Experience

C3 Revenue Cycle Solutions

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

• Patient Access Specialist

  • Aug 2021 - Present

  Preregister patients for upcoming visits. Verify patient information and benefits. Obtain authorizations and referrals when needed prior to services performed. Collect copays, deductibles, and co insurances on high dollar accounts to help increase revenue. Evaluate and research all information received from the client to determine which insurance to bill and obtain all necessary documentation to send with each claim. Ensured the integrity of each claim that was being billed. Engage in large A/R cleanup project so client could go live with new system. Researched account denials and filed written appeals. Document in detail all efforts to collect each outstanding debt in the company database and updated client information as required. Follow up on all claims filed while continuously updating assigned queues. Assist management with reports and critical account cleanup. Entrusted to train new employees in software and how to effectively maneuver through client databases. Work on average 100+ accounts daily as assigned with 100 percent accuracy. Show less



ABLM Inc.

• Hospitals and Health Care
• 1 - 100 Employee

• Independent Revenue Cycle Consultant/ Team Lead

  • Aug 2019 - Jul 2021

  In collaboration with the Manager, responsible for the quality monitoring activities including identifying areas of improvement and plan implementation of improvement areas. Assesses, evaluates and addresses daily work load and queues; adjusts work schedules daily to meet the workload demands. Have a solid working knowledge of insurance plans and benefit structures in order to obtain detailed benefit information and maximize plan benefits. In collaboration with the Manager, responsible for the quality monitoring activities including identifying areas of improvement and plan implementation of improvement areas. Assesses, evaluates and addresses daily work load and queues; adjusts work schedules daily to meet the workload demands. Have a solid working knowledge of insurance plans and benefit structures in order to obtain detailed benefit information and maximize plan benefits.



Wake Forest Baptist Hospital

• Patient Service Representative

  • Nov 2015 - Aug 2019

  Provides exceptional customer service by performing all registration, HIM, scheduling, reception, and financial functions with accuracy. May float to various operational sites within WFBMC Corporate Revenue Cycle (CRC). Expedites and provides healthcare access by obtaining accurate critical data elements from a variety of sources (e.g. patients, families, physicians, etc.). Ensures reimbursement for services rendered through verification of insurance and benefits and timely authorizations and pre-certs. Identifies, informs, and collects patients’ financial obligations. Identifies and refers patients seeking financial assistance to the appropriate internal departments and external agencies. Fosters positive relationships with all patients and family members, peers as well as external customers to ensure quality services. This position requires multi-tasking and effective problem solving skills. Show less

• Independent Revenue Cycle Consultant

  • Sep 2014 - Jul 2015

  Worked with patient access (scheduling, pre-registration, insurance verification/financial counseling) while also working the ED after hours and weekends doing registration/admissions (inpatient, outpatient, ambulatory). Had patients pre-registered weeks in advance and assisted other team members with their patient queues. Answered, screened, and processed requests and telephone inquiries with adherence to HIPAA confidentiality regulations. Obtained and accurately entered necessary demographic, clinical, and billing information. Explained processes, forms, and procedures to ensure that patients understood required documentation. Processed required information according to client policies and procedures. Provided professional, compassionate, and concierge-like service to patients. Collected co-pays according to hospital and insurance regulations increasing revenue for the customer. Billed for claims in a timely manner utilizing the insurance provider's website or via landline. Responsible for the collection and account resolution of patients with delinquent accounts. Prepared and worked denial, adjustment, and reimbursement processes for identified insurance carriers and ensured appropriate revenue was collected. This included interpreting and processing EOBs, researching and handling denied claims, and preparing appeals. Utilized friendly customer service style behavior when dealing with patients, clinical personnel, and insurance carriers to properly and adequately troubleshoot unpaid claims in order to satisfactorily collect outstanding payments. Consistently had extremely high productivity and collection rates. I am always highly motivated to increase revenue for the customer and make the company I am representing succeed. .Assisted in EPIC education with the ability to multi-task in different areas. Ability to adjust to different areas of need efficiently. Provided assistance where ever needed. Show less



Community Health Systems

• United States
• Hospitals and Health Care
• 700 & Above Employee

• Front End Interviewer / Follow up Collections

  • Mar 2010 - Sep 2014

  Expertise with ADT, HMS Patient Accounting, and Revenue Cycle applications. Ability to manage multiple projects. Provided reports and created project plans along with PowerPoint presentations. Assisted with the development and implementation of Quality Assurance training tools and internal reporting programs. Advised clients on alternate methods of solving problems or recommended specific solutions. Provided leadership and development to ensure professional outcomes were met. Provided timely feedback to staff. Extensive knowledge of State and Federal Regulations and JCAHO standards. Ability to effectively lead, mentor and supervise staff Responsible for maintaining high level satisfaction with performance, attitude, knowledge, skills, communication and excellent customer service. Assisted with daily direction of all functions within the Patient Access Department effectively reducing overtime and reducing employee time and attendance issues. Assisted with staff supervision and departmental staff schedules-direct and indirect (10-20 employees) Assisted with integration of departmental services with hospital’s primary function. Assisted with preparation of departmental schedules and time and attendance records. Participated in community events and disaster preparedness exercises for the employees. Maintained work operations by following policies and procedures. Show less



Dr.Sid Spencer

• Optometry Patient Care Assistant

  • Sep 2006 - Jun 2009

  Collected medical information and insurance information from patients. Collected co-pays or co-insurance payments. Filed all insurance information for the patient. Provided billing and insurance follow-ups. Physician's Assistant with hands on medical care. Collected medical information and insurance information from patients. Collected co-pays or co-insurance payments. Filed all insurance information for the patient. Provided billing and insurance follow-ups. Physician's Assistant with hands on medical care.



Med-Assist

• United States

• Account Resolution Specialist

  • Oct 1999 - Jan 2002

  Followed up on denied medical claims. Collected information needed to re-submit claims and receive insurance payments for services. Was responsible for collection of high dollar claims.Was specially selected to be placed at St. Mary's in Cincinnati, OH for collection of old debts. Recovered over $2,000,000 in old debt for hospital in a 6 month period. Followed up on denied medical claims. Collected information needed to re-submit claims and receive insurance payments for services. Was responsible for collection of high dollar claims.Was specially selected to be placed at St. Mary's in Cincinnati, OH for collection of old debts. Recovered over $2,000,000 in old debt for hospital in a 6 month period.