Patient Care Services
Resume:
MICHELLE HALE
Douglasville, GA *****
****.**********@*****.***
EDUCATION
Bachelor of Science in HealthCare Administration Nov 2021-May 2023 Purdue University Global
Associate in Applied Science
South Suburban College May 2016
WORK EXPERIENCE
Piedmont Healthcare -Augusta, GA September 2023- May 2024
Patient Connection Associate III
● Pre-registering and scheduling moderately complex procedures and coordinating multiple resources for patient services.
● Identify patient medical record utilizing Piedmont’s process/policy Support an exceptional experience through all customer interactions by connecting caller needs with organizational resources, utilizing information from various applications.
● Operate and utilize the Scheduler Program in the hospital computer system
● Respond to correspondence regarding scheduling changes/cancellations both written and oral in a timely, accurate manner.
● Assess and prioritize requests to include communicating accurate, pertinent information to external and internal customers.
● Maintain overall knowledge of the patient scheduling system in order to answer patient inquiries about insurance billing/payment and self-pay liability.
● Preregister patient encounters by obtaining patient demographic and financial information for clinic, hospital and outpatient departments.
● Support a prospective payment program by communicating organizational policies, providing estimates, financial options, explaining insurance coverage/non-coverage, communicating and collecting patient liability/co-pay.
● Reviews orders to ensure completeness prior to scheduling. Prepares for the patient visit by verifying patient insurance, confirming benefits, reviewing medical necessity, and creating patient liability estimates. Communicates expected patient liability and collects.
● Reviews medical necessity and creates patient liability estimates.
● Calculates and determines financial responsibility for patients including deductibles, co-payments, and amounts covered for requested services. Piedmont Atlanta Hospital - Atlanta, GA
Patient Care Tech/Unit Secretary December 2020 - July 2021
● Performed clerical and receptionist duties while delivering quality customer service.
● Kept department stocked with supplies.
● Obtained vitals and glucose level.
● Assisted RN’s and the charge nurses with direct and indirect patient care in ICU.
● Monitored patients and assisted with their needs. Northwestern Medical Faculty Foundation - Chicago, IL Procedure Scheduler/Insurance Liaison November 2012 - May 2020
● Scheduled all in-office surgical treatments, and follow-up sessions as marked by medical professionals.
● Pre-certified all surgical procedures with insurance company - verified eligibility, deductibles, co-pays, and coverage of service with pre-cert numbers to be used for billing purposes, prior to services being rendered.
● Assisted in scheduling/rescheduling/canceling patient appointments.
● When requested by a physician-assisted with opening and closing doctor schedule templates in Epic
● Interacted with clients, medical professionals, and additional teams both within the Clinic and at outside facilities offering precise, prompt, and responsive info.
● Responded to patient requests and inquiries in a timely fashion while exhibiting warmth, compassion, and responsiveness to patients and their families.
● Acted as a key contact for coordinating care, scheduling appointments, and resolving issues in and between multiple specialties.
● Communicated balances owed, explained statements of account, and educated patients on payment policies as well as financial assistance. Took patients' co-pays and other payments.
● Was on the design and build team when we went to Epic from IDX for our department. Spi Healthcare - Tinley Park, IL
Insurance Follow Up November 2008 - November 2012
● Analyzed weekly denial reports, reviewed delinquent accounts, aging periods, and payment sources to spot trends for assigned insurance carriers. Resulted in $
● Follow-up daily on post processing activity including but not limited to, rejected billings, adjustments, and rebilling, and denied claims for account greater than 30 days old
● Resolved insurance denials and prepared appeal letters with carriers, resulting in a 65% increase in paid claims.
● Communicated with third-party representatives as necessary to complete claims processing and / or resolve problem claims.
● Contacted clients for missing data elements on claims and performed charge corrections.
● Posted denial codes and adjustments on patient invoices and updated registration information.
Lurie Children's Hospital - Chicago, IL
Lead Patient Representative Account Liaison December 2002 - March 2008
● Managed 30 Patient Rep Acct Liaison Associates in the Emergency Room and Admitting
● Maintained effectiveness of patient flow, Oversaw the daily activities of registration area to ensure department standards are met. Maintained QA statistics and report results to Director, provided and supported ongoing recommendations for optimization of front-end processes in response to ever-changing reimbursement rules, regulated and implemented such changes as directed. Monitored and secured all signatures necessary for treatments, release of medical information, and assignment of insurance benefits and payment of services from legally responsible patients.
● Served as a Lead for Patient Registration; supervised personnel which included work allocation, training, and promotion, enforcement of internal procedures and controls, and problem resolution; evaluates performance and makes recommendations for personnel actions; motivates employees to achieve peak productivity and performance.
● Completed timecards for staff and approve and disapprove personal and sick leave based on workload, coordinated with Patient Registration Director
● Acted in the capacity of Director in his/her absence and informed the Director of all issues upon return. Served as a primary contact for Directors relating to technical areas.
● Assisted the Director in educating registration staff of any changes pertinent to their roles and developed procedures and trained staff on new systems.
● Was on the design and build team when we went to Epic from IDX for our department and was the Go live person in my department.
SKILLS
● BLS certified. CHAA certified.
● Knowledge of commercial insurance, Medicaid, and Medicare insurance
● Customer service, data entry, typing 60 wpm and supervisor experience
● Epic, Meditech, Health Fusion Medi Touch, IDX, Athena, Phreesia, NextGen
● Familiar with ICD-10/ICD-9 and medical terminology knowledge
● FEMA training and certificate-Introduction to National Response, Introduction to National Incident Management System, Introduction to Incident Command System & Standardized Awareness Training program
Contact this candidate