ASHLEY NICOLE M.

Serves as the initial contact for Kaiser Permanente member/patients handling inquiries related to eligibility inquiries, adding/removing dependents, facility inquiries, billing inquiries, web support, kp.org, ID cards, complaints, and benefit inquiries. * Represents Health Plan by answering and documenting all incoming contacts to determine their nature and to respond to complex calls related to specialized product lines or queues. * Increased customer satisfaction and retention by providing members, customers, patients, and providers with accurate, consistent, timely and meaningful information. * Assisted members and providers with claims inquiries, claims referral inquiries, and the overall claims process. * Provides support to members with an increased level of complexity in inquiries and issues as they utilize the KP plan and provider services while continuing to build rapport and collaborative relationships with current and prospective members in accordance with compliance guidelines.

Uploaded and archived patient registration documentation into electronic health records using Health Connect. * Established patient profiles in Health Connect by entering essential data, confirming eligibility, and validating copay amounts. * Interpreted physician's orders accurately to input correct testing information and verify admissions criteria. * Identified non-participating and out-of-network insurance plans, collaborating with patients and providers to resolve issues. * Detected and rectified claim discrepancies to expedite claims processing and minimize delays. * Consistently managed a workload of at least 180 accounts daily, achieving productivity peaks of over 220 accounts.

* Ensured patient safety and minimized infection risks through thorough cleaning and sterilization of equipment. * Conducted comprehensive patient assessments to identify and address wounds, behavioral issues, and relevant medical symptoms promptly. * Effectively monitored, documented, and communicated vital patient information to healthcare teams and in health connect, optimizing treatment planning and delivery of care. * Facilitated referrals to external physicians when necessary, ensuring comprehensive healthcare management. * Delivered patient education on medication usage, recovery protocols, coping strategies, and available community resources. * Administered vital signs assessments and performed routine lab tests, including STD screenings and treatments, for an average of 50 patients daily. * Provided essential reproductive health education and training to patients, ensuring informed decision-making and wellness management. * Managed patient check-ins and efficiently processed payments as required for services rendered. * Managed patient check-ins and efficiently processed payments as required to support front desk staff.

* Enhanced customer experience by promptly and courteously greeting and assisting internal and external customers and visitors. * Ensured accurate registration and HIPAA compliance by requesting and verifying patient identification for services. * Conducted patient registration duties, including checking in/out patients, collecting co-pays, verifying insurance, and gathering patient demographics. * Developed and implemented streamlined office management procedures, resulting in increased training efficiency, team productivity, and overall accuracy. * Managed incoming calls by screening and transferring them appropriately, ensuring efficient communication flow within the office. * Acted as the primary point of contact for office-related information and document transmission. * Cultivated positive relationships with colleagues, managers, and customers through proactive communication and effective anticipation of their needs. * Oversaw office supply orders and maintained inventory levels to support operational needs. * Facilitated the collection of patient and client documents and information upon referral, ensuring completeness and accuracy. * Addressed and resolved member complaints promptly and professionally over the phone and in real time. * Managed patient appointment scheduling, enhancing patient satisfaction and provider productivity by proactively contacting patients 24 hours in advance.