Scheduler Coordinator Third Party
Resume:
Lashawn Gaines
***** ********* *******, ** ***** <> (Cell) 313-***-**** <> Email: ad0kff@r.postjobfree.com
OBJECTIVE
I would like to secure an industrious position with a well accomplished company, where I can meet the demands of a challenging position and contribute to the success of the organization.
EDUCATION
Mary Grove College 1983-1984
Detroit, Mi
Certificate of Completion- Nurse’s Aide
Wayne County Community College 1981-1983
Detroit, MI
Major -Nursing
Carnegie Institute 1980
Detroit, MI
Certification of Completion- Medical Terminology and Reception
EXPERIENCE
Tenet Health-DMC – Surgical Scheduler Coordinator, Detroit, MI 48235 Sept. 2019 to Present
Responsible for scheduling and boarding surgeries and diagnostic procedures. Obtain benefits and authorizations for both through insurance companies such as Blue Cross, United Healthcare, Medicare etc.
Perform all office duties such as answering phones, greeting patients, and scheduling appointments.
Responsible for keying charges, collecting surgery co-payments, completing insurance forms and medical records billing.
Apply CPT and diagnosis codes on a regular basis.
Enter charges for pre- and post-operative and anesthesia.
Knowledge of CPT Code and some Medical Terminology
Work closely with physicians and their office staff.
Lashawn Gaines
19133 Wisconsin Detroit, MI 48221 <> (Cell) 313-***-**** <> Email: ad0kff@r.postjobfree.com
Conifer Health Solutions- Patient Access Rep II, Detroit, MI 48201 Jan 2015 to Sept. 2019
Responsible for obtaining accurate patient demographic and financial information for registration and accurate claim reimbursement.
Collections start with the position quoting the estimated patient portion at the time of pre-registration which allows the hospital to collect at the time of service.
Receives incoming calls from physician’s patients or other departments to pre-register outpatient diagnostic exams for the various departments.
Collects the appropriate level of demographic clinical and financial information.
Monitors and secures referrals and authorization prior to date of services and advises supervisor of incomplete accounts. Contacts patients when appropriate to advise them of their responsibility to contact primary care physician to obtain referrals or authorizations.
Scan and files referrals and authorizations into IDOC and documents
Create and determine the appropriate patient type based on the type of services and/or procedures that have been scheduled that will ensure accurate and timely claim reimbursement from third party payers.
Always demonstrate excellent customer service skills.
Maintain a working knowledge of manage care contract that have unlimited numbers of payers to minimize the Hospital’s financial risk for claim denials thus maximizing reimbursement for services.
Sinai Grace Hospital/The Detroit Medical Center Aug 1992 to Jan 2015
Patient Management Clerical Associate/ Insurance follow-up, Detroit, MI 48201
Review, monitor and reconcile patient accounts to ensure accurate bill production.
Function as a resource person for the Patient Management Clerical Associate
Resolve complex and sensitive work-related issues.
Effectively interviews patients, family members and their representatives to obtain appropriate demographic and insurance information.
Maintain daily operations and flow of work for assigned shifts.
Collaborate with management to achieve projected goals, quality production and customer satisfaction.
Appropriately updates patient accounts with current information.
Assists utilization review staff in obtaining length of stay, coordination of benefits and authorizations data for billing.
Lashawn Gaines
19133 Wisconsin Detroit, MI 48221 <> (Cell) 313-***-**** <> Email: ad0kff@r.postjobfree.com
Hutzel Women’s Hospital- Patient Services Rep, Detroit, MI 48235 Jan 1986 to Aug 1992
Accurately maintains all confidential patient records.
Screens patients for accurate Medicaid eligibility
Assists patients with completing Medicaid applications.
Assist with Assigned Claims applications for motor vehicle accidents and crime victims.
Verification of insurance information using online tools and telephone verification systems
Data entry
Provided financial counselling and assisting patients to identify and obtain payment sources as well as bedside interviewing.
Accomplishments
Former members of MPAA Medicaid Advisory Committee
Former members of Healthcare Financial Management Association
References
Available upon request
Lashawn Gaines
19133 Wisconsin Detroit, MI 48221 <> (Cell) 313-***-**** <> Email: ad0kff@r.postjobfree.com
To Whom It May Concern:
I am interested in seeking employment opportunities with your company. I have attached my resume for your consideration and review.
I am seeking a position that will allow me to utilize my talents and develop my strengths. I am a people person, a team player, dependable, eager to learn and welcome a challenge. I am certain that I can meet the demands of a challenging position with your company and contribute in a positive manner.
I would greatly appreciate an interview with you, and I am available at your convenience. I can be reached at the above number or email address.
Thank you for your time and consideration. I look forward to hearing from you soon.
Sincerely,
Lashawn Gaines
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