Rhey Duran
La Palma
Summary
Dedicated healthcare professional adept at coordinating training, paperwork, and specific community-based resources. Exceptional communication and planning abilities with an organized and thorough nature.
Overview
8
8
years of professional experience
Work History
Community Health Worker
Carelon
05.2024 - Current
- Helped vulnerable individuals navigate complex healthcare system.
- Developed and maintained relationships with community partners to build program scope.
- Collaborated with local organizations to expand health services and resources.
- Provided crisis intervention and supportive counseling services to assist clients facing issues and problems.
- Explained required eligibility applications to patients and helped complete applications for services.
Admissions Counselor
Alsana – Eating Disorder (Remote)
05.2023 - 11.2023
- Manage clients/patients census for over 20 facilities
- Conduct thorough analysis of clients by completing in-depth assessments
- Facilitate and coordinate patient treatment plan between clinicians and program
- Present financial payment plans to prospective patients
- Work directly with Program Directors and Therapists to manage patient continuity of care
- Review current in-network and out of network benefits and discuss financial payment options
Admissions Coordinator
Discovery Mood
06.2019 - 05.2023
- 1 of top 3 performers in sales out of 50+ employees
- Highest sales in Outpatient Mental-Health Department
- Managed and assessed clients with mental illnesses for treatment at several facilities
- Conducted thorough analysis of clients by completing assessments
- Worked directly with Program Directors and Therapists to manage patient continuity of care
- Managed verification of benefits/insurance and present financial responsibilities
Practitioner Management Coordinator
CareMore (Contract Position)
10.2018 - 04.2019
- Performed data analysis on projects and suggested solutions
- Tracked and processed license renewals, including national certifications, DEAs, status changes and other related files
- Conducted sanction searches for health care professionals nationwide
- Managed timelines and generate status reports
- Completed more than 100 attestations on CAQH
Compliance Administrator
First Class Nurses
10.2017 - 10.2018
- Recruited, evaluated, and oriented potential candidates
- Performed human resource duties
- Conducted professional in-person and phone interviews
- Participated in 2018 Joint Commission certification
- Staffed 6-20 professionals for multiple contracted hospitals
Contracting Assistant
Mix Solutions Inc
03.2016 - 10.2017
- Completed over 100 applications for various health plans
- Collected and submitted documents including W-9s, State Surveys, Licenses and Certificates of Insurance
- Participated in contract negotiations by submitting letters of intent and reviewed multiple contracts
- Assisted in billing projects and reimbursed more than $50,000
Education
Bachelor of Science - Healthcare Administration
California State University of Long Beach
Skills
- HIPAA Guidelines
- Report Preparation
- Microsoft Office proficiency
- Cultural Competency
- Public outreach
- Schedule Coordination
Timeline
Community Health Worker
Carelon
05.2024 - Current
Admissions Counselor
Alsana – Eating Disorder (Remote)
05.2023 - 11.2023
Admissions Coordinator
Discovery Mood
06.2019 - 05.2023
Practitioner Management Coordinator
CareMore (Contract Position)
10.2018 - 04.2019
Compliance Administrator
First Class Nurses
10.2017 - 10.2018
Contracting Assistant
Mix Solutions Inc
03.2016 - 10.2017
Bachelor of Science - Healthcare Administration
California State University of Long Beach