Insurance Specialist Data Entry

Amber Kelley

Richmond, VA 804-***-**** *************@*****.***

PROFESSIONAL SUMMARY

A highly motivated and dedicated Medical & Office Administrative professional with 10+ years of experience spanning healthcare administration, business operations, and patient/customer service. Proven ability to operate in various levels of healthcare administration, operational planning, program management, and process improvement initiatives. An effective communicator who builds relationships with team members to work towards common project objectives within strict deadlines.

SKILLS & COMPETENCIES

●Medical Terminology

●ICD-10 & CPT Coding

●Office Administration

●Records Management

●Process Improvement

●Data Collection & Analysis

●Windows XP/Vista

●Microsoft Office Suite

●QuickBooks Accounting

Technical: Microsoft Office Suite (Word, Excel, Access, Outlook, PowerPoint), ADP (Pay Expert, EZ Labor Manager, HR Expert), Cerner, Futura, OPS, Athena, Windows XP/Vista, QuickBooks Accounting, Epic, IDX, Cerner

WORK EXPERIENCE

Prestige Staffing (Piedmont Healthcare)

Patient Connections III 09/2022-Present

Schedule appointments for Radiology such as MRI, Ultrasounds, PET Scans, Echocardiograms and etc.

Transcribe Radiology orders from providers and patients.

Create insurance estimates and collect copay for Radiology orders that has been transcribed in epic.

VCU Health Systems 01/2018 – 09/2022

Schegistrar

Responsible for verifying patient’s insurance for upcoming appointments

Conduct audit on accounts that have been denied by insurance companies to identify root cause for resolution

Schedule appointments for Radiology and Oncology, managing multiple calendars of personnel

Meet all customer call guidelines including service levels, handle time, and productivity

Adhere to all confidentiality requirements at all times, to provide a confidential workplace for patient information

Staffmark Staffing Services - UPS 09/2017 - 12/2017

Customer Service Representative (Temporary Assignment)

Tracked packages for smallpak and supported office administration during a temporary contract assignment

Created ECM cases for the local customer’s centers

Modeled a customer first attitude to provide optimal levels of service to meet their needs and requests

County Of Franklin Area of Aging 07/2017 - 08/2017

Fiscal Assistant (Temporary Assignment)

Prepared and checked payroll for court employees to ensure accurate entries of time worked vs pay allocations

Processed requisitions and service orders

Maintained an inventory and record of maintenance and operation funds

Checked for fraudulent or improper endorsement or other discrepancies to quickly resolved potential risks

Issued deposit permits for money to be deposited

Computed public assistance grants from written instructions

UNI Urgent Care 01/2017 - 07/2017

Medical Receptionist

Responsible for welcoming patients and checking in patients for appointments

Performed responsibilities of registering patients by following protocols of the organization

Checked and verified accuracy of medical records and insurance information of patients

Handled incoming calls and responded to queries in a warm and professional manner to provide world class service

Collected payments from patients by following insurance guidelines, and maintained accurate medical coding

Family Healthcare 06/2016 - 02/2017

Medical Receptionist/Medical Records Clerk (Temp Assignment)

Welcomed patients and visitors by greeting them in person or on the telephone to answer or refer inquiries

Optimized patients' satisfaction, provider time, and treatment room utilization by scheduling appointments

Kept patient appointments on schedule by notifying provider of patient's arrival, reviewing service delivery compared to schedule, and reminding provider of service delays

Comforted patients by anticipating patients' anxieties, answering patients' questions, and maintaining the reception area

Maintained business office inventory and equipment by checking stock to determine inventory level, anticipating needed supplies, placing and expediting orders for supplies, and scheduling equipment service and repairs

Protected patients' rights by maintaining confidentiality of personal and financial information

Retrieved all medical records from clinic nursing stations for filing and assembled medical charts

Maintained confidentiality of all client information in accordance with HIPPA guidelines

Appropriately filed medical, imaging, and lab sheets in medical records

Facilitated copy of records for transfers in accordance with HIPAA guidelines

MMI 05/2016 - 06/2016

Insurance Authorization (Temporary Assignment)

Verified patient's insurance benefits for physical and occupational therapy

Submitted authorization requests for physical and occupational therapy

Conducted peer-to-peer reviews with commercial insurance

Nascott Orthotics and Prosthetics/Hanger Clinic 03/2012 - 04/2016

Office Administrator / Reimbursement Specialist

Reviewed and resolved delinquent accounts on assigned A/R maintaining the minimum standard of collector productivity

Recorded accurate and detailed notes in accounts pertaining to payment status, denials, and action taken

Compiled all necessary documentation to file claims and effective appeals to insurance companies

Conducted outbound calls daily to insurance companies using adequate negotiation and analytical skills

Kept up on current industry trends and compliance issues including the Fair Debt Collection Practices Act

Reviewed and processes denials and correspondence within 72 hours of receipt

Answered phone calls and directed calls to appropriate personnel, while maintaining professional communication skills

Provided the highest level of customer service is provided to patients, fellow employees, and referral sources

Obtained accurate insurance information, verification, and pre-authorization

Processed all billing daily, ensuring that claims are accurate, timely, and fully documented

Followed up on all open accounts, maintaining thorough chronological financial records on each patient account

Provided counseling to patients advising them of their financial responsibility and obtained credit agreements for outstanding balances

Applied payments and adjustments to patient accounts, processed deposits, and maintained accurate records of all cash received and in accordance with Company policy

Maintained accurate and complete patient files, ensuring that they are in compliance with Hanger Compliance Policies

Ensured the privacy and security of protected health information per HIPAA requirements

Assisted with quality assurance to ensure patient satisfaction with PCC services as necessary

Complied with the system of internal controls to ensure proper handling of cash receipts, including billing system data entry and bank deposits

Infinite Technologies Orthotics and Prosthetics 11/2010 - 03/2012

Medical Receptionist/Insurance Specialist

Responsible for receiving premium payments and preparing for deposit

Documented all communication with insurance carriers, as well as prospective and present customers

Welcomed patients by greeting them in person or on the telephone to answer or refer inquiries

Maintained security by following procedures and abiding by HIPAA laws

Acted as liaison between practitioners and patients to provide a smooth and efficient patient experience

Maintained safe and clean reception and exam rooms area by complying with procedures, rules, and regulations

Ensured continuity among work teams by documenting and communicating actions, irregularities, and continuing needs

Recorded demographic and insurance information into database

Prepared and maintained all patient files including copying ID, scripts, referrals, and ensuring all forms are signed

Coordinated the faxing of hospital orders and face sheets prior to sending required information to physicians

Assisted with validating insurance coverage and followed up in regard to current and past due claims

Maintained “stock and bill” billing for offsite facilities

Scheduled and confirmed patient appointments

In-depth knowledge of the insurance basic policies, procedures, strategies, and of federal, state, and local laws

EDUCATION & TRAINING

Bryant and Stratton College: Medical Billing & Coding, 01/2022 - Present

Bladensburg High School: High School Diploma, Graduated: 06/2002

Contact this candidate