Data Entry Customer Service

OBJECTIVE

To obtain a stable, growth potential position that will allow me to utilize my expertise in leadership and excellent customer service in the medical clerical field.

SKILLS

• Excellent Communication Skills

• Analytical & Time Management Skills

• Ability to Coordinate Multiple Tasks Simultaneously

• Ability to Interact Effectively & Diplomatically with a Wide Range of People

• EMR Proficient/ Proficient in Medical Terminology

• Exceptional Customer Service Skills

• Knowledgeable of CPT and ICD-10 Coding

• Proficient Computer Software Skills (Excel, Microsoft Word, PowerPoint, Explorer, Windows, Outlook Electronic Mail/Calendaring Systems, EPIC, Skype for business, QuickBooks, PayChex Payroll, Google Docs, AVATAR, AVAILITY, EMDEON and IMS.

WORK HISTORY TELECARE (HERITAGE HOSPITAL) 08/2014-CURRENT

•FINANCIAL COUNSELOR

Deciphers insurance eligibility and coverage to ensure accuracy of all revenue cycle activities for assigned program. Updates billing system to reflect accurate insurance status of all patients. Reviews daily census for all members served to determine Revenue Cycle intervention appropriateness. Calculate liabilities and relay all benefit details and co-payments; provided face to face and or telephone financial counseling for members and family. Confirmation of all demographic information. Collection of all co-payment liability along with assisting with repayment agreements. Process and or appeal all authorizations for in-patients. Initiate appeal and retro claims process. Ensures accurate and timely posting of billing information and posts cash receipts. Point of contact for Kaiser web portal access for Heritage. Generates aging report to assist with identifying clients that are eligible to be forwarded to collection company. Point of contact for all program activities related to Revenue Cycle.

WEBSTER ORTHOPEDICS 08/21/12- 08/22/2014

•REGISTRAR/REIMBURSEMENT SPECIALIST

Solely responsible for the Dublin, CA offices. Coordinates assignment of beds, transfer and or discharging of patients. Assist patients in filling out all mandatory paper work, explain financial obligation and collection of all co-pays, deductible and co-insurances prior to services being rendered. Deposit daily revenue to financial institution. Accurately complete all demographic and insurance verifications, obtain all necessary referrals and authorizations, Generate claims to Medicare, Medi-Cal and/or commercial insurance, Generate claims related to inpatient and/or outpatient mental health services, track and manage authorizations for services when appropriate, Accurate recording of charges, payments and adjustments, Ensures accurate and timely posting of billing information and posts cash receipts, Prepares and submits claims to third party payers, both in paper and electronic format, Performs collections follow-up process in accordance with established procedures.

AEROTEK STAFFING (11/2011- 08/1/2012)

•LEAD FINANCIAL COUNSELOR (ONCOLOGY DEPT)

Provide financial counseling and support to patients faced with undergoing various types of Chemotherapy infusion and Radiation treatment, obtain prior authorizations, counsel patients and their families on the financial reimbursement plans for his/her treatment to include discussion of insurance-covered services and benefits also, working closely with the patient and his/her family to develop solutions to meet their financial responsibilities. Assist the patient with identifying sources of financial assistance to include drug manufacturer programs and support from foundations to help with health care bills. Responsible for answering patient's questions regarding financial matters related to recommended treatment plans, payment options, available medical coverage and ensures patient's care plan meets reimbursement regulations outlined by state, federal and third party payers. Ensuring all pre-certification and prior authorization requirements are met.

PAIN & REHABILITATIVE CONSULTANTS (11/01/2006 - 09/28/2011)

• SURGICAL SCHEDULER/AUTH COORDINATOR SUPERVISOR

Supervise daily functions and operations of the surgery/authorization department. Perform and monitor personnel functions of the department, subject to established clinic policies. Perform monthly evaluation for bonus details. Yearly status evaluation completions. Develop and infuse policy and procedures. Recruit and train all incoming staff. Responsible for payout of vendors and monthly department needs. Validate and complete weekly payroll audits. Schedule all in and outpatient surgery cases including minor and non-minor procedures, schedule all pre and post-operative appointments, process authorization requests for outpatient surgeries and diagnostic services for commercial & work comp accts on a daily basis, verify eligibility and benefits, inform patient of detail benefits including deductible and rate of reimbursement for facility and physicians, negotiate with facility coordinators to refer specialty diagnostic services, provide monthly data and numbers reports, acquire retro authorizations, correct authorizations including incorrect CPT, ICD-9 coding or facility changes, provide excellent customer service to patients, heavy phones and data entry.

SUTTER SOLANO MEDICAL CENTER (2001-2006) Vallejo, CA

• LEAD FINANCIAL COUNSELOR/CENTRILIZED SCHEDULER

Team lead over department of (5) schedulers; provided training and guidance in daily procedures including monitoring of accounts for proper documentation. Screen and select temporary candidates to fill department vacancies. Scheduled all outpatient diagnostic surgical services. Assured patients of all clinical information needed and financial obligations. Performed quality control functions for scheduled procedures; generated weekly status reports, insurance verifications, and collection of deposits, co-pays, deductibles, and self-pay balances. Secured reimbursements for all non-insured admits, reviewed and visit all in-patient admits, very knowledgeable of Medi-Cal, Medicare, HMO/PPO and Worker’s Compensation plans.

EDUCATION

*NOBLE FIELDS SCHOOL OF REAL ESTATE- 2016-2016

*ALAMEDA COMMUNITY COLLEGE 1998-2000 ALAMEDA, CA

(BUSINESS ADMINISTRATION, APPLIED COMPUTER SCIENCE)

*BERKELEY HIGH SCHOOL, BERKELEY, CA

*(GENERAL EDUCATION)

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