Medical Insurance

Summary of Qualifications

A highly driven Bi-lingual Healthcare Professional, with expertise in

problem solving, organization, multi-tasking, case and time management

skills. Also, I possess leadership experience and have developed new

strategies for policy implementations. I also have the ability to perform

under pressure. I am looking for an opportunity to expand my knowledge in

the health care field.

Professional Experience

Financial Counselor

Children Healthcare of Atlanta-Scottish Rite . Atlanta, Ga. . Present

. Responsible for representing the Hospital in financial matters pertaining

to obtaining payment on patient accounts.

. Assists patients and families to find appropriate sources to pay hospital

bills, such as Medicaid, Charity Care, Family Care, and/or payment plans.

Referring patients to appropriate state or county programs for financial

assistance.

. Contacts insurance companies to verify payment eligibility and plan

specifics regarding coverage and benefits

. Interacts with all payers to provide necessary information and document

authorizations on patient accounts.

. Go to quarterly training programs to stay up to date on the newest

insurance policies and procedures.

. Travel between hospitals 75% of the time.

Registration Coordinator

Children Healthcare of Atlanta-Scottish Rite . Atlanta, Ga. . 2010-2014

.Communicated with patients, physicians, and clinical staff on a daily

basis to verify insurance to assure quality patient care and payment of

hospital.

.Responsible for the authorization, pre-certification and referrals

services by coordinating and performing activities required for

verification and authorization of insurance benefits for services.

.Interviewed and registered over 100 outpatients daily.

.Collaborated with appeals department to overturn denials

.Interpreted for Spanish speaking families between doctors, hospital staff,

and insurance companies.

.Proactively identified and communicated with families the financial

resources available to patients, whose health plan does not include

coverage for services, coordinating counseling services with Social Worker

as required.

.Provided other registration, clerical and billing support as required such

as scheduling appointments, medical records chart creation, charge entry,

billing adjustment and account resolution etc

.Took Epic provider template course in order to help manager maintain and

edit schedule for physicians and patients.

.Trained new Access Specialist employees in our department.

Financial Counselor /Medicaid Specialist

Chamberlin Edmonds. Atlanta, Ga. . 2007- 2010

. Responsible for maintaining communication between agency case workers and

clients in assistance with the resolution of Medicaid Applications and

resolving patient hospital accounts.

.Acted as a liaison between Chamberlin Edmonds and Metro Atlanta Hospitals

to ensure invoices for hospital visits are compensated.

.Collaborated with caseworkers for accuracy prior to submittal

.Possessing knowledge of medical terminology in order to collect and

correctly document applicant profile

.Worked on documents and performed updates in Patient Advocacy Chamberlin

Edmonds System (PACE) and (CITRIX) Systems. Process all RSM Medicaid

application and assist with ongoing updates needed for hospital accounts.

Caseworker

Cobb County Department of Family and Children Services (DFCS) . Marietta,

GA . 2005- 2007

.Registered English and Spanish Medicaid, Temporary Assistance for Needy

Families (TANF), and Food Stamp Applications

.Utilized Microsoft Excel while documenting applications in DFCS worker

card for the entire Medicaid Unit

.Finalized registration procedures by creating and organizing case records

.Responsible for distribution of agency mail, and front desk attendance

.Translated letters and phone calls from Spanish speaking clients

.Assisted caseworkers with appointments and interpreted applications for

Registration Unit

Childcare Director

Saint Jude Day School . Smyrna, Ga. . 2003- 2005

. Supervised and managed approximately 15 teachers, assistant teachers, and

kitchen staff

. Developed and reviewed teachers' lesson plans and chose curriculum used

in the center.

.Responsible for administrative tasks involving including processing

enrollments, keeping attendance

. Maintained and organized health and safety records, including medical and

emergency contact information, ordered supplies and kept billing records

Education

.Medical Interpreter Training Certificate- Georgia Mutual Assistance

Association Consortium (GMAAC) - July 2006

CERTIFIED THROUGH CHILDREN Health care of Atlanta Bilingual

Software Familiarity

. Microsoft Word, Access, Excel, Power Point, Outlook, Lotus Notes, EPIC,Citrix and EHR system Chart Max.

Contact this candidate