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patient access rep

Location:
Houston, TX
Posted:
September 22, 2016

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Resume:

Michelle Wynn

PATIENT ACCESS ADMITTING & EMERGENCY ROOM REGISTRAR - Medical

Receptionist

acwqfi@r.postjobfree.com - 832-***-****

I have over 25 years in the patient access. Very knowledgeable of insurance verification. Also have experience as a centralized scheduler, medical office receptionist. Willing to relocate to: Houston, TX - Atlanta, GA - North Carolina Authorized to work in the US for any employer

WORK EXPERIENCE

DME Verifier/ Medical Biller

TMMS - Houston, TX - May 2015 to Present

Verify and obtains all patient eligibility, authorizations, benefits, and claim information with insurance companies, 3rd party payer at least within 3 business days prior to their appointment for durable medical equipment using Centricity. All verify that all necessary documentation is on the patient's chart if not notify the ordering physician that documentation is needed prior to the patient's. Generate and processes all insurance claims.

Perform follow up activities timely on all accounts to ensure prompt payment. Prepare accounts for rebilling and for filing secondary insurance; sends to carrier with necessary documents, as needed.

Completes filing and follow-up on insurance denials with coder and physicians. Serve as back up for business office positions when needed. Assist other employees when time allows and completes other duties as assigned. Perform routine clerical and administrative functions, including answering incoming phone calls. Other duties as assigned based on business operational needs. SECRETARY-PRN from home.

US Global Construction, LLC - Raleigh, NC - April 2014 to Present Answered, screened and directed inbound phone calls.

• Performed general secretarial duties, including - meeting scheduling, appointment set up, faxing and mailing.

• Took verbal and written messages and transmitted them to exact person/destination.

• Handled general requests for information and data.

• Handled delicate situations, such as - customer requests, special needs and complaints.

• Performed basic customer service functions.

PATIENT ACCESS ADMITTING & EMERGENCY ROOM REGISTRAR Office Team - Midlothian, VA - September 2014 to March 2015 Richmond & Midlothian, Virginia

PATIENT ACCESS ADMITTING & EMERGENCY ROOM REGISTRAR

• Accurately register patients by bedside or workstation in a timely manner for demographic and insurance information.

• Using a patient secure palm scanner to identify patients

• Admit patients in a timely manner, obtain appropriate signatures, copies of insurance cards and driver's license.

• Verify patients insurance for active coverage hospital using the Epic system

• Collecting ER co pays admit co pays deductibles and payments.

• Post patient payments

• Obtain signatures on a notice from Medicare about their rights as a patient. PATIENT ACCESS OB ER REGISTRAR

Methodist Hospital System - Houston, TX - August 2010 to April 2014 Accurately register patients by bedside or workstation in a timely manner for demographic and insurance information.

• Admit patients in a timely manner: obtain appropriate signatures, copies of insurance cards and driver's license.

• Verify patients insurance for active coverage hospital coverage via PWL, Availity and Insurance websites.

• Collecting ER co pays admit co pays deductibles and payments. Collected $155,717.13 in 2013 one of the top collectors in my area.

• Post patient payments

• Obtain signatures on Medicare letters and Advance beneficiary Notices INSURANCE VERIFICATION SPECIALIST

North Cypress Medical Center - Cypress, TX - July 2009 to August 2010 Verify patient insurance & obtain prior authorizations for same day surgeries.

• Initiate admission notification for authorization for hospital and observation stay.

• Notify case management of pending authorizations. PATIENT ACCESS ER REGISTRAR

HCA West Houston Medical Center - Houston, TX - March 2009 to July 2009 Accurately register patients by bedside or workstation in a timely manner for demographic and insurance information.

• Admit patients in a timely manner; obtain all signatures, copies of insurance cards and driver's license.

• Verify patients insurance for active hospital coverage via PWL and Availity websites.

• Collecting ER co pays, admits co pays, deductibles, and payments.

• Post patient payments.

PATIENT SERVICE COORDINATOR

MD Anderson Cancer Center - Houston, TX - January 2008 to March 2009 Working with physicians, physician assistants and nurses for scheduling, rescheduling and add-ons

• Conveying appointment information to patients in a timely manner in person, telephone or in writing

• Provided patients with pertinent information regarding their schedule and for ancillary appointments

• Answered telephones, scheduled appointments, and revised appointments to accommodate with other clinic appointments.

• Interpreted and coordinated physician orders to schedule diagnostic test, procedures and treatment OFFICE COORDINATOR

National Wound Healing, INC - Petersburg, VA - April 2007 to December 2007 Reviewed all dictations for E/M, Entered and verified charges reconciled charges accordingly to physician dictations.

• Tracked patient being treated with HBO and discharged patients and readmitted after 10 treatments

• Communicated with the patient primary care physician or referring physician as needed to obtain initial visit authorization.

• Identified the need for additional visits before the current time and number of visits expired.

• Generated reports to send to Corporate Office.

INSURANCE VERIFICATION SPECIALIST

Southside Regional Medical Center - Petersburg, VA - May 2005 to April 2007 Verify patient hospital insurance for active hospital benefits via Passport One Source system

• Run the Patient admission and observation report in order to make sure all patients that were admitted were accounted for and all necessary paperwork were attached

• Report hospital admission to various insurance companies to obtain authorization while using ICD 9 codes and or CPT codes

• Coordinate with case management for report clinical for pending authorizations

• Answer any questions patients may have had regarding their insurance benefits FRONT DESK RECEPTIONIST

Virginia Heart Group, LTD - Chester, VA - February 2004 to May 2005 Check patient in and out of the clinic for the three providers of the practice

• Obtain an input demographic information into computer system

• Schedule office follow up and various test/procedures for patients

• Collecting office co pays and payments & post patient payments.

• Ran patient encounter forms and charts for patients coming for patient appointments

• Copy patients progress note to send to patient's referring physician

• Answer telephone calls and transfer to appropriate personnel. REGISTRATION REP THEN PROMOTED TO INSURANCE VERIFICATION SPECIALIST Southside Regional Medical Center - Petersburg, VA - February 2001 to February 2004 Accurately register patient's workstation in a timely manner for demographic and insurance information into the AS 400 system

• Admit patients in a timely manner; obtain all signatures, copies of insurance cards and driver's license.

• Verify patients insurance for active hospital coverage via Passport OneSource.

• Collect copays and deductibles

• Report hospital admission to various insurance companies to obtain authorization.

• Coordinate with case management for report clinical for pending authorizations. Medical Receptionist

Prime Care Family Practice - Colonial Heights, VA - September 2000 to February 2001 FRONT DESK RECEPTIONIS

• Check patient in and out of the clinic

• Obtain and input demographic information into computer system

• Call and verify insurance eligibility

• Schedule office follow up and various test/procedures for patients

• Collecting office co pays and payments &post and receipt patient payments without errors

• Answer and transfer calls to appropriate personnel

• Pull patients charts and copy for their medical records for the Smart Corp system

• Ensure that all patient encounter forms for each provider are returned at the end of the day and ensure proper billing for the billing department

REGISTRATION VERIFICATION SPECIALIST

Medical College of Virginia - Richmond, VA - August 1999 to August 2000 Analyze and verify demographic and insurance information as entered by the registration staff within the Clinical, Business and the MCV hospital departments is accurate and complete as required to ensure proper claim submission to insurance companies

• Review and analyze transactions edits.

• Identify and flag accounts for the Insurance Management Staff

• Maintain the established individual productivity goals of 120 accounts

• Identify and report to my supervisor all data entry trends which negatively impact claim submission

• Preformed other duties/projects as directed and observed by my supervisor to achieve department and or team goals

REGISTRATION COORDINATOR

Southside Regional Medical Center - Petersburg, VA - August 1989 to August 1999 Train all new employees for the Patient Registration department.

• Accurately register patient's workstation in a timely manner for demographic and insurance information into the AS 400 system

• Admit patients in a timely manner; obtain all signatures, copies of insurance cards and driver's license.

• Work extensively with physician offices and insurance company to obtain prior authorizations.

• Transport patients to their designated room/procedure waiting area

• Was the Infection Liaison person for the registration department cross trained to register patient for the Emergency room department.

EDUCATION

DIPLOMA

DINWIDDIE COUNTY HIGH SCHOOL - Dinwiddie, VA

1986

ADDITIONAL INFORMATION

SKILLS

Customer service, collections, cashiering functions, insurance verification, basic computer skills including Email Software, Internet Browser, Peripheral Devices, Personal Computers, Spreadsheet Software, Word Processing Software, office management, Centralized scheduling, basic medical terminology.



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