Experience

Adeptus Health

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

• Facility Resource Specialist

  • Jul 2014 - Present

  Responsible for greeting patient, and efficient check in Accurately enter patient demographics in a timely manner Assist Medical staff as needed Obtain the appropriate identification and insurance information at time of check in Verify insurance eligibility in formation, and collect the proper copayments Properly answer any billing questions and help to educate patient on prompt payment. Responsible for properly scanning paperwork into Centricity Answer phones and direct calls appropriately Assist outside offices in obtaining medical records and other information for follow up care Trained new staff on facility resource duties, as well as company and department policies and procedures Had the opportunity to collaborate with the Facility Administrator in hiring and termination decisions for department staff Conducted performance reviews and counseling sessions. Prepared monthly work schedule for the department; includes scheduling PTO and minimizing overtime Reviewed all department hours and submits to payroll Managed staffing for open shifts and coverage for managers allowing for time off Reviewed and processed patient registration forms and medical records ensuring they contain all necessary documents. Completed and balance all daily transaction paperwork. Maintained consistent and professional attendance, punctuality, personal appearance, and adherence to relevant health & safety procedures. Followed and maintained current knowledge of company and department policies and procedures Show less



UnitedHealth Group

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

• Referral Specialist

  • Oct 2013 - Jul 2014

  Responsible for daily processing of Tricare referrals for Tricare beneficiaries, and coordination with Military Treatment Facilities Responsible for proper routing of referrals to MTF in order to help provide efficient and timely healthcare services. Make outbound calls as needed to providers to gather required information for referrals Resolve customer service inquiries which could include and not limited to; entering notifications, provider’s status of an existing notification, and determine if notification is required. Complete notification wizard along with ICD-9 and CPT coding. Meet/ record established productivity, and quality standards. Assist with faxes, emails, and letters to the beneficiaries, providers, and Military Treatment Facilities Show less



Centura Health

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

• Patient Access Representative/Registar

  • Aug 2012 - Oct 2013

  Interview patients and families to obtain demographic and financial information in order to complete registration process. Verify insurance benefits, and explain the financial requirements to the patient or patient representative. Collect co-payments and any other patient portion prior to the point of service Demonstrate positive customer service to all patients and visitors Escort patient, family, or visitors to the proper clinical areas Answer phones and take detailed messages Serve as a mentor to new associates, and assist in new employee orientation. Show less



University Hospitals of Cleveland

• United States
• Medical Practices
• 1 - 100 Employee

• Patient Service Representative

  • Mar 2012 - Jul 2012

  Performs order entry for Laboratory and Radiology testing Ensures prompt registrations for an efficient and timely patient flowProcess Direct AdmissionsObtain necessary signatures and insurance information Collect co-payments and deductibles at the time of service Assist in the training process of all new employees of the ER

• Lead Patient Access Representative

  • Sep 2011 - Mar 2012

  Acts as a liaison between site employees and administration; provides daily supervision to employees Prepares/Reconciles reports for administration in a timely manner Reviews physician schedules to ensure patients are scheduled appropriately and in accordance with physician/departmental guidelines Proactively notifies and assists direct report of any inconsistencies with patient/physician scheduling Successfully transfers information on policy and clinic related matters to staff Performs audits to assist in continued employee/departmental growth Registers patients in a courteous and efficient manner; obtains accurate and complete registration Schedule patient appointments Show less



Cleveland Clinic

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

• Resource Center Assistant

  • Feb 2011 - Sep 2011

  Assists the department with case management issues, utilization management processes, and facilitation of simple discharge planning needs such as the faxing for home care referrals and simple nursing home returns. Provides non-clinical support to the Case Management staff in order to ensure appropriate and efficient use of hospital services and resources Help to maximize financial reimbursement for the facility Assist with payor management communications, concurrently and during the denial management process Acts as a resource and guide for the physician and case management staff on utilization and payment issues Show less



University of Colorado Hospital

• United States
• Medical Practices

• Patient Registrar

  • Nov 2010 - Feb 2011

  Registers patients, obtaining and entering all necessary demographic and financial related information Updates and corrects patient account information in the computer system. Ensures new and updated documentation is filed in the medical record. Verifies insurance coverage eligibility prior to the services Prepares and issues receipts, processes credit card payments and properly performs daily cash handling procedures and end-of-day accounting functions. Answers telephone, screens calls, provides information to patients and other callers as directed. Identify and print lab and x-ray requisitions for patients. Assist with error corrections and correcting accounts Obtains appropriate information for registration and billing Responsible to coordinate and communicate effectively with scheduling, physician offices and insurance companies to ensure authorization is in place of services prior to scheduled appointments Collect co-pays/deposits and accountable for funds according to policy. Interviews patients to verify accurate insurance, employment, and demographic information. Show less



Pikes Peak Cardiology

• United States
• Hospitals and Health Care

• Patient Registrar

  • Jul 2010 - Nov 2010

  Worked as a liaison between Memorial Health System and Cardiodiagnostics/PPC to ensure an efficient registration process for patients Helped to create and implement effective registration processes for newly created registration office Trained employees in Memorial Health System pre-registration/registration processes and all payment posting processes. Responsible for Greeting and checking in all Memorial Health System patients in a professional and courteous manner Verified insurance, employment, and demographic information Maintained accurate receipt book and cash drawer Ensures all documents/signatures have been completed. Show less

• Patient Access/Account Analyst

  • Nov 2009 - Jul 2010

  Ensures all documents/signatures have been completed, to include the Medicare/Tricare Rights forms and properly noted in HIS. Reviews the hospital admission census, and other related systems/reports daily to perform job duties Responsible to make proper notification and follow-up on transfers between facilities, account updates and for Observations/Inpatient status changes. Provides follow-up and further investigation based on changes to the patients type or change in appointment/physicians order. Show less

• Patient Account Analyst/Insurance Specialist

  • Apr 2009 - Nov 2009

  Responsible to validate payor specific errors, transmit all electronic, hard copy claims in accordance with federal, state, and contractual guidelines. Review and research charges, CPT, HCPCS, and ICD-9 codes for accuracy in compliance with government regulations. Coordinate any and all charges and errors with appropriate department.

• Billing A/R Manager

  • Mar 2008 - Apr 2009

  Contact insurance companies to obtain claims status information Follow up with insurance carriers and PPC staff for information essential for proper billing and collections Correct insurance information and redirect bills to appropriate payer Post all payments and adjustments to the specified patient account and reviewed scanned documentation to identify contractual amounts, denials or payment adjustments that require posting to patient accounts Worked to identify the appropriate account for unidentified cash and ensured that all such cash was posted or that a refund was requested within the appropriate time lines Assisted in the research and correction of posting errors Responsible for posting of daily nuclear charges into the Centricity billing system Independently tracked A/R's and report monthly progress to the head of the Billing department Post charges from encounter forms within 24 hours, and perform daily audits to ensure that all forms have been received Followed up with appropriate personnel to obtain complete information Show less

• Patient Service Representative

  • Jun 2004 - Jan 2008

  Responsible to perform general clerical duties related to greeting patients, answering incoming/outgoing calls, and scheduling appointments Registered patients, including entering patient demographics, verifying and updating insurance coverage Responsible for collecting co-payments and daily balancing of monies collected Responsible for correcting weekly registration errors reports Responsible for taking messages, documenting orders for various test and medications

• Patient Account Representative

  • Apr 2000 - Jun 2004

  Responsible for contacting insurance companies to obtain claims status information. Verify and update patient insurance information utilizing ADTR, HBO, and Epic systems. Research and examine recent insurance denials for all insurance payers. Identify trends to determine preventive and corrective action. Bill corrected claims, access cases for refunds and adjustments. Proficient in using Internet based payers such as SMS, Claims Track, Last Word, and Microsoft Excel.