Customer Service Insurance

EDUCATION:

Master Degree, Health Care Administration and Management with an emphasis in Strategic Innovation and Change Management- Colorado State University

Currently Enrolled-50% Complete

Certifications:

Foundation of Healthcare Administration and Management-80% Complete

Applied Strategic Leadership in the Healthcare industry-75% Complete

Bachelors of Arts, Criminal Justice and Law Enforcement – Colorado State University

Completed January 2014

Certifications:

Applied Criminal Justice and Law Enforcement

Foundations of Criminal Justice and Law Enforcement

Understanding, Interpreting, Enforcing U.S. Law

HEALTHCARE WORK EXPERIENCE:

Centura Health:

January 2015-Present- Castle Rock Adventist Hospital, Castle Rock, CO

OR Charge Auditor and Scheduler

Process OR supply charges, implant logs, and reconcile the invoices against the charges to ensure accuracy onto patient accounts. The invoices are then processed into our Lawson system to create requisitions that can then be processed by our buyers. I have developed numerous tracking systems for charges, RN errors, Bill Only Invoices, as well as department information such as meeting minutes and education material to ensure ease in having to research information and help track down problems. Provide training and materials in scheduling to OR, PACU, and GI staff. I also back up scheduling, I work with physicians and their office staff as well as the OR staff to ensure proper scheduling and obtaining correct instruments, equipment, and implants.

Trouble-shoot problems with charting, verifications, and missing supplies and implants.

Work with multiple departments and staff to resolve issues with charting, charges, and other items on JA numbers also ensuring no time discrepancies between Pre-Op, OR, and PACU. Re-open Verified accounts for RNs in need of updating/correcting charting.

Create training material, reference material, and help guides.

Maintain Iron Mountain Storage box tacking for the department as well as coordinate pick up, and processing of boxes.

Complete month end reporting and keep all tracking information for the department.

Update Vendors with their PO numbers as well as help find patient information and implant records for vendors and contact them if they were missing an invoice for processing.

Handle Block time changes such as releasing block early, changes to block and submitting new block days and times.

Health One/HCA:

November 2014 to January 2015 – Aspen Building at Sky Ridge Lone Tree, CO

Business Office Specialist

Worked in the GI ambulatory surgical center for the South Denver Gastroenterologists physician group where I created charts for upcoming patient procedures, checked in patients, validating patient demographic and insurance information, and validated and pre-authorized insurances. Also took payments for the surgery center and the physician’s office and maintained the payment tracking spreadsheets as well as input required Medicare tracking information.

Memorial Hospital Sweetwater County:

September 2013 to November 2014

Pre-Admissions Registrar/Radiology Schedule

Scheduled appointments for the Radiology, cardiopulmonary, and Pre-Surgical departments. Verified eligibility and obtained any pre-authorizations needed for all patients that were scheduled for exams. During the scheduling process would verify patient demographics, insurance, and ran Sure Pay sheets for patients to give them estimates as to costs of their procedures. I worked with doctor offices and departments within the hospital to ensure same day add-on patient appointments. I also trained back up staff and new hires for the department.

Worked with the software systems Affinity, Quadramed, QES, and Recondo as well as various insurance websites.

Find charge codes, CPT codes, and ICD 9 codes for the pre-authorization process

Organize orders and get orders prepared for the next day’s exams.

Verify and ensure order accuracy.

Verify patient’s lab work and any necessary imaging required for the schedule exam/procedure.

May 2012 to September 2013

Radiology Admissions Specialists

Admitted patients for Radiology services as well as outpatient services check the patient’s demographic information and pre-registered patients for surgical services and OB services. Entered radiology orders into the order system for the technicians to be able to access for the various exams done in the Radiology department. Review Sure Pay sheets generated by scheduling that showed a patient their cost for the exam and take payments. I covered in the ED department when needed.

Scan admissions paperwork, physician orders, driver’s license, and any/all insurance cards and attach to patient records.

Trained new hires to be able to check in patients for general admissions and radiology and trained on the software system for entering in orders.

June 2010 to December 2010

ED Admissions Specialist

Shift lead within the ED admissions team, where I admitted patients, verified patient demographics and insurance information, ran insurance eligibility and payment quotes for visits. Also admitted patients for surgery, OB, outpatient services and direct admit and covered general admissions if needed. Entered charges, faxed the T-P sheets, and broke down charts for HIM and the contracted ED physician biller. Taking payments, balancing the cash drawer and batching the credit card machine were a shift responsibility. I also trained new hires and worked with them on various shifts to ensure that they were knowledgeable for all shifts.

NON HEALTHCARE WORK EXPERENCE:

Warren Federal Credit Union Cheyenne WY:

June 2011 to May 2012

Collections Officer:

Responsible for monitoring over 300 delinquent accounts, worked with members to resolve their delinquency issues, and also worked with many of my members on restructuring their loans, creating loans for Deficient balances, and set up Automatic Clearing House payments. I built relationships with many of my members and was able to work with many of them on getting their loans in a current status.

Consistently met delinquency goals and loan write off goals.

Repossessed vehicles.

Rebuild loans to verify payment history and due dates and send out certified Right to Redeem and Deficient Balance Letters.

File insurance claims for uninsured vehicles, damaged vehicles, & repossession expenses as well as file for refunds for repossessed vehicles GAP, service contracts, Mechanical breakdown insurance, and Warranties. Filed Skip repossession for unit that has been out for repossession over 30 days.

March 2011 to June2011

Shares Process Server

Ran reports and monitor accounts, both savings and checking, that fell into a negative balance status. I would work with members to help with their accounts and could load the 3 month repayment loan that the credit union offered for.

Generate late notices and send letters regarding account information.

Charged off accounts negative over 45 days.

Report charged off members to the Chex system

Run reports and compile information for reports and perform mail merges for various account information and members.

Helped fill in and cover the collections department when needed.

December 2010 – March 2011

Floating Teller

Floated between 3 different branches working where I was needed and helped fill in the Shares Process Server position when needed. Warren had an extensive teller training program as well as an extensive customer service training program which I completed both programs within the first 30 days of hire.

I deposits, withdrawals, loan and visa payments, and various complex transactions.

I assisted with account information and maintenance for members.

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