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Milagros V

Medical or Health Services Manager - 20 Years of Experience - Near 07087

Occupation:

Medical or Health Services Manager

Location:

Union City, NJ

Education Level:

Some College Units Completed

Will Relocate:

YES

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To obtain a challenging Coordinator position that will utilize my skills such as customer service, scheduling, insurance verification, prior authorization & follow ups. Knowledge on CAHC, JACHO and URAC. February 2017 - Present Empire Specialty Pharmacy West New York, NJ Intake/Prior Auth Coordinator * Obtain referrals from doctors, insurance companies and account representatives * Insurance verification and eligibility * Obtain initial authorization and follow ups * Calls to MDO on refills, clarification on new scripts and discontinued medications April 2016 - Jan 2017 E&K Medical West Orange, NJ Scheduler * Scheduled RT to patients home or in office for West Orange, Newark, Middlesex and Tom Rivers offices. * Handling 200+ calls a day from patients, MDO, nursing facilities and insurance companies * Insurance verification and eligibility * Obtain initial authorization and follow ups September 2015 - April 2016 Home Care Services Edison, NJ Intake/Reauthorization Coordinator * Obtain referrals from MDO, case managers/discharge planners, insurance companies and liaison * Insurance verification and eligibility * Obtain initial authorization and follow ups * Schedule delivery, service calls and pickups February 2011 - Dec 2016 Best In Care Solutions Jersey City, NJ On Call Coordinator * Obtain new referrals from DYFS (Division of Youth and Family Services) * Cover any call outs or new referrals * Acting as a liaison with the Home Health Aides and clients * Supervised over 100 field employees * Confirming and verifying scheduled hours and overtime for payroll * On call duties after hours, weekends and holidays April 2011 - May 2015 AllCare Medical Sayreville, NJ Account Executive * Worked closely with Case Managers and Social Workers upon patients discharge * Obtain orders from other referrals: MDO, insurance companies and home care agencies * In-serviced hospital staff, home care and wound care agencies on the products * Insurance verification and eligibility * Obtain initial authorization on DME (Durable Medical Equipment) products * In-service patient and family on their equipment * Delivered products to patients room prior discharge * Scheduled delivery, pick up and service calls * On call duties April 2009 - 2011 North East Regional Epilepsy Group Hackensack, NJ Patient Care CoordinatorSche * Scheduling and confirming appointments for Hackensack, Jersey City, Morristown, Overlook, New Brunswick and Somerset offices * Obtain referrals from MDO and insurance companies * Insurance verifications and eligibility * Obtain initial authorization / precertification October 2004 - April 2009 KCI Teterboro, NJ Dispatcher/Supervisor * Dispatching and assigning work schedule for Service Consultants * Customer Service, in-service and organize team meetings * Confirming and verifying all pages, cancelled orders, correct equipment ordered, call back with estimated time of arrival * Obtain Proof of Delivery and Assignment of Benefits * Coordinating deliveries, pick ups, service calls to home care agencies, hospitals and patient homes * Confirming and verifying hours schedule and overtime for payroll * Filing, placing orders for office supplies and Customer 1st * Travel to other service centers to train new hire Dispatchers * Supervised over 75 field employees * On Call duties Region Administrative Coordinator * Working directly with Region Service Directors, Regions Service Managers and Customer Service Managers * Obtaining and gathering all staff meeting from 13 Service Centers * Confirming and verifying that all employees are up to date with KCI Best and KCI ED * Coordinating staff meetings with the Region Service Directors and Service Managers * Coordinating weekly conference calls with Region Service Directors, Service and Customer Service Managers * Supervised over 200 field employees * On Call duties Coordinator of Patient Administrative * Intake referrals from hospitals, MDO, long-term facilities and insurance companies * Coordinating deliveries, force pick ups and discharge * Obtaining monthly wound measurements from MDO, wound care centers and health care agencies * Insurance verification and eligibility * Obtain authorizations from insurance companies * Confirming and verifying with the RN Supervisor and Clinical Consultants on patients delivery of products * Working side by side with the Account Executive and Clinical Consultants on unbilled orders, rebills, discharge and restarts * In-service with MDO, home care agencies and wound care centers June 2003 - October 2004 A&T Healthcare Hackensack, NJ Staff Supervisor * Intake referrals from numerous agencies * Verify Medicaid eligibility for the current month * Obtaining authorization from insurance companies * Confirming and verifying scheduled hours for payroll * Coordinating and scheduling monthly visit with RN Supervisor, Home Health Aides and patients * Acting as a liaison with patient and home health aide * Supervised over 100 field employees * Knowledge of CAHC and JAHCO * On Call duties February 2002 - June 2003 Bayada Nurses Union, NJ Staff Supervisor * Intake referrals from numerous agencies * Verify Medicaid eligibility for the current month * Obtaining authorization from insurance companies * Confirming and verifying scheduled hours for payroll * Coordinating and scheduling monthly visit with RN Supervisor, Home Health Aides and patients * Acting as a liaison with patient and home health aide * Supervised over 50 field employees * Knowledge of CAHC and JAHCO * On Call duties May 1999 - February 2002 Helping Hands Healthcare Hackensack, NJ Field Staff Supervisor * Intake referrals from numerous agencies * Verify Medicaid eligibility for the current month * Obtaining authorization from insurance companies * Confirming and verifying scheduled hours for payroll * Coordinating and scheduling monthly visit with RN Supervisor, Home Health Aides and patients * Acting as a liaison with patient and home health aide * Supervised over 50 field employees * Knowledge of CAHC and JAHCO * On Call duties June 1997 - March 1999 Walgreen's Pharmacy Jersey City, NJ Senior Pharmacy Technician * Aided Pharmacist for preparing medications for dispensing from Physician's orders * Required to contact doctors on refills of medications * Responsible to verify eligibility with insurance company * In charge of inventory under the supervision of Pharmacist in Charge * Skilled in customer service and cashier duties * Trained new hires January 1997 - December 2001 Meadowlands Hospital Secaucus, NJ Pharmacy Technician * Aided Pharmacist for preparing medications for dispensing from Physician's orders * Required to contact MDO for refills * Perform related pharmacy task such as inventory control, stocking, general clerical duties and billing June 1990 - December 1997 Santa Maria Pharmacy Union City, NJ Pharmacy Techician * Aided Pharmacist for preparing medications for dispensing from Physician's orders * Required to contact MDO for refills * Perform related pharmacy task such as inventory control, stocking, general clerical duties and billing * In charge of inventory under the supervision of Pharmacist in Charge * Skilled in customer service and cashier duties March 1982 - June 1990 Dr. Jesus Perez-Mendez Union City, NJ Receptionist * Scheduling confirming appointments * Required to verify insurance and Medicaid on a monthly basis * Advised of any contagious patients and place them in the isolation room * Responsible to obtain, maintain and file patients records * Customer service, weekly inventory of office and medical supplies

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