Insurance Medical

MELISSA THOMPSON

C: 773-***-**** E: adgr67@r.postjobfree.com

“Communication- is the key to personal and career success” (Paul J. Meyer)

RELEVANT SKILLS

Time management

Strong oral and written communication skills

Effortless comprehension

Customer service experience

Calm and appeased under pressure

Proficient in Epic software, Microsoft Word, and Microsoft Excel, Mosaiq, Surginet, PowerChart, and RightFax

Strong organization skills

WORK EXPERIENCE

07/2017 – Current: Financial Clearance Specialist – focus: Radiation Oncology services

Northwestern Memorial Hospital – Chicago, IL

• Independently oversees system wide radiation therapy service authorizations for Northwestern Memorial Hospital (Prentice and Galter locations) and Northwestern Lake Forest Hospital (Lake Forest Cancer Center and Grayslake Cancer Center locations)

• Monitor hospital schedule for patients scheduled for upcoming radiation therapy treatment and maintain organized list with status of precertification status

• Verify insurance eligibility and benefits and prior authorization requirements via phone or online verification systems

• Maintain strong rapport with Oncology nursing staff and Oncology specialists to communicate precertification status, schedule peer to peer, and provide information that could postpone upcoming treatment

• Communicate with Financial Counseling department regarding self-pay patient status or insurance related dilemmas on patient account

• Occasionally contact patient as courtesy if there is an insurance related dilemma that could affect upcoming treatment

• Provide necessary radiation therapy treatment and ancillary codes with supporting clinical to health plan or third party payor to ensure radiation therapy treatment is approved and authorized

• Assist appeals and denials departments to investigate and appeal denied services at point of claims, if required

11/2018 – Current: Epic Super User

Northwestern Memorial Hospital – Chicago, IL

• Attend monthly WebEx trainings to stay abreast of hospital wide upgrades

• Supports manager and team during upgrade periods to assist with additional questions and training

• Work effectively with the IT Training Team

02/2016-07/2017: Financial Clearance Specialist – focus: Urgent and Elective admissions

Northwestern Memorial Hospital – Chicago, IL

• Ensures all admissions, scheduled surgeries and certain outpatient procedures are financially cleared to allow for maximum and timely reimbursement to the hospital for medical, behavioral health and radiation therapy services

• Reviews and analyzes all required demographic, insurance/financial and clinical data procured by patient intake and registration areas necessary to expedite payment on patient accounts

• Verifies eligibility and benefit information using multiple on-line programs

• Performs pre-certification notification via telephone or electronically

• Maintains patient confidentiality per HIPPA regulations

• Verifies eligibility and benefit information using multiple on-line programs

02/2016-05/2016: Financial Clearance Specialist – focus: Pre-Service Collections

Northwestern Memorial Hospital – Chicago, IL

• Maintain positive relationship between patient and facility by placing informative outbound calls to patients to provide financial summary of upcoming procedure

• Encourage pre-payment by patient and processed credit card payment via phone while protecting patient financial information

• Verify eligibility and benefit information using multiple on-line programs

10/2014 – 02/2016: Full Revenue Cycle Medical Biller

Northwestern Medical Group – Chicago, IL

• Answer high volume of calls for hospital and professional billing inquiries made by external and internal customers according to the department protocol

• Confirm benefit coverage, eligibility and claim status using a variety of insurance company software, contacting insurance to rebill or appeal claim denials when appropriate to get a resolution

• Process payments over the phone and post payments to account

• Reverse and void payments and issue refunds according to department standards

• Collect and update demographic and insurance information on patient accounts

• Review and interpret explanation of benefits, insurance remittance, and patient medical records

AWARDS

Department of Radiation Oncology Partner in Care Award 05/2018

Northwestern Memorial Hospital

EDUCATION Expected Gradation: May 2024

University of Illinois at Chicago (UIC) – Chicago, IL

Bachelor of Applied Health Sciences: Health Information Management

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