RESUME OF PETER AYCART

aduo51@r.postjobfree.com

Cell# 623-***-**** HM:623-***-****

Professional Summary:, Seasoned Healthcare Scheduler with successful experience in knowledge of Medical billing, Medical Terminology and CPT, HCPCS, and ICD-9 coding, Medical claims processing,Authorizations for medical billing, Assist in Special Projects and coordinating with Medical staff, and providers, multi-tasking and detail oriented, analytical, Data Entry, and Administrative Assistant

Education: High School Diploma obtained Associates

Professional Experience:

September 2020 to Current

Banner Health Dermatology /Banner Staffing Agency

Patient Financial Representative/ Referral Specialist/ Biller/scheduler

Schedules medical appointments through coordination of patients, providers, facility resources, ancillary staff, records, referrals, authorizations and payers. Receives and initiates calls to/from patients, providers, provider offices and facilities, while following all established scheduling procedures and protocols to ensure patients receive the care they need, when and where they need it.

Effectively schedules appointments, tests and/or procedures leveraging various electronic medical records / scheduling software systems according to protocols established by clinical staff and scheduling standards. Identifies alternative schedule solutions in the event patient’s preference is not available, while adhering to procedures and protocols and ensuring patient safety.

. Obtains patient demographics, insurance information and necessary documents required to secure authorizations, referrals, or other data as determined by various facilities and insurance carriers. Responsible for obtaining and properly documenting all necessary and accurate data during the intake/registration process. Acquires and documents pertinent patient medical information in accordance with procedural guidelines.

Provides patients with information, pre and post-test instruction, provides location of appointment and directions. This position answers questions as necessary within guidelines and protocols. Refers questions to medical offices as appropriate. Ensures patient has “no surprises” at point of service by setting payment expectations, as well as, providing estimated payment detail where applicable.

Effectively communicates and builds impactful relationships through written, digital and verbal channels with patients, facilities, providers and other clinical colleagues to ensure an easy, empathetic, solution-orientated patient experience, included but not limited to phone, chat, email, electronic medical record messaging and other digital channels. Anticipates patient and provider needs and responds accordingly.

Solicits, labels, stores and manages scanned documents and orders received from physician offices in the document imaging software system. Ensures that all appropriate documents are received prior to appointments and ensures that orders are compliant with each facility’s policy.

Where applicable, collects pre-payments and verifies insurance coverage to ensure “no surprises” and enable patient ease.

Services inbound and outbound customer and staff communications for all facilities in the states in which they operate. Works with various departments and staff to provide accurate managed care information.

Performs all functions according to established policies, procedures, regulatory and accreditation requirements, as well as applicable professional standards. Provides all customers of Banner Health with an excellent service experience by consistently demonstrating our core and leader behaviors each and every day.

April 2020 to September 2020

Banner Health & Surgery Center

Banner Staffing Agency

Patient Financial Representative/ Referral Specialist/ Biller/Scheduler

This position coordinates a smooth patient flow process by answering phones, scheduling Surgery Consult Appointments, providing registration of patient and insurance information, obtaining required signatures following established processes, procedures and standards. This position also verifies insurance coverage, validates referrals and authorizations, collects patient liability and provides financial guidance to patients to maximize medical services reimbursement efforts. This also includes accurately posting patients at the point of service and releasing information in accordance with organizational and compliance policies and guidelines.

Performs registration/check-in processes, including but not limited to performing data entry activities, providing patients with appropriate information and intake forms, obtaining necessary signatures and generating population health summary.

Verifies insurance eligibility benefits for services rendered with the payers and documents appropriately. Assists in obtaining or validating pre-certification, referrals, and authorizations

Calculates and collects patient liability according to verification of insurance benefits and expected reimbursement. Explains and provides financial policies and available resources for alternative payment arrangements to patients and their families.

Enters payments/charges for services rendered and performs daily payment/charge reconciliation in a timely and accurate manner. Balances the cash drawer at the beginning and end of the day and prepares daily bank deposits with necessary paperwork sent to centralize billing for record purposes.

Schedules office visits and procedures within the medical practice(s) and external practices as necessary. Maximizes reimbursement by scheduling patients in accordance with payer plan provisions. Confirms patient appointments for the following day as necessary and ensures patients are properly prepared for visits.

Demonstrates proactive interpersonal communications skills while dealing with patient concerns through telephone calls, emails and in-person conversations. Optimizes patient flow by using effective customer service/communication skills by communicating to internal and external customers, care team, management, centralized services and HIMS.

Assists in responding to requests for patient medical records according to company policies and procedures, and state and federal laws.

Provides a variety of patient services to assist in patient flow including but not limited to escorting patients, taking vitals and patient history, assisting in patient treatment, distributing mail and fax information, ordering supplies, etc.

Independently under regular supervision and follows structured work routines. Works in a fast paced, multi-task environment with high volume and immediacy needs requiring independent decision making and sound judgment to prioritize work and ensure appropriateness and timeliness of each patient's care. This position requires the ability to retain large amounts of changing payer information/knowledge crucial to attaining reimbursement for the services provided Primary external customers include patients and their families, physician office staff and third party payers.

May 2019 to April 2020

Banner MD Anderson Cancer

Center

Banner Staffing Agency

Patient Financial Services Representative/Referral Specialist/Biller/Scheduler

Performs pre-registration/registration processes, verifies eligibility and obtains authorizations, submits notifications and verifies authorizations for services. Verifies patients' demographics and accurately inputs this information into the A/D/T system, including documenting the account thoroughly in order to maximize reimbursement and minimize denials/penalties from the payer(s). Obtains federally/state required information and all consents and documentation required by the patient's insurance plan(s). Must be able to consistently meet monthly individual accuracy goals as determined by management.

Verifies and understands insurance benefits, Collects patient responsibility based on estimates at the time of service or during the pre-registration process. As assigned collection attempts may be made at the bedside. Must be able to consistently meet monthly individual collection targets as determined by management.

May provide financial counseling to patients and their families. Explains company financial policies and provides information as to available resources. Assists patients with applying for Medicaid. Assists patients with completing all financial assistance programs (i.e.: basic financial assistance enhanced financial assistance, prompt pay discount, loan program).

Acts as a liaison between the patient, the billing department, vendors, physician offices and the payer to enhance account receivables performance and meet payment collection goals, resolve outstanding issues and/or patient concerns and maximize service excellence.

Communicates with physicians, clinical and hospital staff, nursing and Health Information Management Services to resolve outstanding issues and/or patient concerns. Work to meet the patients’ needs in financial services.

Consistently meets monthly individual productivity goals as determined by management. Completes daily assignments/work lists, keeps electronic productivity log up to date and inputs information accurately. Identifies opportunities to improve process and practices good teamwork.

Provides a variety of patient services and financial services tasks. May be assigned functions such as transporting patients, may perceive new hire employees, recapping daily deposits, posting daily deposits or conducting other work assignments of the Patient Financial Services team.

Sun Radiology/ Part time

February 2018 to April 2019

Billing Representative

Collects and verifies all necessary Information on Doctors referring orders. Complete patient insurance authorizations for all Insurances including AHCCCS. Researching and processing Eligibility, and CPT and ICD CODES for fee schedules on patient billing and exams performed CT exams, MRI exams, PET exams, X-rays exams, Ultrasound exams, Mammograms and Dexa exams. Maintains database for patient information or any communication with referring practices. Crossed trained in medical records and front end responsibilities and makes first attempt to obtain orders, labs, clinical history, and physical notes before exam. Furthermore, processing end of day reports on Excel and posting monies on Centricity and reconciling and balancing accounts for the company.

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Blue Cross/Blue Shield

July 2017 to February 2018

Provider Network File Technician

Review and researched provider files, ensures adjudication of assigned Provider claims in an accurate and timely manner to include the completion of adjustments and the coordination of benefits.

Verify adjudicate claim payments independently and in accordance with plan guidelines.

Claim payments must be directed and approved by the Claims Manager prior to

Adjudication.

Provide timely and accurate information to plan members and providers regarding claims, benefits. Must have thorough Knowledge of CPT, HCPCS, and ICD-9 coding and how they apply to claims adjudication.

Cigna Healthcare

July 2015 to July 2017

Data Entry Associate

• Maintain eligibility data for Medicare and Commercial Customers also Secondary

Insurance. Ensure the accuracy and appropriateness of both input and output data for claims and eligibility processing. Responsible for auditing membership eligibility and correspondence processes. Works Part D Medicare Secondary Payer and coordination of benefits records. Responsible for validating special needs plans and diabetes plans for the verification process.

September 2014 to July 2015

Cigna Home Delivery

Pharmacy Service Associate

Responsible for providing a high level of customer service to customers, providers and prescribers, quality, and accuracy typing new prescription orders and refills and renewals information into our dispensing system, assist pharmacists in interpreting prescription medication, quantity and instructions according to the provider's written instruction, and route the established orders as dictated by departmental policies and procedures accurately .

June 1995 to September 2014

Case Management Officer

Legal support in Collection of child support payments on delinquent accounts and

Negotiated Repayment plans by contacting customers by inbound and outbound telephone calls. Review legal child support orders and Resolve complex collection issues and inquiries while making decisions on personal and written payment agreements of partial payments or payoffs. Assisted in compiling reports and other special projects. Performs Skip Tracing investigations thru Credit Bureau, Motor Vehicle Department, Maricopa County Sheriffs, and Asset Seizures on bank Accounts or other Enforcement remedies. Conducted and maintained collection histories.

EDUCATION Phoenix College, Associates General Studies 70 credits, 2008-2012 Phoenix, AZ Alhambra High, Diploma Phoenix, AZ 1990 Emergency Medical Technician and Medical Terminology

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