Patient Registration Customer Service
Resume:
REGINA DIANNE SHACK
**** ******** **, *********** ** 37421·706-***-****
***********@*****.***
It is my objective to use my skill and knowledge to serve those around me and grow in the community. EXPERIENCE
05/20/2024-PRESENT
UNIVERSITY SURGICAL ASSOCIATES- AR SPECIALIST
Manage accounts for various assigned payors
Process an average of 50 claims a day and log claim status in Claim Control Research and resolve issues with common causes of delays Resolve insurance corrections, rebill claims, file appeals as necessary Reconcile past due invoices
Accurately process adjustments and write-offs
12/18/2023-05/14/2024
CONIFER HEALTH SOLUTIONS-EES PATIENT ADVOCATE
Conducts interviews with patients and/or family members. Records and maintains complete documentation of activities performed on account while Performs financial clearance function including collections. Cancels accounts that have not had any patient cooperation and are not eligible for any programs and prepares accounts for Financial Assistance review. Follows up on EES assigned accounts to ensure follow-through on Government application submitted. Develops a working relationship with patients, based on good communication skills, enabling accounts to be processed quickly with government program eligibility.
Calls SSA to schedule phone interviews, completes Medicaid and Food Stamp applications when appropriate Conducts field visits to patient homes for skip tracing and or assisting patient with documents. Notifies hospital case management, social services and admissions staff of case screening determinations and outcomes via verbal and written communication.
09/19/2022-12/17/2023
CONIFER HEALTH SOLUTIONS-PATIENT ACCESS REP II
Greeting customers following Conifer Standards of Care Provides world-class customer service
Completes full patient registration at date of service, adheres to financial & cash control policies & procedures, thoroughly explains and secures Hospital & patient legal forms (i.e., Advance Directives, Conditions of services, Consent for treatment, Important Message from Medicare, EMTALA, etc.).
Scan Protected Health Information
Create and file patient information packets/folders for upcoming Hospital services Assist with scheduling and coordination post discharge care for patients Secure medical necessity checks/verification in accordance with CMS & Medicaid services Verify insurance, benefits, coverage & eligibility Complete assigned registration financial clearance work list activities, obtain insurance authorization Arrive patients presented by EMS
Assist with training new employees and support management as necessary 07/11/22-09/16/22
MEDICAL PERSONNEL SERVICES-BILLING SPECIALIST (SKIN CANCER AND COSMETIC DERMATOLOGY) Download remits daily from each applicable vendor
Post insurance payments to the appropriate accounts Apply copayments, contractual write off and adjustments Transfer copay/coinsurance and deductible balances to patient responsibility Working knowledge of EOB’S, EFT’S, AND ERA’S
2
Post denials to patient accounts
Balance end of the day reports
.
06/01/2021 - 07/08/22
Mountain Management-Financial Assistance Counselor Knowledge of accounting, credit, collection laws, current insurance and government financial assistance programs and regulations, as well as clinic financial options, payment alternatives, insurance billing/authorization requirements
Knowledge of federal and state payer requirements (Medicare, DSHS, HMO/PPO Contracts), medical terminology, abbreviations and coding protocols (e.g., / ICD-10) Ability to explain reimbursement questions regarding health-plan eligibility, benefit issues, co-pay requirements and medical referral requirements, billing processes, hospital and clinic statements and availability of financial assistance, alternative medical financing and assists in completion of applications and/or contracts to meet patient needs while assuring maximum reimbursement Receive and process charity care and/or financial assistance applications, work with health insurance providers to determine coverage and benefit limits Verify financial information to determine insurance coordination of benefits, pre-certification/prior authorization requirements, estimates of procedures, calculates payments requirement, and informs patient of acceptable payment arrangements on balance, both current and previous Self-pay adjustments made on charity accounts to zero balance Daily work queue of Financial Assistance accounts and FA for follow up 09/07/2007 to 06/01/2021
Eranger Health System-Financial Advocate
Serve as a liaison to explain hospital charges, financial assistance And providing various financial assistance forms.
Completed TennCare applications for uninsured patients completed Newborn Presumptive Eligibility
Responsible for screening self-pay patients at hospital bedside for Eligibility in various governmental and non-governmental programs. Responsible for identifying all sources of potential payers including Auto insurance, workers' compensation, commercial insurance, private Insurance, TPL, etc. and assisting patients in the process of applying Verify insurance information and update patient demographics Collection of patient financial responsibilities
Prepare collection reports
Work with clinical staff to update patient information in timely manner Organizational skills and commitment to teamwork
Discuss patient account balances and create
Estimates for upcoming procedures or hospital stays 01/2014-02/2015
PM Pediatrics-Front Desk/Billing follow up Part time Provide excellent customer service to patients
Check in patients
Verify benefits, collect co-pays and patient balances schedule Follow up on outstanding claims and rebill as necessary Post insurance payments from EOB as well as patient payments Scan patient forms and labs
Balance end of day reports
Complete daily deposits
Worked Aging Accounts Receivable to collect Bad Debts Posted Insurance Payments and downloaded remits from the website Billed secondary claims
Filed appeals for denied claims
10/2012-01/2014
Cigna HealthCare-CSA Medical Call Center Choice Fund Analyst Provide excellent customer service to members and providers Verify patient eligibility and benefits
Verify in/out of network providers
Check claim status and resolve claim issues
Send adjustable claims back to be reprocessed
Provide excellent customer service to members and providers 3
Choice fund trained to handle HRA, HSA & FSA account issues and Access to account balance information
05/2008-9/2012
Med Write, Inc. - Claims processing 423-***-**** Enrolled physicians/practice with ZirMed clearinghouse as needed Provide excellent customer service patients and providers Check all charges entered for errors
Batch and submit all claims to insurance or clearinghouse Payment posting and AR follow
Download remits and reports
Work all errors or forward to designated person for that account Enter coordination of benefit info to submit secondary claims Enter daily charges and hospital charges for 2 primary accounts Answered billing questions from patients (8 accounts we handled) Coded and entered charges for thoracic surgery group in Kansas Maintained good working relationship with physicians and PA’s out of state 08/2007-05/2008
Northgate Neurology 423-***-****
Entered daily office charges and hospital charges
Coded and entered Ambulatory EEGs performed
Check all charges entered for errors
Generate and submit all claims to insurance or clearinghouse Payment posting and AR follow up
Download remits and reports
Enter coordination of benefit info to submit secondary claims Answered billing questions from patients
Filed Appeals for insurance denials
11/2002- 08/2007
Chattanooga Neurology & Headache Center 423-***-**** Provide excellent customer service to scheduled patients and physicians Check in patients
Verify patient insurance and demographics
Collect and post office visit co- payments and old balances Schedule radiology procedures/obtain precertification and authorizations Triage patients- patient assessment, blood pressure/pulse and temp Preparation of all medical records request and billing appropriately Worked the AR and insurance follow up aggressively 4/2000-11/2002
Baptist Health Center - Front desk, billing specialist 205-***-**** Provide excellent customer service to scheduled patients Worked both check-in/check-out windows
Verify patient insurance and demographics
Enter coordination of benefit info to submit secondary claims Worked Aging Accounts Receivable to collect Bad Debts Collect and post office visit co- payments
Entered daily office charges, hospital charges, some ambulatory Worked AR and insurance follow up aggressively
Filed insurance appeals for denied claims
Triage patients- patient assessment, blood pressure/pulse and EDUCATION
DeVry University, Medical Coding and Billing Certificate Upon completion/graduation July 2024
Miller Motte Technical College, Massage Therapy diploma 2005 Northwest Shoals Community College, Medical Office Administration Certificate Graduate May 2002
4
Phillips High School, Bear Creek, AL Graduate 1992 SKILLS
• Certified Application Counselor
• ICD-10, CPT, and Medical Terminology
• Various Practice Management Software
• Patient Access
• Registration
• Prior-Authorization
• Revenue Cycle Management
• Claim Entry and Payment Posting
• Productivity
• Adaptability
• Case Management
• Appeals
• Medicare, Medicaid, Commercial payer
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