payment batches and prepared bank deposits. Received, inspected and logged all products for accuracy of shipment, temperature and quality. Assisted co-workers whenever possible. Assisted with guest inquiries, take-out orders and restaurant cleanliness. Relayed orders to bar and kitchen by quickly and accurately recording guest selections and keying them into the register. Followed proper standards for product freshness, food safety, weights and measures, refrigeration and sanitation. Maintained complete knowledge of restaurant menu, including daily specials. Addressed diner complaints with kitchen staff and served replacement menu items promptly. Consistently kept kitchen areas clean and free of debris and water. Set performance expectations and provided honest feedback. Folded napkins throughout the day to maintain an adequate supply. Verified cash drawer against the day’s receipts. Cleaned grocery shelves, storage area and work areas and kept floors free of spills, water and hazardous debris. Effectively listened to, understood and clarified guest concerns and issues. Processed credit cards, checks, gift cards and coupons. Established and maintained a positive work environment. Consistently provided professional, friendly and engaging service. Education High School diploma • 2011 • fairview high school Graduated with Honors. GPA: 3.6 PROFFESSIONAL SUMMARY: Seasoned compliance expert with 5+ years of Customer Service experience in the Healthcare industry while working hand in hand with patients, doctor offices, Medicare and Commercial insurance companies, the Better Business Bureau etc. Excellent research and analytical skills, as well as a comprehensive knowledge of relevant statutory and regulatory guidelines. Dedicated to conducting thorough and detailed research, completing audits and complaints to ensure company stays compliant with legal requirements as well to make sure complaints are resolved.