Shantele Douglas

Laurinburg, NC ***** 910-***-**** ad28dr@r.postjobfree.com

PROFESSIONAL PROFILE

Customer service oriented professional, capable of providing timely and accurate data to ensure reimbursement for patient services. Follows policies, procedures, and guidelines to ensure consistent quality. Maintains and safeguards patient privacy and confidentiality.

Well-organized, manages time and priorities in multi-task environments

Effective problem solver, able to assess situation and identify solutions

Work as part of a team and maintain a professional and positive environment

Microsoft Office Applications / MS Word MS PowerPoint Typing Speed: 30 WPM

KEY QUALIFICATIONS

Medical Practice Management Systems Medical Terminology Medical Records HIPAA Compliance

Insurance Verification Insurance Claim Processing Reimbursement Processing Revenue Cycle Management

Medicare / Medicaid Government Payers Third Party Payers CPT & ICD-10 Coding

Medical Billing Medical Office Medical Administrative Patient Registration Data Entry

EDUCATION

Ultimate Medical Academy Diploma – Medical Office and Billing Specialist, 2021

Ultimate Medical Academy HIPAA Essentials for Healthcare Professionals Certificate

PROFESSIONAL EXPERIENCE

Scotland Surgical & GI/Wound & Cancer Center – Laurinburg, NC 09/2022 – Present

Patient Registration (PRN)

Handled inbound and outbound telephone calls

Adhere to HIPAA law and Scotland Surgical & GI

Perform registration services for the Wound and Cancer Division

EPIC EMR Software: verify patients’ demographics, confirm the insurance eligibility and healthcare plan status

Citrix EMR Software: utilize the electronic medical system to log in and enter the hospital internal sites

Billing: process patients healthcare bill and co-payments. Accept cash, credit/debit cards, and checks to satisfy the out-of-pocket expenses, and at the request of the patient mail out the invoices

Check in/out, scheduling and discharges of patient’s appointments and release from the hospital

Scheduling: receive the settings to setup the patients’ appointments from the clinical team and apply the patient’s availability for the next medical treatment, doctor visits, and examinations. Send out medical reminders to patients via standard United States Postal mail and email concerning physician medical appointments.

Medical Screener: screen all incoming visitors, clinical staff, vendors, and guest for COVID-19. Update the daily log and reports in accordance with the hospitals SOP requirements.

Sitel/United Healthcare Group – Nashville, TN 03/2022 – 06/2022

Customer Service Representative (REMOTE)

Handle inbound and outbound telephone calls

Adhered to HIPAA law and United Healthcare Group policies

Process Medicaid/Medicare and Standard Healthcare Insurance

NC Track Medical Management System: verify the patients’ demographics, insurance, process payments and billing

Insurance verification: review and confirm the insurance coverage and eligibility

Process medical claims, prior authorizations, referrals and appeals

Reviewed CPT codes/ICD-10 to ensure proper billing of the medical claim

Billing: review the claim, and accepted payments, and reimbursement. Accepted credit and debit cards and mail out bills to patients

Wendy’s – Laurinburg, NC 08/2011 – 03/2022

Crew Member/ Cashier / Customer Service

Perform opening and closing duties, answer inbound phone calls, and train new hires

Process payments, operate cash register, and accept payments

Cook and prepare batches of food, prepare deposits, and count tills

Make outbound phone calls and assist with interview process

It's Fashion Metro – Laurinburg, NC 02/2015 – 10/2019

Floor Manager / Customer Service

Completed opening and closing duties, supervised 6 employees, and trained new hires

Collected payments, handled light cleaning duties, and operated cash register

Prepared bank deposits, maintained inventory levels, and handled inbound and outbound phone calls

Maintained displays, processed layaway orders, and upsold products

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