MELANIE GRIMLEY

P.O. Box **** EATON PARK, Florida 33840

C: 410-***-**** - email:adker4@r.postjobfree.com

PROFESSIONAL SUMMARY

Office Assistant with 10 years of billing and coding, patient charting, insurance claims and appointment scheduling in a busy medial office setting. Medial Receptionist who goes above and beyond basic administrative tasks and take son multiple projects at once. Excellent work ethic and strength in boosting company morale. Referral Specialist who continually maintains a positive attitude while interacting with demanding clients. Serves as the primary point of contact for both in-house and external phone and website queries.

SKILLS

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Professional phone etiquette

Accurate and detailed

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Excellent communication skills

Excellent planner and coordinator

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Database management

Works well under pressure

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Articulate and well-spoken

Social media knowledge

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Customer service-oriented

Pleasant demeanor

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Flexible

Appointment setting

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Advanced clerical knowledge

Team building

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Multi-line phone proficiency

Compensation and benefits

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Administrative support specialist

Medical billing

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Critical thinker

HIPAA compliance

•Microsoft Excel certified

•CMS-15oo billing forms

•Filing and data archiving

WORK HISTORY

Medical Practice Representative 7/2017 to 5/2018

Sinai Community Care – Sinai Hospital of Baltimore, United States

Performs registration and scheduling of outpatient appointments, charge entry, collection of co-pays and medical records functions. Optimizes facility and professional collections. Attends morning and afternoon rounds to coordinate with doctors, nurses, and social worker regarding the scheduled patients for continuity of care. Takes the lead with training new medical practice representatives, and also acts as liaison to medical doctors regarding registration concerns, scheduling, and insurance.

•Collects co-pays and fees for facility and professional services

•Reconciles cash drawer on a daily basis.

•Prepares and submits Hospital and faculty practice deposits

•Verifies patient insurance coverage and assists patients with obtaining specialty referrals.

•Interviews patients to obtain correct demographic and insurance information.

•Inputs a complete patient registration into a computerized registration system

•Reviews completed registration with patient; assists patient with the signing of admission forms and other forms that may be required for the department.

•Notifies provider of patient’ arrival.

•Prepares admission packet of forms and labels for provider.

•Schedules appointments into computerized systems.

Referral Specialist, 06/2014 to current

Watson Clinic Main – Lakeland Florida, Remote

Performed screening on all pre-authorization requests. Referred cases as needed for review to preauthorization nurses. Monitored voice mail on a regular basis and processed telephone pre-authorization requests. Maintained appointment logs and confirmed appointment times with patients. Upheld telephone service standards in adherence to department rules.

•Precisely completed appropriate claims paperwork, documentation and system entry.

•Correctly coded and billed medical claims for various hospital and nursing facilities.

•Scheduled appointments, registered patients and distributed sample pharmaceuticals as prescribed.

•Supporting documentation for accounting records and input clinical information for medical and disability claims

•Determined prior authorizations for medication and outpatient procedures.

•Investigated, evaluated, resolved claims through the normal claim handling process.

•Pre-certified medial and radiology procedures, surgeries.

•Resourced COPT and ICD-9 coding discrepancies for compliance and reimbursement accuracy.

•Maintained strict patient and physician confidentiality

Patient Account Specialist 3/2011 to 06/2014

Rotech Healthcare – Lakeland, Florida, United States

Responsibility included receiving medical record documentation and providing thorough review and quality assurance for physician orders, testing, progress notes, audited files and prof of delivery documents to confirm products and services were provided as ordered; resolved error by communication with patients and referral sources; provided product and serve information; entered data accurately into the system and ensured questions and concerns were processed in a timely manner.

•Identified and resolved patient billing and payment issues.

•Printed and reviewed monthly patient aging report and solicited overdue payments.

•Updated patient financial information to guarantee accuracy

•Denials and Appeals

Medical Receptionist, 03/2006 to 06/2009

Clark & Daughtrey Medical Group – Lakeland, Florida, United States

Greeted patients, answered phones, scheduled and confirmed appointments, verified insurance benefits and eligibility, prepared and processed paperwork for billing, entered patient demographic and information into system, maintained medical records and prepared charts for services, collected co –aments for services.

•Ordered and distributed office supplies while adhering to a fixed office budget.

•Answered and managed incoming and outgoing calls while recording accurate messages.

•Opened and properly distributed incoming mail.

•Greeted numerous visitors, including VIP’s, vendors and interview candidates.

•Maintained a clean reception area, including lounge and associated areas.

•Answered and quickly redirected up to 200 calls per 1 hr.

Medical Secretary, 04/2000 to 03/2006

Gessler Clinic- Winter Haven, Florida, United States

•Scheduled and accompanied clients to medical appointments.

•Monitored expiration of medical supplies and medications.

•Obtained information about clients’ medical history, drug history, complaints and allergies.

•Supported duties for diagnostic and technical treatment procedures, such as setting up and operating special medical equipment and apparatus.

Medical Receptionist, 06/1996 to 04/2000

Blake and Franklin Mds – Lakeland, Florida, United States

•Ordered and distributed office supplies while adhering to a fixed office budget.

•Managed office supplies, vendors, organization and upkeep.

•Directed guests and routed deliveries and courier services.

•Answered and managed incoming and outgoing calls while recording accurate messages.

•Opened and properly distributed incoming mail.

•Greeted numerous visitors, including VIP’s, vendors and interviewed candidates.

•Helped distribute employee notices and mail around the office.

•Maintained a clean reception area, including lounge and associated area.

•Organized all new hire, security and temporary paperwork.

•Answered and quietly redirected up to 100 calls per hr.

EDUCATION

Bachelor of Science: Human Services, 2012

Southeastern University- Lakeland

•3.25 GPA

•Minor in Elementary Education

•Coursework in Organization Behavior, Compensation, Labor Relations and Recruitment

•Microsoft PowerPoint certification training

High School Diploma: 1986

Dale County high School – Midland City, AL

•Coursework in Business Administration, Communications and Accounting

Contact this candidate