Experience

Arcadian Health Plan

• United States
• Hospitals and Health Care
• 1 - 100 Employee

• Intake Coordinator

  • Jun 2010 - Present

  Process pending Request for Autholrizations for approval, defer to the nurse case manager or resource physicianNotify hospital case managers or UR departments for provisional clinicalsCall hospital medical records department for dispositionProcess inpatient, outpatient and referral notifications as per Medicare guidelinesCheck members’ files for duplicates, verify CPT codes and ICD-9 codes and attach medical records to correct authorization requestNotify provider of out-of-network facility or physician with in-network provider or any pending status for more clinical needed Show less

• Office Coordinator

  • May 2009 - Jun 2010

  •Analyze and organize office operations and procedures, such as information management, filing systems and requisition of supplies•Maintain uniform correspondence procedures and style practices•Prepare various activity reports•Assist Provider Relations Department with directories, filing, chart requests and non-compliance issues.•Assist area sales coordinator with inventory and mailings to agents•Organized Town Halls for Charleston and Greenville – managing RSVP responses and ordering all printed materials•Scheduled venues for sales seminars and recruitment meetings as well as processed payment via check request procedures•Assisting with enrollment procedures, entering members via Sales Force, Batching and FileZilla Show less



InfuScience, Inc.

• Hospitals and Health Care
• 1 - 100 Employee

• Branch Secretary/Administrative Assistant/Admissions Representative/Patient Accounts

  • Feb 2004 - Mar 2009

  •Receive new referral information from hospitals, case managers and doctors’ offices •Collect demographics information, insurance, diagnosis, history and physical, doctor’s orders and medical necessity to verify benefits •Enters all data into clinical patients records (CPR+) •Contact insurance companies to verify eligibility, benefits and to check authorization •Inform patients with assignment of benefits and responsibilities •Check patients insurance and benefits monthly upon scheduled deliveries, appointments or new orders •Contact newly referred patients to explain financial responsibilities and co-pays •Negotiate payment arrangements with new patients and outstanding balances •Monitor outstanding balances and compliance with payment arrangements •Complete Medicaid Certificate of Medical Necessity Form and update CPR+ •Inform patients of Patient Assistance Programs and Financial Hardship applications •Respond to questions from branch employees regarding Policy and Procedures •Update patient’s demographics and insurance information and notify appropriate department •Update CPR+ and calendar with payment/co-pays due •Provide administrative support to the Branch Manager •Report Payroll information when Branch Managers out of office •Answer and directs incoming calls •Collects Credit Card Payments and inform appropriate departments Show less



The Post and Courier

• United States
• Newspaper Publishing
• 200 - 300 Employee

• Graphic Artist

  • Aug 1995 - Nov 2002

  •Designed layouts for local retail, classified, automotive, tabloid, preview and movie advertisements to include various graphics and formats •Collaborated with the imaging department to customize photographs and graphics •Received electronic ads from advertisement agencies, modified and processed them for printing •Proofread and edited display ads before they are released for publication •Worked under strict time constraints to meet production deadlines •Handled customer service requests by phone and responded in a timely manner •Worked with a team to assist 12 sales representatives to comply with customers’ needs •Organized and prioritized ads according to specific newspaper sections and corresponding deadlines Show less