Computer Operator Patient Representative

Angela Thomas

**** ********* **.

Smyrna, TN ****7

313-***-**** cell

*************@*****.***

Patient Service Representative - Medical Customer Relations - Insurance Verification

I bring over 30 years of experience in the Medical Registration and Customer Relation fields. I offer outstanding customer service and organizational skills with proven reliability and dedication to the hospital, doctors and patients that I am in contact with. I strive to build strong lines of communication between doctors and their patients while maintaining a high level of accountability and professionalism.

Education

Wayne County Community College, Detroit, MI Business Administration

Ottawa Hills High School, Grand Rapids, MI College Preparatory

Work History

Tennessee Orthopedic Alliance: Smyrna, TN December, 2012 – Present

Patient Services Coordinator 1: Physical Therapy front desk check-in/ check-out, interviews patients to obtain all necessary account information and schedules all appointments, Workmen Compensation verification precertification/authorization, verify benefit and all insurances, and answers all incoming calls. Calculate and collect patient liable amounts, collect co-pays, deposits, deductibles and balances due on accounts and document collections status in the system. I issue waivers for signatures when appropriate, scanning of all charge tickets to the billing department, faxing as well as other assigned job duties such as sanitizing all examine tables after patient use, also change table linen as well after patient use and the washing of the laundry.

Saint Thomas Heart: Nashville, TN June, 2012 – October, 2012

Patient Account Representative: Obtained and verified patient demographic information, loaded, and completed insurance verification process and ensured insurance coverage by telephone, web, or fax. Respond promptly to all written communications. Resolved any issues with coverage, also responsible for total coordination and processing of all patient referrals for specialty services. I provided financial counseling options to patients including cost estimates, payment plans, discounts, and supplemental financial assistance. Reviewed and explained insurance benefits to patients to guarantee full understanding of payment policies and procedures. Knowledgeable of CPT codes, ICD-9 codes and obtained prior authorizations and or referrals for patients. Provided medical documentation if necessary to obtain prior authorization. Verify primary/secondary payer protocol and seek pre-authorizations followed protocols for proper authorization and processing of all referrals. Assisted team members in educating patients/family, follows standing orders/protocols, and assisted patients with external resources when needed. I communicated with the patient on a timely basis for all scheduling requirements, coordinate requirements with clinic personnel and patient. Completed all administrative functions associated with referral activities in a timely manner. Entered all referral, hospital, outpatient, and other patient specialty health service authorizations into the computer system according to STPS policy and procedure, received reports, maintains documentation, and routes to the appropriate physician promptly. Responsible for monitoring all referral reports not received and timely follow-up in accordance with STPS policy and procedure. I met daily production goals as directed by management. Attended all Insurance Verification Team meetings and performed other duties as assigned.

Randstad Staffing Agency: Nashville, TN September, 2011 - June, 2012

Saint Thomas Central Scheduler: Diagnostic Imaging scheduling from doctors offices and patients, making sure that all calls are handled in a prompt and professional manner. Gathers necessary demographic information and enters into appropriate database. Assists in coordination of all activities related to insurance verification and medical necessity. Provide proper pre-services instructions to patient, patient representative and physician. I also perform clerical duties as requested.

Carl M. Karoub, M.D. / Frederick M. Karoub, M.D.: Royal Oak, Michigan January, 2010 – March, 2011

Patient Registration / Communication: Primary responsibility to ensure that patient calls are handled in a prompt and professional manner. Additional duties include appointment scheduling, insurance verification, patient check in and check out. I responded to patients request for prescriptions and test results and questions to physician and medical records request.

University Physician’s Group: Warren, Michigan July, 1999 – September, 2009

Appointment Scheduling Coordinator: Supervised the Appointment Scheduling Department. Provided orientation and training to staff of Schedulers and also provided evaluations of employee’s job performances. Promoted and increased team building by structuring meetings to encourage positive communications between the staff and doctors. Established and maintained department records on the IDX Systems. I enforced and maintained policies and procedures for the Appointment Scheduling staff. I also performed insurance verifications and operational responsibilities by the University Physician’s and Administrator. I worked with employees at various locations including Children’s Hospital and Detroit Receiving Hospital to ensure an effective and efficient flow of patients through each location.

St. John’s Northeast Community Hospital: Detroit, Michigan May, 1995 – June, 1999

Senior Computer Operator: Maintained operation of IBM AS400 to allow for all users. I performed data entry and computer operations for all systems application on all shifts. Entered data from all source documents, monitored controls and follow through on special assignment.

Saratoga Hospital: Detroit, Michigan October, 1991 – April, 1995

Emergency Room Patient Registration Clerk: Job duties included all aspects of Patient registration encompassing patient intake interviews for incoming patients. Working with patients to gather demographics, insurance and emergency information while ensuring completion of paperwork as well as sign-in and security procedures prior to admissions. Duties also included explaining hospital policies, preparing and distributing patient identification bands, and the assignment of account and medical record account numbers. I served as a problem solving resource for patients dealing with insurance issues. I answered all inquiries in a timely fashion and in a manner that promotes customer satisfaction.

Additional Experience and Training

Henry Ford Hospital Detroit, Michigan July, 1991 – August 1991

Orthopedics Casting & Splinting for surgical procedures

Software Knowledge

Microsoft Word

Microsoft Excel

Citrix and IDX Systems

SCI Solutions

Cerner Patient Management Office

Nextgen

Misys

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