Customer Service Medical Billing

**** **** *** ****** *****, NY ***** C: ***. ***.*150 E: **********@***.***

SHENA MCCAULEY

EXPERIENCED ADMINISTRATIVE SUPPORT PROFESSIONAL

Specializing in Data Management & Client/Customer Services

SUMMARY OF QUALIFICATIONS

•Intake & Eligibility Screening, Planning & Coordinating

•Proficient in MS-Word, PowerPoint, Excel, Med iSOFT, Avatar,

EPACES; McKesson & Sandata

EDUCATION

•Project Management; Strategic Outreach

•Office Support; Research; Inventory

SANFORD BROWN INSTITUTE, New York, NY

Medical Billing and Coding September, 2013

CITY COLLEGE, New York, NY

B.A., Management & Administration/ Economics September, 2011

EXPERIENCE

CARE COORDINATOR Memorial Sloan Kettering Cancer Center, NEW YORK, NEW YORK [4/2021 to 10/2021]

•Worked as a member of the practice staff team of Care Coordinators to ensure that each physician practice session is well-prepared, organized, and fully utilized and that each patient visit occurred with satisfaction

•Served as a liaison between the patient, family, and clinical team during the office visit

•Greeted/check-in and orient patients to the outpatient visit and to the environment, as well as completed the patient visit by scheduling and coordinated all appropriate tests, procedures, visits, treatments, and consultations in accordance with the physicians’ orders

REGISTRAR\ JACOB JAVITIS CENTER, NEW YORK, NEW YORK [03/2021 to 4/2021]

•Served as the first point of contact for residents receiving COVID-19 vaccinations.

•Scheduled appointments for residents registering for COVID-19 vaccinations while ensuring that all eligibility requirements were met

•Ensured that all scheduled residents provided accurate identification and personal information and verify for accuracy

•Distributed post vaccination information to residents to inform them of possible symptoms and side effects

•Monitored patients post vaccination to ensure that they are not experiencing complications and alert the medical team if necessary

•Provided residents with informational pamphlet on symptoms to look out for post vaccination

Residents were required to be observed for 15 minutes post vaccination for any adverse side effects. Resident raised hand if they are not feeling well. Monitored the post-vaccination group of residents and if anyone raises their hand, alert clinical team to assist the resident.

PRACTICE OFFICE ASSOCIATE NORTHWELL HEALTH-PEDIATRICS, Mt. Kisco, NY [10/2020 to 2/2021]

•Performed diversified office-clerical duties including, but not limited to scheduling appointments; facilitated communications; preparing consultation charts; taking and prioritizing telephone calls; maintained and documented incoming reports, filing, receptionist duties, light typing/data entry.

•Performed other various receptionist duties and maintains reception area. Collect, verify and records demographic, insurance and referral information. Collect, record and receive outstanding money. Prepares patient charts.

•Maintained patient and correspondence transcription records. Collects, sorts, files, locates and distributes needed information, materials, records and paperwork. Proof reads transcribed correspondence. Operated related office equipment.

•Prepared various correspondence, reports, articles or data entry; may prepare and maintain various statistical data.

SERVICE COORDINATOR ABLE HEALTH CARE SERVICES, Brooklyn, NY [10/2017-07/2020]

• Represented Able as a front-line customer service liaison. Under direction of the Director of Nursing to assure that the skills of the caregiver team assigned to each case are appropriately matched to the needs of the patient/clients. Responsible for assigning the same care team to each patient/client; facilitating continuity of care, supporting the attainment of desired outcomes, and improving customer satisfaction. Schedule only the amount, frequency, and duration of services identified in the plan of care and ordered by the physician; Maintain a standardized weekly schedule for all active patient/clients and document schedule changes on the scheduling form. Validate caregiver documentation against schedules prior to payroll and appropriately to resolve differences. Create and update active patient/client and caregiver lists weekly, and more frequently, if requested.

ENROLLMENT ASSOCIATE FIDELIS CARE, Queens, NY [11/2015-10/2017]

• Established and verified product compliance to ensure quality standards were met. Reviewed and determined applicant eligibility for Government sponsored health insurance programs using State and Federal regulations; follows standards while maintaining quality service. Reviewed and assessed all applications/documentation for integrity. Ensured all member accounts correctly reflected activity performed; accurately recorded, input, updated, and edited information. Determined eligibility and processed applications for government programs; updated customer account information in database.

INTAKE SPECIALIST I CARE TO CARE, LLC, New York, NY [02/2015-11/2015]

• Received authorization requests for radiology department; reviewed request and verifies eligibility, provider participation, and rendering facility participation; Entered medical information; Initiated online authorization based on information received; Provided customer service. Familiar with various plans including Touchstone, 1199 and Elder Plan; Performs functions according to client program design.

Collaborated with UM staff and management; performed other duties as directed or as requested by Care to Care management

GUEST SERVICE AGENT, Seasonal INTERCRUISES, New York, NY [06/2008-12/2014]

• Provided general customer service and direct assistance at check-in and in boarding areas; review and verify traveling documents. review safety procedures; Enter customer data and traveling information into company database; inform customers of sailing schedules; Process cash/credit and online transactions; Distributed ships' sales and future promotions

STORE OPERATIONS REPRESENTATIVE, Contract ADECCO/GOOGLE, New York, NY [04/2014-05/2014]

• Performed daily shopping tasks and inventory validation checks; Worked directly with Retail Store Managers to integrate operations processes, troubleshoot issues and report feedback to the Store Operations Lead; Assisted Design Team with testing new operational processes; Helped Field Operations Lead to manage hardware assets used for in-store processes

ADMINISTRATIVE SUPPORT, Intern VIP COMMUNITY SERVICES, Bronx, NY [07/2013-08/2013]

• Entered patient data and Medicaid information into EPACES and AVATAR database; Processed food vouchers; Verified patients' insurance coverage; Tracked patients' visits to determine physician eligibility for insurance payments; Maintained strict confidentiality and followed all HIPAA policies

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