Customer Service Patient Access
Resume:
Yvonne Marcano
Saint Cloud, FL *****
*****@*****.***
Hardworking, highly motivated professional eager to lend combined knowledge and skills to enhance business performance. Operates well in both individual and team capacities, leveraging seasoned work ethic to quickly adapt to different processes and drive company objectives. Resourceful and results- driven with a passion for growth and efficiency to meet company needs and increase service value. I have experience in working in the following settings: medical office, pharmacy call center, diagnostic office. I have excellent written and verbal communication skills. Work Experience
Patient Access Representative II
Express Scripts-Orlando, FL
July 2018 to October 2018
• Ensured compliance with all HIPAA regulations regarding patient privacy and confidentiality.
• Provided efficient and courteous service to customers at all times.
• Performed data entry into pharmacy software systems for prescription processing.
• Provided customer service to patients, physicians and other healthcare providers.
• Informed patients of any co-pay assistance programs available to them Insurance Verifier / Prior Authorization Representative Apex Systems- Contract/ Alliance Rx-Orlando, FL
December 2017 to March 2018
• Answered questions from patients and clerical staff regarding coverage.
• Ensured compliance with federal and state laws governing the handling of confidential patient information.
• Answered telephones and directed calls to appropriate staff.
• Committed to delivering excellent customer service while working in a fast-paced environment. Front Desk/Referral Coordinator
Kidsville Pediatric-Orlando, FL
March 2017 to May 2017
• Resolved issues related to patient access, insurance coverage, and other barriers quickly and efficiently.
• Communicated with physicians and staff to gather information for referrals.
• Provided excellent customer service by responding promptly to inquiries from both internal and external customers.
• Obtained authorization for referrals and diagnostic testing using proper documentation.
• Scheduled patients, notifying of appointment date, time, and location.
• Accepted phone calls from referral sources, patients, and third-party payers.
• Managed incoming calls regarding referrals in a professional manner while providing accurate information.
Insurance Verification Coordinator,
Acaria Health Specialty Pharmacy-Orlando, FL
July 2015 to June 2016
• Verification pharmacy benefits using on- line portals or via phone
• Communicated with medical providers office and patient's regarding status of authorization
• Processed pre-authorizations for medical services according to established guidelines.
• Answered telephones and directed calls to appropriate staff.
• Followed established verification processes to confirm insurance benefits, medical necessity, and authorization.
Insurance Verification Specialist
Arnold Palmer Hospital, Endocrinology Specialty Practice-Orlando, FL December 2013 to June 2015
• Answered questions from patients and clerical staff regarding coverage.
• Accurately verified insurance coverage for patients and providers in accordance with HIPAA regulations.
• Reviewed patient deductibles and copays and entered into billing system.
• Assessed insurance policy terms to determine patient coverage and limitations.
• Verified insurance coverage and eligibility prior to appointments and procedures. Charge Entry Specialist
Arnold Palmer Hospital for Children-Orlando, FL
September 2011 to June 2013
• Expertly reviewed insurance claims for accuracy prior to submission.
• Utilized software programs to accurately document patient information into electronic databases.
• Resolved and clarified codes and diagnoses with conflicting, missing and unclear information by consulting with doctors and others and by participating in coding team's regular meetings.
• Worked with coworkers to complete tasks.
Front Desk Medical Receptionist / Prior- Authorization Coordinator Arnold Palmer Hospital for Children/ Pediatric Neurosurgery-Orlando, FL March 2010 to September 2011
• Trained new employees on the referral process as well as relevant policies and procedures.
• Obtained authorization for referrals and diagnostic testing using proper documentation.
• Communicated with physicians and staff to gather information for referrals.
• Scheduled patients, notifying of appointment date, time, and location.
• Coordinated and processed patient referrals with precision, detail, and accuracy.
• Provided excellent customer service by responding promptly to inquiries from both internal and external customers.
Insurance Verification Specialist / Authorization Coordinator Arnold Palmer Hospital for Children, Pediatric Orthopedics-Orlando, FL April 2009 to March 2010
• Maintained detailed and organized records of all insurance verifications.
• Provided excellent customer service when responding to inquiries from patients and providers regarding insurance verification.
• Verified insurance coverage and eligibility prior to appointments and testing.
• Addressed and resolved issues identified by billing staff related to eligibility and coverage.
• Scheduled diagnostic testing for patient's as per doctor's order. Education
Associate of Science in Medical Coding and Insurance Billing Herzing University - Winter Park, FL
January 2009 to May 2012
Skills
• ICD-10
• Medical Billing
• Hospital Experience
• Insurance Verification
• Medical Receptionist
• Medical Scheduling
• ICD-9
• Medical Records
• Medical Office Experience
• Anatomy Knowledge
• EMR Systems
• Physiology Knowledge
Contact this candidate