Shelia Donley

Senior Member Service Representative at Family Health Network
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Contact Information
us****@****om
(386) 825-5501
Location
Greater Chicago Area

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Bio

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Credentials

  • Business Administration Certificate
    -
    Jun, 1984
    - Oct, 2024

Experience

    • Hospitals and Health Care
    • 1 - 100 Employee
    • Senior Member Service Representative
      • Oct 2014 - Present
    • United States
    • Hospitals and Health Care
    • 700 & Above Employee
    • Patient Coordinator
      • Jan 2014 - Aug 2014

      Greet patients and visitors who enter the clinic and help/greet accordingly and provide excellent customer service. Receive phone calls from patients, physician offices, attorney offices, and rehab counselors. Schedule patients for initial evaluations, follow up appointments and take referrals over the phone. Refer all clinical matters regarding patients to attending or nurse. Call insurance companies to verify benefits in a timely manner and obtain pre-certification for services by those insurance companies which requires it. Obtain authorization when requested by the physician. Follow up on requests for authorization sent to insurance carriers. Follow up on progress reports sent to referring physician office in regards to patient's progress. Assist patients with making follow up appointments, calling for transportation needs, scheduling interpreter services, and/or helping patients schedule follow up appointments with their physicians as needed. Provide patients with update information what insurance benefits will cover and not cover. Accurately enters patient demographic and billing information into EPIC database. Process weekly co-payments and create a deposit. Resolves billing issues that come over from Corporate Office. Show less

    • United States
    • Hospitals and Health Care
    • 700 & Above Employee
    • Customer Service Representative
      • Nov 2010 - Jul 2013

      Handled incoming and outgoing customer calls, scheduling patients, explaining payment and insurance options, connecting external calls to the correct internal contact and answering general questions about the services we provide, location and hours. Occasionally, dealt with account inquiries, billing, payment arrangements, customer complaints and support issues.• Scheduled patient's appointments using EPIC database.• Fulfills request by clarifying desired information, completing transactions and forwarding requests.• New patient information via patient portal or manually.• Update job knowledge by participating in educational opportunities.• Keeps equipment operational by following established procedures and reporting malfunctions Show less

    • Hemophilia & Thrombophilia Clinic Coordinator II
      • Sep 2008 - Oct 2010

      Obtained all information for new referrals correctly and accurately from the referral source or patient utilizing the Intake Referral Form. Confirmed that all insurance is verified and approved prior to services and quote patient benefits. Notify referral source, patient/caregivers of acceptance or denial, insurance coverage and estimated daily charges. Ensured that all patient demographics and insurance information was correctly entered into database in a timely manner. Double checked that all initial admission paperwork was compiled and forwarded to Nursing Department in a timely manner. In addition, responsible for checking emails on a daily basis and responding to email in a courteous, service-oriented manner. Forward comments and emails to appropriate individuals if necessary. Maintained updated calendar of conference and computer room reservations. Routes mail to appropriate party, retains copy for follow up, and closure.• Daily scanning, data entry and troubleshooting of patient paperwork using EMR• Oversee records request and other front desk invoices.• Organize the details of special events, travel arrangements, corporate agendas and itineraries.• Managed and assisted with tracking budgets and expenditures.• Promote accuracy and efficiency in front desk procedures and paperwork. Show less

    • Lead Front Desk Clinic Coordinator - Pediatric Subspecialty Clinic
      • May 2006 - Sep 2008

      Answered and initiated calls, took and reported messages in a timely and accurate fashion, received visitors and directed them wherever required. Maintained front desk areas clean, spacious and presentable. Maintained good, productive contacts with clients and company staff. Performed bookkeeping and accounting work such bank transactions, accounts report and insurance. Kept detailed records of important conferences such as board meetings and committee meetings. Word-processed documents, edited and proofread when necessary, wrote thank you letters and prepared mailing lists. Managed incoming and outgoing mail, emails and checks and kept a daily deposit ledger. Helped company employees with administrative issues on a regular basis.• Oversee patient intake and reception for multiple clinic shifts.• Answer phone calls and assist with phone system.• Assist clients with all clinic and billing paperwork.• Provide extensive referrals for client to various community agencies.• Engage in crisis intervention and client advocacy.• Filed all charts, medical records and correspondence into patient charts Show less

    • Secretary III
      • Sep 2004 - May 2006

      Organize and provided documents, reports and information to department and external clients in a useful and well-organized manner. Create and maintain active files. Schedule travel, coordinate with travel agency to obtain the best possible trip and prepare travel expense reports accordingly. Plan meetings and conference calls and arrange and manage meetings. Take and compile minutes of meeting. Initiate purchase requisitions. Order office supplies and equipment. Maintain files and folders of patients. Maintain weekly schedules for employees. Handle and screen telephone calls, routine mail and reallocate as required. Train and supervise casual and clerical staff. Process client orders, invoices and payments. Perform basis billing, bookkeeping activities. Create and maintain database records. Manage front office operations. Manage physician calendars.• Performed secretarial/clerical duties including medical transcription, composition and dictation.• Prepared and processed all correspondence.• Responded to incoming telephone calls, screening calls, taking and relaying messages and providing information.• Providing support services to patients and medical staff.• Scheduling appointments and admissions as requested. Maintained appointment books for patients and updating physician EPIC schedules/templates when needed Show less

Education

  • Robert Morris University - Illinois
    Bachelor's Degree, Business Administration and Management
    2008 - 2011
  • Robert Morris University - Illinois
    Associate's Degree, Business Administration and Management
    1982 - 1984

Community

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