Service Representative Authorization Specialist

MARCELINE WILLIAMS

845-***-**** PORT JERVIS, NY *2771

SUMMARY

Dependable Customer Service Representative, Medical Record/Billing Clerk, with excellent communication skills, ability to multitask, and over five years of experience working in the healthcare industry.

EDUCATION

Health Information Systems/Associate Degree Expected 12/2023 University of Cincinnati, Cincinnati, OH

Medical Terminology for the health professions

Healthcare Reimbursement

Health Insurance Billing

Revenue Cycle Management

Advanced Coding Applications with 80 hours of Capstone Coding

ICD-10-CM, CPT, PCS, HCPCS II

Dental Hygiene - Associate Degree 05/2019

Orange County Community College, Middletown, NY

Registered Dental Hygienist State of New York

Local Anesthesia and Nitrous Oxide New York State Dental Hygiene Association 07/2018

Associates in Applied Sciences 05/2019

Orange County Community College, Middletown, NY

Liberal Arts 06/1996

Hunter College, New York, NY

CERTIFICATIONS

Reimbursement Coding and Billing Certificate

CPR Certified and BLS for Healthcare Providers American Heart Association

Certified Translator: Haitian Creole and French

Certified NY State Medication Technician

EXPERIENCE

Authorization Specialist • Bon Secours Community Hospital 08/28/22- Present

•Contact insurance carriers to verify patient’s insurance eligibility, benefits, and requirements

•Request, track and obtain pre-authorization from insurance carriers within time allotted for medical and services

•Request follow up and secure prior authorizations prior to services being performed

•Demonstrate and apply knowledge of medical terminology, high proficiency of general medical office procedures including HIPPA regulations

•Communicate any insurance changes or trends among team

•Maintains a level of productivity suitable for the department

•Clearly document all communications and contacts with providers and personnel in standardized documentation requirements, including proper format

Guest Services Representative • Bon Secours Community Hospital 05/23/22- Present

•Answer incoming calls, transfer calls to the appropriate person or department

•As necessary assist in placing outgoing calls.

•Handle special and priority calls such as medical emergency, code alerts and a variety of emergency and time sensitive calls from the public, patients, and medical personnel

•Follow prescribed procedures and using page/alerts systems

•Notifies appropriate personnel in cases of medical emergencies, cardiac arrest, drills disasters, or other contingencies

•Maintain trouble log and assist in the training and orientation of console operators

Patient Services Representative • Crystal Run Healthcare 06/2009 – 02/2010

Greeted, registered, and checked in patients upon arrival in a courteous and respectful manner.

Verified insurance, patient eligibility at time of visit.

Assisted members of the care team by processing all forms, business, messages, and referrals.

Scheduled appointments with 95% accuracy.

Clerical Associate • Kings County Hospital Center 07/2003 – 09/2007

Registered patients into the Unity and Softdent system.

Collected cash payments from self-pay patients and performed necessary fee scale for self-pay patients.

Obtained authorization/referral from HMOs.

Ensured accurate data capture such as insurance, demographic, and financial.

Made daily appointments into the Softdent database for various dental procedures.

Performed other supportive functions to facilitate a productive and efficient work environment for the ambulatory Patient Accounts Department.

VOLUNTEER EXPERIENCE

Patient screening procedures, such as assessment of oral health conditions.

Review of the health history, oral cancer screening, head and neck inspection, dental charting and blood pressure and pulse check.

Taking and developing dental radiographs (x-rays).

Teaching patients’ appropriate oral hygiene strategies to maintain oral health; (e.g., tooth brushing, flossing and nutritional counseling).

Making impressions of patients' teeth for study casts (models of teeth used by dentist to evaluate patient treatment needs).

OTHER PROFESSIONAL EXPERIENCE

Census Field Supervisor • 20/20 Census Bureau, NY 1/2020 – 11/2020

Used automated devices (e.g., tablets, smartphones, or laptop computers) to conduct job activities.

Supervised Enumerators, including reviewing their work.

Facilitated group training sessions using Census Bureau training guides and materials.

Conducted personal observations of Enumerators as they worked in the field and conducted on-the-job training.

Provided instructions to Enumerators for improving production and performance to meet deadlines and quality standards.

Approved and processed employee payroll.

Assisted in the recruiting of census workers.

Applied Equal Employment Opportunity principles in hiring practices, training and employee development.

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