Office Assistant Intake Specialist
Resume:
MAYRA AMAYA
**** **** **** ■ Houston, TX ***** ■ *************@*****.***
PROFESSIONAL SUMMARY
Bilingual Insurance Verification Coordinator with fluency in English and Spanish. Adept at reviewing, analyzing and interpreting insurance policies for patients. Hands-on experience verifying patient insurance information and obtaining pre-certification / authorizations for upcoming visits and procedures. PROFESSIONAL WORK EXPERIENCE
Houston Methodist - Scheduler II
Houston, TX // November 2019- current
● Obtain demographic, insurance and financial information from patient or guarantor to complete registraton
● Schedule patient appointments and enter required information into EPIC in an accurate and timely manner
● Verifies insurance eligibility and benefits
● Communicates in an effective and professional manner with physicians, office staff, nurses, and insurance companies
● Other duties as assigned by management
Kelsey-Seybold- Utilization Management Representative Pearland, TX // June 2019- November 2019
● Assisted with clerical report related to bed day process
● Collect, report, clarification and entry of bed day data
● Collect- non clinical data, report generation, health plan coordination for non- clinical issues
● Handling and appropriately directing referral status request received
● Assist with requesting clinical updated via phone and fax from facilities McKesson, Intrafusion - Intake Specialist
Houston, TX // December 2017 to Current
● Re-verify insurance benefits for new and existing patients.
● Evaluate charges and reimbursement estimates for infusion therapies.
● Review all medical documentation against medical policy and initiates pre-determination, precertification, and authorizations as needed.
● Obtain all authorizations and assure on file for treatment.
● Obtain PCP referrals as needed.
● Complete special projects as needed.
Altus Infusion - Account Manager/Team Lead
Pearland, TX // August 2016 to December 2017
● Responsible for training new account managers and retraining for existing accounts.
● Performed various audits of team members to ensure quality and production metrics were met.
● Managed all communications with providers office, the patient and the corporate office.
● Obtained authorizations, referrals, pre-determinations and pre-certifications as required by the patients’ plan.
● Was a first point of reference for team member questions and escalated issue resolution.
● Responded to customer requests via telephone and email. CHI St. Luke's Health - Epic Scheduler- Temp. Assignment Houston, TX // November 2015 to July 2016
● Scheduled Epic training for new hires to the organization.
● Scheduled refresher training for physicians or current staff members.
● Created training schedules in Health Stream.
● Handled incoming calls.
● Responded to emails from certified trainers, training coordinators.
● Kept track of training history for each individual that is trained in all the Epic modules. Houston Medical Imaging - Bilingual Scheduler- Temp. Assignment Houston, TX // April 2015 to October 2015
● Scheduled appointments for different types of images.
● Canceled and rescheduled appointments.
● Registered patients in Medics system.
● Verified insurance of new and returning patients.
● Confirmed next day appointments.
● Explained procedures to patients prior to coming to appointment. Baylor College of Medicine - Bilingual Scheduler-Temp. Assignment Houston, TX // September 2014 to April 2015
● Responsible for making and scheduling patient appointments in a timely manner.
● Routed calls to appropriate staff member.
● Conducted appointment reminders; canceled and rescheduled appointments.
● Registered patients in EPIC system.
● Gathered insurance information, verified insurance, provided financial responsibility to patients. UT Physicians - Patient Access Representative
Houston, TX // September 2013 to September 2014
● Scheduled all pediatric patients for appointments for different specialties.
● Informed office staff and patients of referrals/testing required prior to appointment.
● Performed insurance verification on Medicaid accounts.
● Gathered and entered accurate patient demographics / insurance information into EMR programs.
● Provided requested information properly in regards to clinic location, services and physicians on staff.
● Created files and maintained medical records.
● Retrieved referrals from fax and scanned into medical record. Spine Associates - Office Assistant
Houston, TX // March 2012 to September 2013
● Answered a high level of incoming calls on a daily basis.
● Scheduled all appointments for Orthopedic Surgeon.
● Inserted lab results or other results received electronically into patients' charts.
● Ensured compliance was met and maintained with all medical record tasks.
● Provided medical records as requested by patients and other medical entities/organizations.
● Converted "paper" medical records to electronic records.
● Scanned incoming medical records/documents to appropriate patient chart.
● Prepared charts as needed for special audits.
● Faxed out requests for records when presented with a properly completed medical release. Harris County Hospital District - Patient Appointment Scheduler Houston, TX // September 2008 to November 2009
● Scheduled, cancelled, and rescheduled medical appointments for 14 different clinics in Harris County.
● Answered 200+ phone calls per day; screened for eligibility of Gold card.
● Verified insurance information; completed registration for clinics.
● Processed specialty referrals.
● Provided general information for clinics and hospitals.
● Obtained and updated demographic information.
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