Patient Access Primary Care
Resume:
OBJECTIVE
My primary objective is to bring consistency and dedication.
Providing task attentiveness daily, conquering with a prepared plan.
REFERENCES
Available upon request.
ADDRESS
**** **ade Creek Trail Forest Park, Ga
30297
PHONE
ad5vqd@r.postjobfree.com ad5vqd@r.postjobfree.com
EXPERIENCE
MAR 2021 TO Mar 2024
GRADY HOSPITAL PATIENT ACCESS ATLANTA, GA 30303
Authenticate call on epic by verifying demographic, insurance.
Proceed with scheduling financial counseling, primary care, specialty, med- subspecialty, Employee line, geriatric, toxicology, radiology and close with making sure Hospital Account Record. Closing with thank you on every call.
Handled insurance verification and referrals for patients, ensuring accuracy and timeliness.
Assisted in prior authorization of the patients.
Managed prior authorizations and coordinated surgical schedules for patients.
Handled Medicaid and Medicare processes for patients, ensuring compliance and coverage.
Managed Explanation of Benefits (EOB) and conducted benefit verifications for patients.
Verified patient benefits and coverage details with insurance companies.
Managed medical claims processing and appeals, ensuring proper documentation and follow-up.
Addressed escalated calls regarding insurance coverage issues, providing prompt and effective resolution.
Conducted detailed calls with insurance companies to verify patient details and coverage.
Managed a high volume of inbound and outbound calls, averaging 50+ calls daily,
Reason of Gap: Family
JAN 2016 TO DEC 2019
NCO FINANCIAL SERVICE ATLANTA, GA 30322
Key responsibility Authenticate call, collect demographic, verified insurance, enter data into computer, schedule /confirm appointments, follow guidelines for stat request, notify patients/physicians on correct authorization needed, properly respond to hearing impaired individuals, upload orders, review order making sure everything displayed, scanned orders, create health record numbers as needed, operate fax/copier machine and review precertification before patients appointments making sure in approved statues.
• Handled insurance verification and referrals for patients, ensuring accuracy and timeliness.
• Managed prior authorizations and coordinated surgical schedules for patients.
• Handled Medicaid and Medicare processes for patients, ensuring compliance and coverage.
• Managed Explanation of Benefits (EOB) and conducted benefit verifications for patients.
• Verified patient benefits and coverage details with insurance companies.
• Managed medical claims processing and appeals, ensuring proper documentation and follow-up.
• Addressed escalated calls regarding insurance coverage issues, providing prompt and effective resolution.
• Conducted detailed calls with insurance companies to verify patient details and coverage.
• Managed a high volume of inbound and outbound calls, averaging 50+ calls daily,
Jan 2011 to Dec 2015
HP Enterprise Georgia Medicaid Tucker, Ga 30384
Authenticate Calls, provide statues of eligibility, copays, and benefit plan, reissue Medicaid cards, EDI password reset for medical members/billing agents, transfer calls as needed, review cpt codes, ICD 9 codes, HCPCS and modifiers, review provider contract, ub04 and HCFA1500 claim forms, provide statues of claim statues paid, denied or pending statues, reviewed provider contracts.
Handled Insurance verification, prior authorization.
Handled benefit verification of the patients.
Jan 2003 to Dec 2010
Tucker Pediatric Tucker, Ga 30384
Schedule/Reschedule confirm appointments, verify insurance, numeric filing, charting, claim review billing, coding, collected co-pays, referrals, and be an advocate by reviewing explanations of benefits with patients. Leadership roles such as overseeing
to patient balances after all collection efforts have been exhausted, Maintain positive relationships with families daily.
EDUCATION
HSD – Aug 2002
Cornerstone christian academy
TECHINICAL SKILLS
EPIC, MICROSOFT WORD, EXCEL
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