Teressa D.Grant

**** ******* ***** **.

Houston Texas, 77038

702-***-****

R E S U M

E'

OBJECTIVE: Seeking a challenging position where my administrative/medical

background will be combined with my professionalism, organizational skills

and where career advancement is prominently available. Flexible individual

that's open to all growth opportunity.

EDUCATION:

Jefferson Davis High School- High School Diploma

Houston Community College- Business Administration

Hargest Vocational & Technical School-Medical Assistant

El-Centro College-Basics Of Credentialing

Univ. of UT @ Arlington-OSHA 510 Standards for Construction Industry

EXPERIENCE:

June 2014 to present HCA/PARALLON HOUSTON, TEXAS

Registrar

Responsible for greeting incoming patients, distributing paperwork,

entering in pertinent information, including insurance and demographic, and

handling the processing of insurance.

Secure all signatures necessary for treatments, release of medical

information, assignment of insurance benefits and payment of services from

legally responsible patients. Work closely and professionally with nursing

and ancillary departments in effort to maintain a teamwork approach. Excel

in all functions performed by patient representatives. Collect/request

deposits and copays. Register all patient types. Assists in resolving

patient concerns. Assist Supervisor to insure all personnel department

policies and procedures are followed .

May 2012 - June 2014 WELLPOINT/AMERIGROUP

HOUSTON, TEXAS

Claims Rep II (HLTH & DNT)

Research and determine status of medical related claims. Review charges

to determine if claim is payable or deniable. Utilize payment or denial

codes within established department guidelines and standards. Process

corrected claims from providers. Request information to support the medical

claim. Meet department production and quality standards. Customer service

internal and external.

8/2009-11/2011 HCA PATIENT ACCOUNTS SERVICES

HOUSTON, TEXAS

Patient Access Teamleader/Registrar

Staff and

order supplies according to budget guidelines and department needs .

Maintain QA statistics (including patient wait times, etc.) and report

results to Supervisor. Oversee the daily activities of the registration

area to insure department standards are met Assists Supervisor in educating

registration staff of any changes pertinent to their roles. When

appropriate, relieve staff members during employee sick/vacation time.

Secure all signatures necessary for treatments, release of medical

information, assignment of insurance benefits and payment of services from

legally responsible patients. Work closely and professionally with nursing

and ancillary departments in effort to maintain a teamwork approach .Excel

in all functions performed by patient representatives. Collect/request

deposits and copays. Register all patient types. Assists in resolving

patient concerns. Assist Supervisor to insure all personnel department

policies and procedures are followed .

4/2008-8/2009 HCA PATIENT ACCOUNTS SERVICES

HOUSTON, TEXAS

Credentialing Verifier

Manuel entry of practitioner data. Review and verify data. Run sanctions on

practitioners. Run verification letters. Responsible for intake and

tracking of all applications and correspondence and maintaining

documentation. Follow-up with practitioners via phone calls, process

incoming mail, process facsimile verifications, scanning, sending written

inquiries, filing and copying. Review files for completeness of

information, identify deficiencies and pursue incomplete information.

Maintain high quality, timely and accurate credentialing processes of

medical and Allied Healthcare Professionals per CPC policy. Ensure that all

credential files are current and complete pursuant to expiration date of

medical licenses, board certification, professional liability insurance

coverage, DEA and other pertinent information, per CPC policy.

8/2005-4/2008 HCA PATIENT ACCOUNTS SERVICES

HOUSTON, TEXAS.

Collection Specialist

Performs account follow-

up and resolution of patient receivables. Monitor insurance claims by

running appropriate reports and contacting insurance companies to resolve

claims that are not paid in a timely manner - Identify coding or billing

problems from EOBs and work to correct the errors in a timely manner -

Identify problem accounts and escalate as appropriate - Update the patient

account record to identify actions taken on the account - Work with

patients and guarantors to secure payment on outstanding account balances -

Sort and file correspondence.

5/2004-8/2005 HCA PATIENT ACCOUNTS SERVICES HOUSTON,

TEXAS

Support Services Clerk

Match corresponding paperwork with account files and document information

in the system. Retrieve and provide information from Explanation of

Benefits (EOBs) for Customer Service. Representatives to respond to

inquiries. Perform research and correspondence functions to assist with

responses to customer inquiries.

12/2003-5/2004 HCA PATIENT ACCOUNTS SERVICES HOUSTON,

TEXAS

Underpayment Analyst

Perform second validation of discrepancy reason code assigned by the

Discrepancy Analyst. Contact payer and initiate request for payment.

Perform appropriate follow up with payor for payment as appropriate.

Escalate contract issues to the Supervisor.

5/2000-6/2003 SIERRA INSURANCE GROUP LAS

VEGAS, NEVADA

Examiner Assistant

Maintain effective diary system for the timely production of appropriate

benefit checks and notices. Obtain statuses from doctors, employers, and

claimants to provide and receive information related to processing the

claims. Assist the examiners in all aspects including, but not limited to,

file and serving any/all documents, sending letters, preparing files, etc.

Accurately and appropriately document both paper and electronic files notes

as needed. Diagnosing and resolving issues where appropriate and forwarding

to the next level as necessary.

3/2000-5/2000 ADECCO/OLSTEN STAFFING LAS

VEGAS, NEVADA

Administrative Assistant

Clerical support and data entry for various departments. All related

functions included.

01/1997-2/1998 TRINITY HOME HEALTH

HOUSTON, TEXAS

Home Health Aide

Duties include patient care, maintaining all patient charts, mapping vital

signs, administer medications as prescribed by the physician and generate

patient progress reports. Also general housekeeping.

9/1991-11/1996 PRUDENTIAL INSURANCE CO.

SUGARLAND, TEXAS

Credentialing Coordinator

Investigate the licensing status of the Health Care providers as well as

the Healthcare Care facilities. Input and update the licensing structure

via correspondence with the State Board and the Division of Licensing.

Forward health claims to the Utilization Management Department when fraud

is suspected. Run provider and facility reports, review reports for quality

control, maintain, and file reports accurately. Provide customer service to

providers as needed, provide back up support for Security Coordinator, and

data entry of health claims.

9/1988-9/1991 MEMORIAL CITY REHAB HOSPITAL HOUSTON,

TEXAS

Unit Secretary/Rehab Tech

Initiate care performed on patients by ordering and coordinating tests and

transcribing onto patients Kardex. Take orders from charts, insure patients

receive correct diet trays, take used equipment to central supply and pick

up needed equipment. Order daily lab, create patient charts for new

Admissions, call codes and arrange for patient transportation. Answer

phones. Patient Care (bathing, dressings, feeding, bed preparations etc.).

Vital signs. Assisting patient to therapy. Prepared rooms for new

admission/discharge.

CPR

TWIC Card-Expiration 1/19/2017

Houston Area

Safety Counsel Basic Plus Card

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