Experience

Relievant Medsystems, Inc.

• United States
• Medical Device
• 100 - 200 Employee

• Patient Access Case Manager

  • Dec 2020 - Present

• Payer Coverage Case Manager

  • Dec 2020 - Present



Providence St. Joseph Health Plan

• Appeals & Grievance Analyst

  • Sep 2013 - Dec 2020

  Investigate and resolve Medicare and Medicaid member appeals and grievances adhering to all Medicare and Medicaid rules and mandates. Investigate and resolve Medicare and Medicaid member appeals and grievances adhering to all Medicare and Medicaid rules and mandates.



Providence

• Hospitals and Health Care
• 700 & Above Employee

• Financial Coordinator

  • Sep 2013 - Oct 2015

  Coordinate & obtain authorizations for all patient care, including high cost diagnostic tests, chemotherapy and hematology oral and infusions medication. Advocate for patient with non-profit organizations and pharmaceutical companies to obtain financial assistance, reduced cost, and/or free medications for patients in need. Appeal health insurance denials for payment or prior authorization for care on behalf of the patient. Coordinate & obtain authorizations for all patient care, including high cost diagnostic tests, chemotherapy and hematology oral and infusions medication. Advocate for patient with non-profit organizations and pharmaceutical companies to obtain financial assistance, reduced cost, and/or free medications for patients in need. Appeal health insurance denials for payment or prior authorization for care on behalf of the patient.



GASTROENTEROLOGY SPECIALISTS OF OREGON, P.C.

• United States
• Medical Practices

• Medical Biller

  • May 2010 - Aug 2013

  Accounts receivables, collections, financial coordinator/ financial assistance, electronic bank deposits and payments. Accounts receivables, collections, financial coordinator/ financial assistance, electronic bank deposits and payments.



THE SURGICAL CENTER, INC.

• United States
• Medical Practices

• Assistant to Office Manager

  • May 1999 - Feb 2001

  Assist office manager with managing five healthcare providers and general run of the office. Maintain and oversee scheduling for all physicians. Train and mentor new front office staff. Schedule patient office appointments/surgeries and diagnostic tests. Work directly with physicians and hospital staff. Counsel patients on medical procedures and out-of-pocket costs. Obtain prior authorizations for surgeries and diagnostics. Assist office manager with managing five healthcare providers and general run of the office. Maintain and oversee scheduling for all physicians. Train and mentor new front office staff. Schedule patient office appointments/surgeries and diagnostic tests. Work directly with physicians and hospital staff. Counsel patients on medical procedures and out-of-pocket costs. Obtain prior authorizations for surgeries and diagnostics.



Kaiser Permanente

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

• Third Party Liability Specialist

  • Aug 1997 - May 1999

  Seek out reimbursement for medcial charges from third party payers. Contact Kaiser members, third-party payers and attorneys to resolve outstanding patient balances. Post payments received to Kaiser member accounts. Process reciprocity electronic biling/collection from Kaiser-Hawaii and Group Health NW members accessing care at Kaiser-Oregon. Seek out reimbursement for medcial charges from third party payers. Contact Kaiser members, third-party payers and attorneys to resolve outstanding patient balances. Post payments received to Kaiser member accounts. Process reciprocity electronic biling/collection from Kaiser-Hawaii and Group Health NW members accessing care at Kaiser-Oregon.