Denisha Hernandez

• Full time remote position
• Verified insurance requirements and prior authorization criteria before submitting referral documentation.
• Processed documentation with accuracy, ensuring compliance with regulatory requirements and internal procedures.
• Maintained accurate referral records in electronic health systems, supporting clean case tracking.
• Communicated with providers, patients, and payers to confirm referral status and next steps.
• Streamlined referral processes for increased efficiency, resulting in timely appointments for patients.
• Promoted clear communication between primary care providers and specialists through detailed documentation and follow-up calls.
• Maintained accurate records on in-progress and completed referrals, ensuring full data integrity throughout the process.
• Demonstrates knowledge and understanding of all job-related policies and procedures and adheres to and consistently applies the Financial Clearance Policy in all patient cases.
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• Full time remote position
• written and oral communication skills • Responded to high volume of inbound phone calls from members, providing assistance and resolving inquiries • Transferring calls to the appropriate department • Make outbound calls to assist members • Actively listened to customers, addressing requests with professionalism and empathy to enhance member satisfaction • Met or exceeded department key performance indicators, demonstrating commitment to service excellence • Adheres to assigned schedules to ensure appropriate phone coverage. • Maturity and ability to exercise sound judgment • Strong computer and telephone multitasking skills • Navigate through multiple systems • Accuracy in data input and documentation
• Responded to member inquiries regarding eligibility, benefits, claims, and plan coverage with accuracy and professionalism.
• Resolved service issues by researching account details, documenting outcomes, and coordinating follow-up with internal teams.
• Processed enrollment, demographic, and account updates while maintaining compliance with confidentiality and quality standards.

• Cultivated positive relationships with clients, staff, volunteers, and visitors to foster a supportive environment.
• Maintains resident safety and confidentiality. Utilize the wand to check all bags as residents enter the facility; administer breathalyzer and random drug tests to all clients; and forward incoming calls for residents.
• Compiled and submitted comprehensive shift and incident reports detailing activities, incidents, and emergencies to ensure accurate documentation.
• Maintains safety and security of the building, company vehicles, and all Veterans Inc. property on site.
• First responder for client-related emergencies, RCs are trained in CPR, First Aid, and Narcan administration. Completed special projects and duties for various teams.

• Full time remote position
• Handled all incoming calls to Intake Department, ensuring timely and professional communication with clients.
• Adhered to procedures for booking and authorizing intake appointments, providing initial insurance verification prior to client visits.
• Completed client intake forms and assigned clients to appropriate programs based on needs.
• Scheduled intake appointments and maintained calendars for streamlined client access and timely service delivery.
• Coordinated intake referrals, gathering demographic, clinical, and insurance information for accurate case initiation.

• developed short and long term goals for Adult Day Health Program to enhance service delivery and participant engagement
• directing and supervising all aspects of the program personnel management: interview and select appropriate candidates, assure orientation of all staff, assure participation in appropriate in service and certification program ensured compliance with standards established by Department of Health and Human Services, maintaining program integrity and quality of care
• overseeing program safety and emergency evaluation plans
• Managed the admissions process to ensure smooth intake of participants into the program.
• Organized transportation logistics to ensure timely arrival and departure of participants.
• establish collaborative relationships to ensure necessary support services are available to members and their families developed and implemented marketing plan for program to increase community awareness and participant enrollment
• Supervised residential program operations, ensuring compliance with person-centered support plans and service standards.

• Advanced to role of Assistant Director, overseeing department operations.)
• completed quarterly notes and yearly social assessments for each client, ensuring accurate documentation of progress and needs
• cComplete behavioral care plans for each client hosted monthly client meetings to address concerns and questions, fostering open communication and engagement with the center
• host quarterly participant and family advisory council meetings with clients and individuals in the community to discuss program changes or client concerns
• assisted floor staff in meeting client needs, enhancing overall support and care delivery complete molst and health proxy paperwork
• participate in weekly care plan meetings with nurses to discuss any questions or concerns

• Obtained client information through telephone calls, client interviews, and verification processes to ensure accurate data entry
• Contacting insurance companies for benefit investigation and coverage eligibility
  Completing prior authorizations with attention to detail and accuracy, to then have the prepared prior authorization reviewed by a clinical pharmacist
• Assisted patients in enrolling for manufacturer and non-profit copay assistance programs, facilitating access to necessary medications
• Providing customers with courteous, friendly, fast and efficient service

• Performed new patient intake procedures at a healthcare facility.
• Identified appropriate candidates for home care services.
• Assessed referred patients for treatment suitability
• Obtained initial and ongoing insurance and managed care benefits for insurance providers.
• Verified eligibility and benefits, reducing delays in admission and treatment authorization.

• Supervised clients in daily activities to ensure safety and well-being.
• Supported clients with daily living tasks to promote independence.
• Maintained an environment that protects safety and well-being being of clients
• Collaborated with team members to deliver effective client care.

• Took incoming referrals and completed the intake form accurately and entered information into the system.Reviewed
• the need list daily and calls for patients.
  Performed all scheduling activities.
• Maintained accurate schedules for clients and staff, ensuring optimal resource allocation and service delivery. Worked with the Supervareor/Clinic Manager to ensure that all start of cares is assigned to the appropriate staff.
• Called hospitals to notify them that we offer fully certified services when our clients are admitted.
• Actively worked to encourage departmental growth (networking with referral sources).
• Organized and filed documents systematically to maintain efficient record-keeping.
• Took a client complaint/concern and passed the message on to the Supervisor for resolution.
• Developed new processes to streamline workflows and enhance operational efficiency.
• Ensured that only authorized visits are scheduled.
• Notified the Agency of emergencies, sickness, and other imminent occurrences that may affect the client caseload as quickly as possible relative to the event's occurrence.
• Prepared clinical client folders.
• Ran assigned daily/weekly reports.
• Participated in on-call rotation to provide support during after-hours emergencies.
• Executed various tasks as needed to support overall team operations.

• Ensured professional and courteous phone responses to enhance client communication.
• Managed inventory of office supplies and forms to maintain operational efficiency.
• Arranged the postal needs of the branch (postage, pickups, mailings)
• Coordinated branch postal services (postage, pickups, mailings) to support timely communications.
• Supported various tasks for C.E.O and C.O.O. in daily operations.

Administrator and or D.P.S Branch Manager.

• Filed all patient/client time sheets and visit notes.
• Reviewed time sheets prior to submission of payroll
• Assisted with the physician orders process.
• Prepared new charts as needed.
• productive and uses time efficiently.
• Followed instructions, is-punctual and attendance is acceptable.
• Executed various tasks as needed to support team objectives.

• Provided Delivered exceptional customer service at TD Bank by addressing inquiries and resolving issues promptly. to all TD Bank customers.
• Responsible for processing transactions, cashing checks and meeting with clients' needs
• Referred customers to appropriate departments, facilitating effective resolution of their inquiriesss
• Processed deposits, withdrawals, cash advances, and loan payments with accuracy and efficiency.
• Balanced cash drawer daily, resolving discrepancies and maintaining strict control over cash limits.
• Assisted customers with account inquiries, transaction corrections, and basic service requests.