Entry Specialist Clerk
Resume:
Gwendolyn D. Frieson
*** ****** * **** ** Circle
Oxford MS. 38655
PROFESSIONAL SUMMARY
Healthcare professional with over 16 years on experience working within the industry handling patient’s accounts while ensuring all information is verified for accuracy and prepared for the facilitation of services rendered
While currently working as a contract employee with Fresenius, documents accurate information within accounts and ensures all information is maintained while reviewing information dating back previous years
While working at Parallon/HCA, ensured all patient insurance, demographic and eligibility information was collected and entered into HER accurately and efficiently
As a Data Entry Specialist at The Little Clinic, verified insurance cards and entered patients’ personal information for the facilitation of the billing processes and created 300-325 claims daily
Verified patient demographics and inputted medical record coding results in a timely and accurate fashion into CMS while working at Optum Health Care
Knowledgeable of ICD-9/10, CPT Codes, HIPPA/OSHA Compliance, Citrix/ECW, Emdeon Meditech, PME, Artiva, Onbase, 1095–A form, the Affordable Care Act (ACA) as well as proficient in Microsoft Office Suite – MS Word, Excel, PowerPoint, Outlook, UNIX, Windows 98, 2000, XP, Vista, and Windows
Extensive experience in customer service facing environments with interpersonal skills and the ability to work both independently and collaboratively as necessary
Available to interview within 48 hours’ business days’ notice
PROFESSIONAL EXPERIENCE
Baptist Memorial Hospital-Oxford, MS.
Admissions Rep.Finance
10/2019-8/2022
Obtain accurate demographic, financial and clinical information and enter it into the computer system to create the medical and financial record
Ensure the data base integrity and facilitate claims are processed correctly
Apply financial screening guidelines to make sure proper procedures are followed
Greet patient, visitors, vendors, Doctors families and direct them on which way to go.
Answer the phone and direct calls to different departments in the hospital.
PROFESSIONAL EXPERIENCE
Parallon/HCA /Skyline Hospital
Patient Benefits Advisor
10/2015 - 04/2019
Ensured all patient insurance, demographic and eligibility information was collected and entered into HER accurately and efficiently
Reviewed patient’s medical records to get familiarized with patient’s condition
Verified commercial insurance benefits and to ensure appropriate signatures were obtained on required release of information forms
Screened each patient at bedside to determine eligibility for Medicaid, Social Security and/or VOC
Served as a liaison between the patient, hospital, and state agencies and documented progress notes to the patient's file and hospital EHR system
Worked with case management team to assist patient in obtaining necessary documentation
Obtained medical records, physician statements and all other documentation required for eligibility determination
Acquired all requirements to begin SSI or disability applications and completed and submitted applications on behalf of the patient
Initiated, maintained and documented correspondence between patient and state agency caseworkers to ensure timely processing of applications
Certified Application Counselor through Federal Health Insurance Marketplace 2016, 2017
Contract: Randstad Staffing OR Robert Half International Agency 10/2014-02/2015
Permanent: Cognosante 02/2015 – 10/2015
Fielded an average on 100-150 outbound calls daily to consumers and gathered information in order to complete their 1095-A forms and correction requests
Verified consumers demographic information and ensured information was entered in correctly to ensure forms were completed accurately
Used and interpreted various federal polices, regulations and systems in responding to consumer inquires, regarding their 1095-A
Completed complex applications for appeals, and handled terminations and escalations
Educated customers and Member Representatives on procedures, benefits and polices of Tenncare Medicaid
ComplexCare Solutions
Outreach Specialist/Customer Service
09/2013 – 10/2014
Responsible for contacting prospective health assessment and care management patients
Worked with a variety of commercial insurances including, Anthem BCBS, Medicare Advantage Members of Ohio, Vantage of Louisiana, and Cigna
Scheduled health assessment patients and maintained their schedules on behalf of the clinical providers and Nurse Practitioners
Responded to customers/patients inquires related to the program and the assessment as well as scheduled appointments
Updated schedules based on provider availability, and handled all cancellations
Optum Health Care (Contracted Robert Half International)
Data Entry Clerk
10/2010 – 09/2013
Verified patient demographics and inputted medical record coding results in a timely and accurate fashion into CMS
Acted as a liaison between Data Analytics and Coding Department to ensure quality assurance
Handled abstracted documentation requirements based on CMS guidelines for the internal coding team and ensured all documents adhered to requirements
Followed all policies and procedures to contribute to the efficiency of the department
EDUCATION
Oxford High School – Oxford, MS
High School Diploma
North West Community College – Oxford MS
1988-1989
Everest College- Norcross GA
2009-2010
Reference available upon request
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