Karla Gorham

Insurance Coordinator/Patient Services - Visionary Eye Doctors

Gaithersburg, MD 20886

ad22lt@r.postjobfree.com

+1-240-***-****

Work Experience

Scheduler/Call Center

Maryland Oncology Hematology - Rockville, MD

September 2022 to Present

Weekly rotating schedule

Call center responsible for answering phones, schedule appointments for existing patients. Front desk duties

Check in patients

Check out patients

Scheduler

Adventist HealthCare - Rockville, MD

September 2017 to Present

Receive calls from patients to schedule annual screenings to specialized tests. Respond to online requests from patients requesting to make appointments for CT scans, MRIs Mammograms etc. Insurance Coordinator/Patient Services

Visionary Eye Doctors - Rockville, MD

February 2017 to Present

Verify Insurances, checked vision benefits, Called Insurances to obtain surgery authorizations. Scheduled surgeries in different locations.

Representative/Call Center Representative

Visionary Eye Doctors

February 2017 to Present

Verify insurances and surgical

procedures for patients requiring

surgical procedures

● Front Desk duties Check in check out patients

● Verified Vision Insurances

● Took calls for appointments

● Post payments

● Collect payments

Call Center Representative/Collection Specialist

Global Reimbursements - Gaithersburg, MD

July 2016 to February 2017

Take payments from patients for services rendered.

● Provide patients information for Financial Assistance.

● Assist with Bilingual line.

● Advise patients of services rendered for different Dates of Service

● Outbound Collection calls.

● Verification of Insurance.

Lead Receptionist

Capital Neurology and Sleep Medicine

April 2016 to July 2016

Greet patients check in and check out patients.

● Answer multi line phone system.

● Utilized EMR ATHENA for reconciliation

and daily office tasks.

Certification Specialist

Quadrant Inc - Silver Spring, MD

November 2015 to February 2016

Assisted with name changes.

● Shipped verification notices to clinicians

and also to State Boards as requested.

● Assisted Nurses over the phone with certification procedures.

● Assisted clinicians with shipping

materials for certification testing.

Scheduling Coordinator

Corporate Health - Rockville, MD

June 2010 to October 2015

Received requests from contracted

companies to schedule pre-employment

testing for incoming candidates.

● Contacted candidates for verification of demographic information.

● Scheduled required testing for the companies (i.e. drug screens, pre-employment physicals, lab testing, and surgeries).

● Shipped required paperwork to the

candidates desired facilities Followed the company's protocols and testing recommendations.

Program Representative/Compliance Specialist

TheraCom A CVS Caremark Company - Rockville, MD

May 2008 to June 2010

Provide telephone resource to patients'

physicians and other health care

professionals.

● Contact patients each month to discuss

wellbeing and the medication effects.

● Process general product and support

services inquiries.

● Adverse events reports and refilling and replacing orders. Front Desk Receptionist

Medical Access - Germantown, MD

January 2007 to November 2009

Greeted patients and utilized EMR's for patients.

● Received and obtained messages from patients and other medical professionals.

● Answered multi line phone systems.

● Collected copays from patients.

● Performed Urine drug screens.

Patient Access Representative

Shady Grove Adventist Hospital - Rockville, MD

November 2006 to February 2008

Registered incoming emergency

department patients.

● Contacted insurance for emergency

procedures if needed.

● Assisted essential personnel with translation if necessary.

● Handled on line registration for surgical

procedures also with labor and delivery

department.

● Contacted insurances for prior

authorization.

Member Services Representative/Claims

United Health Care - Frederick, MD

May 2002 to January 2007

Processor

● Assisted consumers with telephone

inquiries regarding health plans.

● Assisted with DME Claims.

● Approved DME prior-authorizations.

● Informed consumers about benefit

allowances.

● Contacted physicians for information to prior authorize surgical procedures

● Processed consumers claims submitted.

Education

Associate in Arts in General Studies in General Studies Montgomery College

High School Diploma

Albert Einstein High School - Kensington, MD

Skills

• billing (Less than 1 year)

• Claims (4 years)

• CPT (Less than 1 year)

• EXCELLENT WRITTEN AND VERBAL COMMUNICATION SKILLS (Less than 1 year)

• multi line phone (3 years)

• ICD-9

• Medical Billing

• Athenahealth

• ICD-10

Additional Information

SKILLS

● Proficient with Microsoft Office,

PowerPoint, and Outlook, and Oracle

● Experienced with multi line phone

system

● Fluent in Written and verbal Spanish

● Experienced with Electronic Medical

Records using IDX, Athena, and EClinical

● Proficient is medical billing and claims

processing using ICD-9 codes CPT

codes, also familiar with ICD-10 code,

coinsurance, deductibles, copays.

● Experience with MedInformatics

● Experienced with Medflow

● Experienced with Clearwave

Experienced in QuickBooks

● Experienced with Sage and Peachtree

program

● Familiar with Composite Health Care

System (CHCS)

Contact this candidate