Experience

Palmetto Infusion

• United States
• Hospitals and Health Care
• 100 - 200 Employee

• Patient Access Coordinator

  • May 2023 - Present

  • Provides timely acceptance and completion of new referrals. • Contacts new patients to review financial responsibility and program eligibility. • Aids patients in the enrollment process for funding assistance programs. • Monitor’s funding resources and on-going patient eligibility. • Negotiates payment arrangements with patients prior to start of therapy as necessary. • Enrolls and manages free drug and ship in patients. • Assists with obtaining financial hardship… Show more • Provides timely acceptance and completion of new referrals. • Contacts new patients to review financial responsibility and program eligibility. • Aids patients in the enrollment process for funding assistance programs. • Monitor’s funding resources and on-going patient eligibility. • Negotiates payment arrangements with patients prior to start of therapy as necessary. • Enrolls and manages free drug and ship in patients. • Assists with obtaining financial hardship information to submit to the Reimbursement Team for evaluation. • Mentored and guided employees to foster proper completion of assigned duties. • Built strong relationships with clients through positive attitude and attentive response • Ensures appropriate documents are up to date and present in patient's medical record. • Utilizes the EMR software exclusively for the purposes of communicating and documenting patient information. • Evaluates new patients that have outstanding balances from previous service and compliance with payment arrangements before accepting. • Completes Insurance Benefit Summaries (IBS) and forwards to appropriate clinic locations/staff. • Completes Advance Beneficiary Notices (ABN) when required and explains to patient why it is required. • Assists with obtaining MD notes from referring physician's office.

• Insurance Benefit Coordinator

  • Oct 2022 - Apr 2023

  • Obtain patient demographic information and data collection systems from referring physician office for support of medical necessity by reviewing payor medial policies and/or medical guidelines providing the initial clinical review. • Verify insurance eligibility for both medical and for upcoming appointments by utilizing online websites or by contacting the carriers directly. • Provides timely acceptance and completion of new referral including insurance verification… Show more • Obtain patient demographic information and data collection systems from referring physician office for support of medical necessity by reviewing payor medial policies and/or medical guidelines providing the initial clinical review. • Verify insurance eligibility for both medical and for upcoming appointments by utilizing online websites or by contacting the carriers directly. • Provides timely acceptance and completion of new referral including insurance verification, authorizations, and predeterminations as needed. • Maintains strictest confidentiality; adheres to all HIPAA guidelines/regulations.

• Patient Assistance Specialist

  • Jun 2021 - Oct 2022

  • Provides timely acceptance and completion of new referrals. • Contacts new patients to review financial responsibility and program eligibility. • Aids patients in the enrollment process for funding assistance programs. • Monitor’s funding resources and on-going patient eligibility. • Negotiates payment arrangements with patients prior to start of therapy as necessary. • Enrolls and manages free drug and ship in patients. • Assists with obtaining financial hardship… Show more • Provides timely acceptance and completion of new referrals. • Contacts new patients to review financial responsibility and program eligibility. • Aids patients in the enrollment process for funding assistance programs. • Monitor’s funding resources and on-going patient eligibility. • Negotiates payment arrangements with patients prior to start of therapy as necessary. • Enrolls and manages free drug and ship in patients. • Assists with obtaining financial hardship information to submit to the Reimbursement Team for evaluation. • Ensures appropriate documents are up to date and present in patient's medical record. • Utilizes the EMR software exclusively for the purposes of communicating and documenting patient information. • Evaluates new patients that have outstanding balances from previous service and compliance with payment arrangements before accepting. • Completes Insurance Benefit Summaries (IBS) and forwards to appropriate clinic locations/staff. • Completes Advance Beneficiary Notices (ABN) when required and explains to patient why it is required. • Assists with obtaining MD notes from referring physician's office. • Enrolls patients in copay assistance and foundation grants.



Augusta University Health

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

• Billing Specialist

  • Aug 2019 - May 2021

  • Submit and advance claims through the insurance billing process. • Address insurance billing issues and respond to various requests from insurance companies. • Act as a patient advocate by identifying the path needed to obtain the maximum reimbursement under the patient's insurance plan. • Review and submit claims based on payer guidelines and within the filing time limits. • Obtain updated or missing claim information from physicians and/or patients. • Complete assigned claim… Show more • Submit and advance claims through the insurance billing process. • Address insurance billing issues and respond to various requests from insurance companies. • Act as a patient advocate by identifying the path needed to obtain the maximum reimbursement under the patient's insurance plan. • Review and submit claims based on payer guidelines and within the filing time limits. • Obtain updated or missing claim information from physicians and/or patients. • Complete assigned claim and follow-up worklist tasks. • Comply with all Billing and Follow-up Worklist process, system, and documentation SOPs. • Meet claim filing and follow-up deadlines by completing assigned worklist tasks in a timely manner and/or reporting to management when assistance is needed to complete the tasks. • Report all changes to insurance company claim processing requirements to the Billing Supervisor. Show less • Submit and advance claims through the insurance billing process. • Address insurance billing issues and respond to various requests from insurance companies. • Act as a patient advocate by identifying the path needed to obtain the maximum reimbursement under the patient's insurance plan. • Review and submit claims based on payer guidelines and within the filing time limits. • Obtain updated or missing claim information from physicians and/or patients. • Complete assigned claim… Show more • Submit and advance claims through the insurance billing process. • Address insurance billing issues and respond to various requests from insurance companies. • Act as a patient advocate by identifying the path needed to obtain the maximum reimbursement under the patient's insurance plan. • Review and submit claims based on payer guidelines and within the filing time limits. • Obtain updated or missing claim information from physicians and/or patients. • Complete assigned claim and follow-up worklist tasks. • Comply with all Billing and Follow-up Worklist process, system, and documentation SOPs. • Meet claim filing and follow-up deadlines by completing assigned worklist tasks in a timely manner and/or reporting to management when assistance is needed to complete the tasks. • Report all changes to insurance company claim processing requirements to the Billing Supervisor. Show less



HireRight

• United States
• Human Resources Services
• 700 & Above Employee

• Verification Specialist

  • Jun 2018 - Jul 2019

  • Perform employment, educational and professional/personal reference checks in an accurate, timely, and professional manner. • Follow all guidelines of Company standards and client specific criteria (Client Information Form – CIF) and adapt to/implement changes as necessary. • Review documents such as Name and Address History, Credit Report, etc. to identify information in order to process request(s) for public record(s) in applicable jurisdiction. • Initiate telephone calls to… Show more • Perform employment, educational and professional/personal reference checks in an accurate, timely, and professional manner. • Follow all guidelines of Company standards and client specific criteria (Client Information Form – CIF) and adapt to/implement changes as necessary. • Review documents such as Name and Address History, Credit Report, etc. to identify information in order to process request(s) for public record(s) in applicable jurisdiction. • Initiate telephone calls to employers, educational institutions, professional organizations, government agencies or other appropriate groups to obtain and/or verify required information. • Follow up on telephone calls as per Company standards and client criteria. • Determine, identify, and research the appropriate information and documentation from client in order to substantiate all time periods under investigation and verify required information. • Contact client or candidate to obtain complete/additional information or for clarification. Show less • Perform employment, educational and professional/personal reference checks in an accurate, timely, and professional manner. • Follow all guidelines of Company standards and client specific criteria (Client Information Form – CIF) and adapt to/implement changes as necessary. • Review documents such as Name and Address History, Credit Report, etc. to identify information in order to process request(s) for public record(s) in applicable jurisdiction. • Initiate telephone calls to… Show more • Perform employment, educational and professional/personal reference checks in an accurate, timely, and professional manner. • Follow all guidelines of Company standards and client specific criteria (Client Information Form – CIF) and adapt to/implement changes as necessary. • Review documents such as Name and Address History, Credit Report, etc. to identify information in order to process request(s) for public record(s) in applicable jurisdiction. • Initiate telephone calls to employers, educational institutions, professional organizations, government agencies or other appropriate groups to obtain and/or verify required information. • Follow up on telephone calls as per Company standards and client criteria. • Determine, identify, and research the appropriate information and documentation from client in order to substantiate all time periods under investigation and verify required information. • Contact client or candidate to obtain complete/additional information or for clarification. Show less



MUSC Health

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

• Billing Coordinator

  • Mar 2018 - Jul 2019

  • Responsible for all medical office basic day to day billing functions to include: charge posting, payment posting, filing of claims - electronic and hard copy. • Process refunds and collections as needed. • Identifying customers’ needs clarify information; research every issue and providing solutions. • Posted payments, adjustments, and denials from private, government, and commercial insurance carriers to patient accounts. • Manage large amounts of inbound and outbound calls in… Show more • Responsible for all medical office basic day to day billing functions to include: charge posting, payment posting, filing of claims - electronic and hard copy. • Process refunds and collections as needed. • Identifying customers’ needs clarify information; research every issue and providing solutions. • Posted payments, adjustments, and denials from private, government, and commercial insurance carriers to patient accounts. • Manage large amounts of inbound and outbound calls in a timely manner. • Accurate and timely follow-up of non-government, government, and commercial claims. • Apply cash payments from commercial, government, and private payers to patient account. • Balances batches daily and monthly for end of month closing schedule. • Responsible for patient interactions with patients regarding their account; updating patient demographic information and scheduling patient appointments. • Responsible for Daily Cash and Encounter form balancing based on their individual processing of daily work. • Responsible for denial management and alerting Billing Manager of suspect denials, following up to maintain highest collection standards. Show less • Responsible for all medical office basic day to day billing functions to include: charge posting, payment posting, filing of claims - electronic and hard copy. • Process refunds and collections as needed. • Identifying customers’ needs clarify information; research every issue and providing solutions. • Posted payments, adjustments, and denials from private, government, and commercial insurance carriers to patient accounts. • Manage large amounts of inbound and outbound calls in… Show more • Responsible for all medical office basic day to day billing functions to include: charge posting, payment posting, filing of claims - electronic and hard copy. • Process refunds and collections as needed. • Identifying customers’ needs clarify information; research every issue and providing solutions. • Posted payments, adjustments, and denials from private, government, and commercial insurance carriers to patient accounts. • Manage large amounts of inbound and outbound calls in a timely manner. • Accurate and timely follow-up of non-government, government, and commercial claims. • Apply cash payments from commercial, government, and private payers to patient account. • Balances batches daily and monthly for end of month closing schedule. • Responsible for patient interactions with patients regarding their account; updating patient demographic information and scheduling patient appointments. • Responsible for Daily Cash and Encounter form balancing based on their individual processing of daily work. • Responsible for denial management and alerting Billing Manager of suspect denials, following up to maintain highest collection standards. Show less



Palmetto Health-USC Medical Group

• Hospitals and Health Care
• 100 - 200 Employee

• Account Receivable Representative

  • Apr 2016 - Mar 2018

  • Contact commercial and government payers regarding underpaid and denied claims as well as contacting patients regarding claim issues. • Handle correspondence from insurance companies regarding billing questions, billing issues, and medical claim denials. • Identify and correct any coordination of benefit problems identified on patient accounts. • Accurate and timely follow-up of non-government, government, and commercial claims. • Posted medical office payments, adjustments, and… Show more • Contact commercial and government payers regarding underpaid and denied claims as well as contacting patients regarding claim issues. • Handle correspondence from insurance companies regarding billing questions, billing issues, and medical claim denials. • Identify and correct any coordination of benefit problems identified on patient accounts. • Accurate and timely follow-up of non-government, government, and commercial claims. • Posted medical office payments, adjustments, and denials from private, government, and commercial insurance carriers to patient accounts. • Apply cash payments from commercial, government, and private payers to patient account. • Process refunds as needed. • Conducted peer interviews to gain a complete idea of a candidate's appropriateness for a position. • Trained staff on new system software as well as system changes. • Accurately enter payment information into the computer system and total receipts for deposits. • Reconcile any issues with billing including locating applicable billing information, determining appropriate rebills, and credits. Show less • Contact commercial and government payers regarding underpaid and denied claims as well as contacting patients regarding claim issues. • Handle correspondence from insurance companies regarding billing questions, billing issues, and medical claim denials. • Identify and correct any coordination of benefit problems identified on patient accounts. • Accurate and timely follow-up of non-government, government, and commercial claims. • Posted medical office payments, adjustments, and… Show more • Contact commercial and government payers regarding underpaid and denied claims as well as contacting patients regarding claim issues. • Handle correspondence from insurance companies regarding billing questions, billing issues, and medical claim denials. • Identify and correct any coordination of benefit problems identified on patient accounts. • Accurate and timely follow-up of non-government, government, and commercial claims. • Posted medical office payments, adjustments, and denials from private, government, and commercial insurance carriers to patient accounts. • Apply cash payments from commercial, government, and private payers to patient account. • Process refunds as needed. • Conducted peer interviews to gain a complete idea of a candidate's appropriateness for a position. • Trained staff on new system software as well as system changes. • Accurately enter payment information into the computer system and total receipts for deposits. • Reconcile any issues with billing including locating applicable billing information, determining appropriate rebills, and credits. Show less



PwC

• Professional Services
• 700 & Above Employee

• Medical Collector

  • Sep 2014 - Apr 2016

  • Resolves accounts receivable balance for government and non-government healthcare. • Accurate and timely follow-up of non-government, government, and commercial claims. • Manual and auto posting of incoming payments: patient and insurance. • Posted payments, adjustments, and denials from private, government, and commercial insurance carriers to patient accounts. • Apply cash payments from commercial, government, and private payers to patient account. • Access and interpret… Show more • Resolves accounts receivable balance for government and non-government healthcare. • Accurate and timely follow-up of non-government, government, and commercial claims. • Manual and auto posting of incoming payments: patient and insurance. • Posted payments, adjustments, and denials from private, government, and commercial insurance carriers to patient accounts. • Apply cash payments from commercial, government, and private payers to patient account. • Access and interpret EOB/Remit information • Managed Accounts Receivables follow-up and collection of claims from top to bottom. Show less • Resolves accounts receivable balance for government and non-government healthcare. • Accurate and timely follow-up of non-government, government, and commercial claims. • Manual and auto posting of incoming payments: patient and insurance. • Posted payments, adjustments, and denials from private, government, and commercial insurance carriers to patient accounts. • Apply cash payments from commercial, government, and private payers to patient account. • Access and interpret… Show more • Resolves accounts receivable balance for government and non-government healthcare. • Accurate and timely follow-up of non-government, government, and commercial claims. • Manual and auto posting of incoming payments: patient and insurance. • Posted payments, adjustments, and denials from private, government, and commercial insurance carriers to patient accounts. • Apply cash payments from commercial, government, and private payers to patient account. • Access and interpret EOB/Remit information • Managed Accounts Receivables follow-up and collection of claims from top to bottom. Show less