D'LATISHA BROOKS

***- ***-****

adrnf1@r.postjobfree.com

Hardworking medical administrative professional offers great people skills, organized file management and deep understanding of patient protections. Enhances office operations by staying on top of patient and staff needs. Experience with electronic recordkeeping and insurance documentation. Electronic medical records /Patient scheduling

software Epic, NextGen, HealthSuite, Zendesk,

eClinicalWorks and

Medical Terminology

Patient Medical Records Maintenance

Past Due Account Management

Critical Thinking

HIPAA Requirements

Knowledge of HMOs, Medicare and Medi-Cal

Data Entry

Telephone Etiquette

Patient Callbacks

Patient Referral

De-escalation Techniques

Patient and Empathetic

Multitasking and Prioritization

Call Volume and Quality Metrics

Customer Service

Responding to Difficult Customers

03/2020 to 06/2022

CARBON HEALTH

Central Support Specialist

Triage situations & schedule appointments (via phone) using Dialpad, while gathering information via Support.com,SMS and Zendesk verifying insurance, reviewing self-pay pricing) Ensure operational integrity by following established protocols Helped to develop and suggest process improvements that will have a direct impact on the benefit patients, clinicians, colleagues and overall operations Sought clarification from physicians and other hospital personnel for answers to needed coding interpretations prior to abstracting records.

Used Carbon Health/ Epic medical record software every day and developed advanced skills. Pulled patient records 100-150 a day and transfer information to appropriate parties, health insurance patients PCP Workers Comp,and legal subpoenas.

Followed set protocol for contacting assigned newly diagnosed COVID-19 case patients and documented contact attempts and timeframes.

Analyzed protected health information sharing for public health emergencies. Followed set protocol for contacting assigned newly diagnosed COVID-19 case patients and documented contact attempts and timeframes.

Answered calls and interacted with community members to provide information on advocacy services. Notified individuals regarding appointment follow-ups and referrals and provided transportation to appointments.

10/2018 to 02/2020

ST.FRANCIS MEDICAL CENTER

Administrative Assistant

Performing a variety of administrative, secretarial and clerical duties of a highly responsible, complex and confidential nature.

Preparing agendas and attended meetings with supervisors, department heads, doctors & surgical staff and patients when necessary to take minutes.

Created and maintained confidential patient files; implemented EHR systems to automate patient records management

SUMMARY

SKILLS

EXPERIENCE

Coordinate and track outside consults, tests, and imaging studies for patients also did billing working with insurance as well as cash-paying patients

Resolved billing related issues both in Epic medical billing/coding and cash paying accounts for all patients

Maintained a high degree of knowledge regarding the hospital protocols. 04/2018 to 10/2018

HANGER, INC

Oakland, CA

Office Assistant II (Contractor)

Reviewed charge information to ensure accuracy per payer requirements; made corrections as needed Reviewed claim edits and resolved them, as well as claim rejections and denials, performing voids and corrections as necessary

Responsible for all aspects of patient appointment scheduling, insurance verification, creation of new patient charts and maintenance of patient records

Provided financial counseling for patients and posted payments Purged EMR records to streamline search process

Maintained business records by updating customer information. Served as central point of contact for outside vendors and assisted with negotiations. 04/2017 to 01/2018

SAN FRANCISCO HEALTH PLAN

Clinical Quality (Contractor)

Responded to customer requests, questions, concerns, and complaints in a timely, respectful, caring and competent manner

Answers telephone calls promptly and minimizes delays that may lead to abandoned calls Verified member eligibility, for incentive

Promotes the rights and responsibilities of plan members Provides information, referrals and coordinates member services with community resources for covered and non covered services

Participated in activities that reached out to prospective members and to the communities that the Plan serves.

Solicited medical history information from patients to provide best and most effective medical advice. 08/2015 to 02/2017

AMERISOURCEBERGEN LASHGROUP

San Bruno, CA

Administrative Assistant / Biller

Provided exceptional customer service to internal and external customers; resolved any customer requests in a timely and accurate manner; escalated complaints accordingly Collected and reviewed all patient insurance benefit information, to the degree authorized by the SOP of the program

Checked claims coding for accuracy with ICD-10 standards. Completed and submitted all necessary insurance forms and electronic claims to process the claims in a timely manner as required by all third-party payors Researched and resolved any electronic claim denials Effectively utilized various means for collections, including but not limited to phone, fax, mail, and online methods

Maintained frequent phone contact with provider representatives, third party customer service representatives, pharmacy staff, and case managers 03/2015 to 12/2015

MERIK GROSS

Front Desk Receptionist

Helped with prescriptions, patient interface with other offices and hospitals, appointments, follow-ups, tracking appointments, facilitating patient needs, Managed medical records and made requests for copies Received a routed all incoming and outgoing faxes and handled prior authorizations Obtain prior authorizations for prescriptions and diagnostic exams from insurance companies also work with POS

Arranged and track outside consults, tests, and imaging studies for patients, with a strong deadline of clearing work Ques

Used G Suite comprised of Gmail, Hangouts, Calendar, and Currents for communication; Drive for storage; Docs, Sheets, Slides, Keep, Forms

Analyzed patients labs to identify errors and omissions, taking appropriate action to verify and retrieve critical medical data

10/2013 to 02/2015

UNIVERSITY OF CALIFORNIA

San Francisco

Authorization Assistant

Responsible for obtaining pre-certify/pre-authorize for outpatient visits EKGs, and ECHOs Assist providers with authorization, denial, and appeals process information Reviewed correspondence and rejections from insurance carriers, post and reconcile Answered incoming calls while recording accurate messages. Provided direct support to Specialty Care practices regarding utilization, authorization, and referral activities.

Evaluated credit balances and determine appropriate action Collected, organized, and interpreted paper and electronic explanation of benefits. BACHELOR OF SCIENCE: HEALTHCARE MANAGEMENT Expected in 05/2023 DeVry University, Villa Park, IL

ASSOCIATE OF SCIENCE: PHARMACOLOGY 03/2018

Carrington College, San Leandro, CA

EDUCATION AND TRAINING

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