Objective: To enhance a company’s performance with exceptional organizational, communicative and interpersonal skills in the Administrative Assistant field.

Work Experience:

Chamberlin Edmonds an Emdeon Company, Newark Beth Israel Medical Center. 2/2012 to 3/2015

Resolve Application Specialist Field Representative / Charity Care Center

Responsibilities:

Document and update the PACE (Patient Advocacy at Chamberlin Edmonds System) based on daily contact of select members of assigned applicant group and application evidence requirements, i.e. work activity, medical condition, third party, beneficiary, contact and demographic data financial, life and health insurance information, employment and salary verification, medical history and documentation where evidence is required.

Complete hold report run NJMMIS on line for ins verification, submit ins for billing, call pt. leave voice messages, send out certify letter, send email to supervisor for skip trace and HCR for additional information in SMS system in hospital that may help to make contact with client.

Reviews inbox for daily work queues, identifies missing evidence and follows through for completion

Answer incoming calls from clients and Health Care Representatives

Assist callers in resolving account issues by identifying and taking appropriate actions including completing required forms to support application process

Effectively educate and answers inquiries from patients and family representatives regarding application process

Assist clients with scheduling appointments and reminding of appointments, as needed

Maintain ongoing communication with other internal Resolve Application functions to obtain information and/or provide updates regarding claim status

Identify and take appropriate actions to complete and submit required financial, medical and personal information forms to support the client application process

Review Chamberlin Edmonds software system for document mailings prior to applications, pending documents, etc. packaged and mailed or fedex to external sources

Diligently follows-up with institutions/businesses resolving issues ultimately affecting application approval

Identify appropriate escalation points and works with Escalation Team Leader to resolve issues

Review outgoing client material for accuracy prior to submittal

Comply with CEA’s ethics, privacy and compliance policies and procedures

Follow up with claims for Federal/State and Charity Care

Review daily work list for evidence pending to complete Charity Care Applications.

Assist hospital in obtaining all information to complete applications

Review information in Company’s system, Update and verify all demographics for clients

Follow up diligently with instructions with business resolving issues ultimately affecting application approval

Assist patients on completing the Charity Care applications and mail correspondence as well as follow State guidelines with all HIPAA regulations

Assist in obtaining Medicaid verification via online or phone.

Certification and Awards:

I obtain certifications for Certificate of completion for the New Jersey Family Care CEU’s Award.

Certified Market Place Application Counselor

Certification for Security Awareness HIPPA and HITECH privacy training

Certification of Code of Conduct and Ethics training.

Certificates of completion for CEA, Forms Part 1, ACA.

Certificate of completion of Documentation training

Certificate of completion of Medicare/ Medicaid Cost report training.

Certificate of completion of claims submission training.

Mount Carmel Guild / Integrated Case Management Services Nov 2007 to Nov 2011

Medical record Clerk/Patient Accounts

Proactively establish and maintain working team relationships with all supporting staff

Establish, maintain organized, secured medical files, sorted by medical record numbers

Complete insurance verification, Commercial Insurance / Managed Care and medical Eligibility though the electronic System EMEVS

State specific UFTS acceptance and terminations in the CMHC program for hospital and clinic data base partial care for adults, and integrated case management behavioral health services.

Providing Team leaders, Case Manager, supervisor and Program manager with update client biweekly Case loads

Responsible in taking meeting minutes for CQI and Staff meeting minutes

Medicaid Data entry and internal Chart Audit

I would be responsible in backing up supervisor or medical biller if and when it would be necessary with Medicaid billing and compliance

Patient’s changes of statues update.

In charged of agency’s vehicles Maintenance service slips also biweekly vehicle check lists (Insurance Registrations Oil change, Inspections as well as getting proper towing services for road assistance if needed Insurance claims, Incidents reports). Responsible for sending all incident or accidents reports to Human Resources.

Participated in interview Panel.

. Have some knowledge in Entitlements,

Screening potential uninsured Clients for Medicaid Eligibility though SSI

La Casa De Con Pedro, Newark NJ Aug 2007 to Oct 2007

Secretary / Support Staff

Temporarily Assigned

Greeted all visitors as well as provided useful information

Delivered a clerical support to staff including but not limited to filing, faxing and data entry

Maintained a professional work environment

Skills

Fluent in Spanish and English (written and oral)

Expertise Knowledge in power point, Microsoft Word and Excel

45/55 WPM

Education

Phoenix University Jan 2011- February 2016

Health Administration Arts and Science

Contact this candidate