Taylor Efurd
Greenwood
Summary
Dynamic UM Manager at Valley Behavioral Health with proven expertise in optimizing service utilization and enhancing reimbursement processes. Skilled in team leadership and complex problem-solving, I effectively managed denied care appeals and improved patient admission workflows, ensuring a supportive environment while maintaining rigorous documentation standards. Committed to excellence in customer service and staff development.
Overview
8
8
years of professional experience
Work History
UM Manager
Valley Behavioral Health
08.2020 - Current
- Managed and motivated employees to be productive and engaged in work.
- Accomplished multiple tasks within established timeframes.
- Monitor utilization of services and optimize reimbursement for the facility while maximizing use of the client’s provider benefits for their needs.
- Communicate ALL daily UR activity effectively verbally and in writing with CEO, CFO, administration, clinical, nursing, business and UR staff about impending review issues.
- Ensure UR information is updated, correct and current in multiple systems (accounting, daily census, etc.) in a timely manner.
- Participate in monthly director calls, management and leadership meetings and related training as required.
- Manage denied care by preparing & documenting appeals, including leading and participating in monthly facility denial meetings.
- Responsible for the concurrent and retrospective reviews for all clients.
- Work with physicians, therapist and nursing staff to provide optimal review based on client needs.
- Work with ancillary services in order to prevent delays in services.
- May review charts and make necessary recommendations to the physicians, regarding utilization review and specific managed care issues.
- Provide oversight and direction to utilization staff.
- Meets facility and regulatory training requirements by attending all mandatory staff meetings and training sessions as required.
Intake Coordinator
Valley Behavioral Health
08.2017 - 08.2020
Greet and search new patients and those transporting patients upon arrival.
Responsible for clerical duties such as managing paperwork, handling data entry, engaging with insurance companies over claims, and answering phones.
Complete the paperwork necessary to admit the patient to the assigned program and explain forms prior to patient signing, notify the clinical lead of the patient’s arrival, and escort the patient and documentation to the appropriate location within the facility.
Efficient and accurate completion of the admission process of patients and the timely distribution of the paperwork necessary to notify staff of the arrival/transfer of each patient.
Ensure all required patient information is received and processed and necessary appointments are made with the proper behavioral or medical health personnel.
Demonstrate a positive, empathetic, and professional attitude toward customers always.
When a patient’s needs are not met, acknowledge and work to resolve complaints. Recognize that patient safety is a top priority.
Demonstrate a sense of urgency related to the importance of patient safety and provide excellent customer service.
Ensure the well-being of patients and provide a positive, supportive, and structured environment.
Responsible for conducting safety checks and ensuring that supervision is conducted at 15-minute intervals, as noted in special precautions, or in accordance with individualized supervision guidelines as needed.
Document timely, accurate, and appropriate clinical information in patients’ medical records and inpatient registration or other technology systems.
Assist in providing a safe, secure, clean and, comfortable environment for patients, significant others and, staff.
Interact routinely with patients, observe behaviors, and communicate significant observations to admissions staff.
May obtain patient's vital signs, height, and weight as assigned and document in the patient record.
Engage patients in activities and interactions designed to encourage the achievement of the treatment goals.
Assist incoming patients/family members with contraband searches, and itemizing belongings and valuables when needed.
Complete and maintain required documentation.
Assist with follow-up and paperwork as required on incidents and events that may take place in the facility.
May provide transportation for the patient, or coordinate transportation with an appropriate staff member.
Recognize that patient safety is a top priority.
Data Entry
Education
Social Work
University of Arkansas- Fort Smith
Fort Smith, ARSkills
- Customer service
- Team leadership
- Time management
- Decision-making
- Complex Problem-solving
- Staff training and development
- Staff management
- Documentation and reporting
- Relationship building
- Multitasking
Timeline
UM Manager
Valley Behavioral Health
08.2020 - Current
Intake Coordinator
Valley Behavioral Health
08.2017 - 08.2020
Social Work
University of Arkansas- Fort Smith
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