Summary
Overview
Work History
Education
Skills
Timeline
Generic

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

Similar Profiles

CREATE PROFILE
Rhey Duran