Krishnaveni Mohanan Nair Jaya

Collaborated with healthcare professionals to enhance resident care outcomes, ensuring comprehensive treatment and support.

Developed and reviewed care plans, completing Mental Capacity Assessments (MCA) and Best Interest (BI) decisions when necessary.

Built strong relationships with families by maintaining confidentiality and demonstrating professionalism in all interactions.

Maintained a clean and safe environment for residents through regular cleaning and safety checks.

Responded effectively in emergencies, minimizing harm and ensuring safety for all involved.

Administered medications according to prescribed guidelines, ensuring correct doses and timely delivery.

Delivered consistent, high-quality care to elderly residents, prioritizing comfort, dignity, and safety.

Streamlined administrative tasks, improving the efficiency and accuracy of patient care documentation.

Kept accurate records of residents’ medical histories and progress, ensuring compliance with care standards.

Led and supervised a team of staff, providing guidance and support to ensure quality care and smooth operations.

Communicated effectively with residents, families, and colleagues to ensure clarity and understanding in all care-related matters.

Adhered to company policies and procedures to ensure consistent, high-standard care and operational efficiency.

Promoted health and safety by following protocols and risk assessments, ensuring a safe environment for both residents and staff.

Complied with GDPR regulations, ensuring residents' personal and medical information was handled securely and confidentially.

Conducted regular risk assessments to identify and mitigate potential hazards, ensuring a safe living environment for residents.

Implemented Deprivation of Liberty Safeguards (DOLS) when necessary, ensuring residents' rights and freedoms were protected in accordance with legal guidelines

Delivered personalized care by adopting a person-centered approach, focusing on the individual needs, preferences, and dignity of each resident.

Provided assistance with personal care, including bathing, dressing, grooming, and toileting, ensuring privacy and comfort for residents at all times.

Read, followed, and updated care plans, ensuring all aspects of each resident’s care were met, and making adjustments where necessary to reflect changes in their condition.

Supported residents with meals, including preparation, assistance, and ensuring a nutritious, balanced diet tailored to their preferences and dietary needs.

Promoted independence by assisting with mobility needs, offering support for residents to move safely within the care home and promoting physical activity where possible.

Monitored and recorded residents' health and well-being, keeping accurate notes of any changes in condition and reporting to senior staff to ensure appropriate interventions were made.

Provided companionship and emotional support, helping residents feel valued and reducing feelings of loneliness by engaging in activities and conversations that were meaningful to them.

Assisted with recreational activities, ensuring residents participated in hobbies or social events that promoted well-being and mental stimulation.

Maintained a clean and safe environment, ensuring that residents' living spaces were tidy, secure, and conducive to their comfort.

Adhered to health and safety standards by following care protocols, conducting risk assessments, and ensuring the safe use of equipment

Oversaw quality checks of dental claims submitted by dental providers, ensuring all claims met necessary standards, guidelines, and regulations before approval.

Managed dental claim denials, thoroughly investigating reasons for rejections, resolving issues promptly, and escalating when necessary to ensure timely resolution.

Led the Tier 2 team, overseeing day-to-day operations and ensuring the team effectively handled dental claims, denials, and escalations.

Handled escalations from both internal teams and dental providers, addressing complex issues related to dental claims in a compliant and efficient manner.

Developed and delivered training programs for new team members on dental claims processes, ensuring they understood the nuances of dental care coverage and claim submissions.

Created and maintained quality improvement documents for dental claims processing, identifying areas for improvement and streamlining workflows.

Designed process knowledge slides focused on dental claims, offering a clear and comprehensive understanding of claim requirements, policies, and procedures.

Monitored compliance with dental provider agreements, ensuring adherence to contract terms and regulatory standards, and addressing any discrepancies or non-compliance.

Supervised and mentored staff, providing consistent feedback and guidance on handling dental claims and enhancing team performance.

Collaborated with the quality team to ensure dental claims were processed accurately and efficiently, participating in audits and quality reviews to improve overall performance

Managed claim denial processes, proactively contacting insurance companies to obtain detailed reasons for claim rejections or denials.

Tracked and followed up on denied claims, ensuring timely resolution by obtaining necessary information from insurance providers and escalating issues as needed.

Updated medical providers (including doctors and healthcare facilities) with accurate information regarding claim status, rejections, and the reasons for denials, ensuring clear communication for resubmission.

Checked insurance websites and portals regularly to monitor claims status, identify potential denials, and ensure that claims were processed accurately.

Collaborated with medical providers to gather any missing documentation or information necessary for claim resubmission or appeals.

Resolved billing discrepancies, working closely with insurance companies and providers to ensure accurate reimbursement and timely payments.

Documented all interactions with insurance companies and medical providers, maintaining detailed records of claim status, communications, and follow-up actions.

Monitored and analyzed accounts to identify trends in denials, recommending improvements to claims submission processes to reduce future rejections.

Ensured compliance with company policies and insurance regulations while handling sensitive patient and financial information with confidentiality and care