Administrative Assistant Front Desk
Resume:
Mandy Smith
Fort Johnson, NY *****
**************@*****.***
Authorized to work in the US for any employer
Work Experience
Insurance Follow-up Representative
RSI - Remote
April 2022 to Present
Follow up and resolve insurance claim denials by reaching out to various payers via web portal and phone calls. Resolved/worked approximately 40-50 accounts per day while maintain a quality score of 97%.Ability to navigate various insurance payor web portals for document or appeal submissions. Member Service Representative
Capital District Physicians Health Plan - Albany, NY July 2020 to April 2022
Assists members with policy questions regarding benefits, enrollment, claims, preparing appeals, initiating prior authorization requests,and filing grievances while providing excellent customer service and adhering to medicare guidelines set by CMS.
Administrative Assistant
Gomez Neurology
January 2020 to March 2020
Responsible for running the front desk including working the front end unsupervised on my second day due to staff shortage,scheduling appointments, checking patients in and out, verifying demographics, etc. Also trained new employees after only being employed for one week. Job duties also include handling of all medical records requests, filling out FMLA and disability forms, prior authorizations for infusion therapy and preparing cost estimates for infusion patients. Administrative Assistant/Physician's Secretary
St. Peter's Healthcare/Albany Associates in Cardiology November 2017 to January 2020
Responsible for front desk staff usage of registration tools. Responsible for all insurance verification, pre-certifications and authorization tracking when required by insurances. Works closely with clinical staff to ensure timely submissions. Develop alliance with patient billing to build processes for effective communication of authorizations and to deal with any other issues, which may cause denials. Demonstrates the ability to analyze medical records to identify all pertinent diagnoses and procedures for billing and coding, and to evaluate the adequacy of the documentation and review for errors. Senior RA will report to Supervisor any issues regarding consistent errors or nonuse of registration tools, late charges. Attends meetings pertaining to billing and insurance needs. Works with patients on billing insurance explanation. Educates staff and provide technical training in registration systems to RA staff. Supports front end office operations when needed as a working team lead. Directly consults with clinical and professional staff for clarification of conflicting, incomplete, or incorrect clinical data in the health record.
Accounts Receivable Representative
St. Peter's Healthcare
May 2016 to November 2017
Duties include following up on insurance claims and denials to ensure proper payment to the hospital. Prepared
Appeals daily, adjusted all incoming EOBs for claims, prepare and send out UB-04s and 1500 claims for The hospital outpatient services, audited daily electronic insurance payments and submitted correction Sheets to cashier's office to ensure payments are posted to the proper accounts. Frequently communicated with HIM and coding to review assigned inpatient and outpatient ICD-10 diagnosis codes for accuracy, as well as determining which inpatient, outpatient, complications and co-morbidity codes are payable and to prepare appeals to insurance companies after coding these services. Reported incorrect documentation or codes to appropriate supervisor. Searched and reviewed the patient charts and records to find documentation to support and justify code assignment based on my expanded knowledge of the facility and structure of the patient record. Independently researched references to resolve any questionable code errors and contacted the appropriate supervisor. Administrative Assistant to Nurse Manager
St. Peter's Healthcare/Albany Associates in Cardiology September 2016 to May 2017
Responsible for managing and booking meetings for Nurse Manager of the unit. Duties include Managing payroll and timecards for employees, taking minuets for meetings, and handling All secretarial duties for the unit, i.e. new hire paperwork, tracking all staff annual education Requirements, etc. Assisted Nurse Manager with chart reviews, and documentation requirements to completely and accurately reflect the care provided to the patient, provided technical support in the areas of regulations and policy, coding requirements in documentation, proper sequencing of codes, and reviewed workload with the entire nursing staff on the unit, Unit Coordinator
St. Mary's Healthcare
September 2015 to September 2016
Responsible for managing the workflow of the unit. Directing patients and corresponding family Members to the appropriate places, ordering blood work, EKGs, and any necessary radiological testing Etc. Job duties also include accessing Medent system and importing necessary documents in chart Preparation from various outpatient clinics. Prepares charts daily including meticulous attention to Proper documentation for the endological suite and all gastroenterology procedures. Patient Registration Representative
St. Mary's Healthcare Rheumatology Health Center
July 2014 to September 2015
Job duties include answering and handling multi line phone system, scheduling office appointments, Entering charges with ICD-9 codes, making sure all claims left the office with appropriate HCPCS And diagnosis codes, obtaining authorizations for radiological testing through various insurance Companies. Also responsible for maintaining the physician's calendar in Outlook, scheduling meetings With administration, booking drug representative meetings with the physician and nurse. Patient Registration Representative/ Office manager St. Mary's Healthcare Pain Management Health Center September 2012 to June 2014
Job duties include answering and handling multi line phone system, scheduling office and surgical Appointments, entering charges with ICD-9 codes, and obtaining authorizations for surgical In addition, radiological testing through various insurance companies. Comfortable with aspects and Forms involving NY state worker's compensation. Job duties also included working with different Pharmaceutical companies in scheduling implantation of spinal cord stimulators and in the complex Process of obtaining authorizations through insurances for this procedure. Also responsible for Scheduling and maintaining the doctor's meeting schedule and all appointments through Microsoft Office. Scheduled various drug vendors to meet with physician and RN. Assisted with initial startup Of the office. Provided director with physician's paperwork, and whatever forms requested to help in Obtaining credentialing with various insurances, the hospital, and The Worker's Compensation board. Document Imaging Specialist/Medical Records Technician St. Mary's Healthcare HIM department
2009 to September 2012
Responsible for preparing and scanning Emergency Room documents into Valco system for viewing. Printed and mailed daily Emergency Room reports for primary doctors as in accordance with New York State regulations. Duties also include scanning referred physician's orders, clinical orders, and Laboratory orders into Valco system weekly. Currently have exceeded minimum statistics set up by Clerical supervisor to catch up backlog of scanning due to short staffing in the previous months. Will Also begin to scan Urgent Care documents as of January 20th in effort to assist with back log at the Memorial Campus. Have worked extensively with record requests, retrievals, and very familiar with HIPAA guidelines. Assisted with chart reviews and provided advisory and technical services to administrative, Technical and administrative staff as it related to the integration of the HER. Chart reviews consisted of Analyzing data retrieved and consistency of coding of registry data, verifying diagnosis, histology, treatment (including surgical procedures, chemotherapy, immunotherapy, hormonal therapy, radiation therapy, hematologic procedures).
Purchasing Clerk
St. Mary's Healthcare
2007 to 2009
Responsibilities included filing purchase orders, and balancing extensive invoices against purchase Orders. Duties also included taking meter readings monthly of the hospital's entire inventory of copier/ Fax machines and placing work orders into IKON for equipment maintenance and repair. Receptionist
Adirondack Park Animal Hospital
2004 to 2005
Responsible for operating the front desk, answering phones, scheduling appointments, checking in out patients, and assisting the clients. Duties also included feeding and caring for the hospitalized Animals, cleaning and maintaining the clinic and kennel areas. Receptionist
Pembroke Veterinary Clinic
2000 to 2004
Duties included handling a four line phone system, scheduling appointments, billing out clients, and Transcribing medical questions and problems. Able to deal with a fast paced work environment in a Large Medical Corporation with a very extensive clientele. Worked frequently with the Chief of Staff Veterinarian to prepare spreadsheets using Microsoft Excel for special projects and presentations. Also Responsible for sending vaccination reminders by mail and email for the office manager when she was Unable to do so.
Receptionist
Sacandaga Veterinary Clinic
1997 to 2000
Responsibilities included answering a multi-line phone system, scheduling appointments, preparing Medical charts and vaccinations for the doctor, and helping the clients with any questions or concerns. Also responsible for filling prescriptions, assisting with x-rays and procedures such as nail trims, Drawing blood for heart worm testing, and preparing slides to identify different types of parasites and Bacteria.
Education
Associate in Medical coding and billing
Bryant & Stratton College-Online - Albany, NY
September 2018 to August 2021
Regent's diploma in Highschool
Amsterdam High School
Skills
• MICROSOFT OFFICE (1 year), MS OFFICE (1 year), MEDITECH (Less than 1 year), MICROSOFT WORKS
(Less than 1 year), RECONCILIATION (Less than 1 year) Computer Skills: Invision/ OAS; Claim Master; Sorian Clinicals; EPACES and other internet based Insurance verification and reconciliation sites; Medent; Microsoft Works 4.0, Microsoft Office, Meditech,
Windows 85, 98, 2000, XP, 8 and 10, Word Perfect, Clientrax 4.0 and Cornerstone. Extensive knowledge
Of email providers, and various internet navigators. Attended courses in computer programming and
General use at college. (10+ years)
• CPT Coding (5 years)
• ICD-10 (5 years)
• ICD-9
• Infusion Experience
• Medical Billing (5 years)
• Pain Management (3 years)
• Medical Scheduling (10+ years)
• Transcription (3 years)
• Medical Coding (2 years)
• EMR Systems (10+ years)
• Anatomy Knowledge
• Hospital Experience
• Epic (3 years)
• Medical Terminology (10+ years)
• Use of EMRs such as EPIC, MEDENT, SORIAN, MEDITECH, Athena (10+ years)
• Medical Records
• User Experience (UX)
• Medical Imaging
• Triage
• ICD coding
• Medical office experience
• HIPAA
• Medical receptionist
• Physiology knowledge
• Medicare
• HCPCS
Assessments
Customer focus & orientation — Highly Proficient
June 2020
Responding to customer situations with sensitivity Full results: Highly Proficient
Indeed Assessments provides skills tests that are not indicative of a license or certification, or continued development in any professional field.
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