Jovetta Johnson

Houston, Texas *****

832-***-****

acxi1x@r.postjobfree.com

Objective: Seeking a Patient Access Representative II/Insurance Verification, Registrar position in a hospital/office setting which will require me to utilize my Clerical skills. Insurance verification of 7 years (Customer service 12+ years) Managed care abilities and experience in the medical field for Medicaid /Medicare (CMS), Tricare, EPO/HMO/PPO In network and Out-of-network Commercial/Employee Insurance Verification.

Skills:

Scheduling/EPIC/Facets/GE Centricity/ Clean/Update Registration/Avality

Insurance Verification (Online/Phone) Team Player/Customer Service Oriented

WPM exceeds 65+ Excellent Verbal and Written Communication

Microsoft Office (All) Problem Solving

Insurance Billing/Claims Active Listening skills

Experience:

U.T Physicians (Seasonal) Temp assignment

Patient Access Representative II/Insurance Verification Specialist, Houston, Texas

September 2016 – November 2016

Identify special policy clauses or pre-existing conditions and verifies effective date of policies along with copayments, deductibles and any other financial responsibilities.

Receive faxes from Community Health Choice requesting medical records to obtain authorizations and extensions. Follow all HIPPAA rules and regulations.

Notify appropriate work units of patient’s insurance coverage, authorizations, or status.

Verify insurance policy benefits for new and returning patients with carriers.

Assure all insurance information has been completely and accurately obtained.

Expert Global Services Houston, Texas May 2015 – May 2016

Patient Access Representative II Commercial/Medicare (CMS Certified

Handling heavy inbound calls via providers, members, doctor offices in to verify INN and OON medical insurance benefits.

Initiates authorizations determine prior authorizations. Following all HIPAA guidelines.

Quoting benefits to providers and members, assisting agents with different techniques to research the questions for the answers. Follow all HIPPAA rules and regulations.

Verify all insurance and obtain pre-certification/authorization. Obtain and enter demographic, clinical, financial information into the computer system.

Intake benefit Coordinator LOA Specialist Temp Assignment June 2014– April 2015

Randstad (Aon Hewitt site), Houston, Texas

Assist Employees with their Leave of Absence Medical Short Term and Long Term Disability Claims/Benefits.

Complete follow up with the different cases to complete case by case.

Heavy inbound calls via payday, paychecks, paperwork verification. Follow all HIPPAA rules and regulations.

Resolve escalated access to care, claims and benefits issues

Answer a wide array of questions and provide education on complex issues, self-resolutions and offer value-added services.

Aetna (Coventry Healthcare) November 2013-June 2014

Customer Service Representative II

Handling heavy inbound calls that consist of members 65+ and older calling about their Medical Benefits/Claims (Medicare Advantage) Part C and D.

Follow all HIPAA rules and regulations. Maintain confidentiality per HIPAA guidelines in regard to patients’ information.

Review over claim statuses, billing, adjusting claims and updating NOI’s-locations, Assisting members with all billing inquires. Monitoring for accuracy.

Investigates, analyzes, and resolves outstanding issues to achieve customer satisfaction and takes responsibility for following through and bringing issues to closure.

More Experience upon Request

Education:

Texas Tech University, Lubbock Texas 2008-2012

Dwight D Eisenhower High School 2004-2008 Diploma Received

Lone-star Community College (Summer courses) 2007-2008

Contact this candidate