Patient Representative Data Entry

Denise Taylor

Health Care Professional

Fort Worth, TX 76120

**********@*********.***

817-***-****

Health care professional with an B.B.A. in Business Administration and management and 20 years of medical experience. Passion to work with patients and staff assessing what is needed, effectively motivating and recommending sensible solutions.

Authorized to work in the US for any employer

Work Experience

Referral Coordinator, Orthopedic Surgical Associates Methodist Orthopedic Surgical Associates - Mansfield, TX November 2022 to Present

• Point of contact for Methodist Medical Groups as it relates to incoming calls, appointment scheduling, and follow up calls related to coordination of care. Maintains strictest confidentiality while attempting to provide first call resolution.

Screens calls, takes messages when applicable, and conveys information to appropriate parties in accordance with department workflows.

• Providing customer service while performing tasks professionally and with a positive attitude. Ability to handle multiple tasks, and able to research required information using available resources, handling and resolving customer issues, identify and escalate priority tasks per department workflows.

• Advise management of potential problems or concerns in the department. Reviews requests from internal and external clients regarding referral issues, scheduling, messaging and tasking as directed in an effort to ensure accurate information is being obtained and documented within the department guidelines. Provides assistance in problem solving and issue resolution via email, phone calls etc.

• Assist in maintaining accurate department training tools, keeping up with day to day guidelines, protocols, and reference documents including distribution of all updated resources.

• Complete Non-Urgent referrals process.

This includes but is not limited to an expert knowledge of the workflow processes required to complete Non-Urgent referrals within expected timeframe.

• Complete 3-Day Urgent referrals process.

This includes but is not limited to an expert knowledge of the workflow processes required to complete 3-Day Urgent referrals within expected timeframe.

complete STAT referrals process. This includes but is not limited to an expert knowledge of the workflow processes required to complete STAT referrals within expected timeframe. Complete Diagnostic referrals process.

This includes but is not limited to a good working knowledge of the workflow processes required to complete Diagnostic referrals within expected timeframe.

• Project management, self-manage organize, analyze and report organizational referral management statistics on a regular basis. Furthermore, leverages prepared reports to enhance referral network development strategies through routinely scheduled meeting with Methodist Medical Group clinical practices and associated medical neighborhood.

• Faxes (eFax) completed specialist referral form, lab results, patient demographics, test data and primary care notes to other physicians and patient service consultants as necessary and directed. Documents all encounters with patients and physicians within EHR system. Logs all referrals into EHR system and monitors status to ensure timely completion. Makes outbound calls as needed to complete assigned tasks related to referrals.

• Complies with all administrative workflows of the referral department. Maintains and follows all policies and procedures of organization and those specific to Methodist Medical Group.

• Communicates to management any issues or delays that may directly impact patients quality of care and customer service.

• Willingly participates in continuing education and other applicable activities to maintain professional competence.

• Works collaboratively with other members of the department to cultivate a team approach focused at achieving the highest quality of patient care and staff cooperation. Precertification Specialist/Patient Representative Medix Staffing Inc./Methodist Orthopedic Surgical Associates - Dallas, TX August 2019 to November 2022

The Center for Cancer and Blood Disorders

• Obtaining and/or updating verification/pre-certification of the patient account prior to the service being provided

• Completion of pre-certification of benefits for all patients receiving Chemotherapy or Radiation Therapy.

• Responsible for working with Revenue Management to ensure that billing requirements are being meet.

• Greet patients in a prompt, courteous, and helpful manner.

• Check-in patients verify and update demographic and insurance information to the medical record.

• Collects payments and enters the charges into the computer system.

• Register the patients into a computer system and verifies all patients’ addresses, telephone numbers, and insurance information.

• Answer telephone, screen the caller’, take messages, and conveys information to appropriate parties.

• Work in EPIC Work Ques for referral and adding external refers into Leading Reach.

Practice Administrator, Orthopedic Services

Cook Children’s Physician Network - Fort Worth, TX June 2015 to February 2019

· Coordinate and plan staffing schedules for all orthopedic locations

· Manage daily business operations of the department, including review of account detail and history; work closely with physicians to ensure charges are dropped in a timely manner

· Monitor quality and customer satisfaction

· Review efficiency and accuracy of referrals and authorizations with respect to billing requirements

· Interview and hire candidates; encourage professional growth; conduct coaching, disciplinary actions, and PACE evaluations

· Assist supervisors with department attendance records in Kronos

· Assist the director with budget requirements; monitor financial performance and attend monthly financial meetings

· Ensure that Epic work queues are worked by staff to comply with system requirements

· Collaborate with other departments to ensure best practices at all sites Manager, Patient Registration

Cook Children’s Medical Center - Fort Worth, TX

January 2010 to March 2015

· Planning and assisting with staffing all areas that report to Patient Registration

· Managing daily business operations of the department, including review of account detail and history; making decisions regarding acceptable payment arrangements according to the System Collection Policy

· Responsible for reviewing patient satisfaction survey results and ensuring strong departmental performance

· Assisting with hiring new employees; perform disciplinary actions and PACE evaluations

· Maintaining attendance records, automated time system for payroll, and departmental staffing schedules, including weekly work schedules, and on-call schedules

· Assisting with training; resource for registration personnel and other departments throughout the Medical Center

· Assist with Athena claims and holds for the Fort Worth Urgent Care Center Training Manager, Patient Registration

Cook Children’s Medical Center - Fort Worth, TX

July 2007 to January 2010

· Designing, planning, organizing, and facilitating computer and procedural programs, along with continuing education for all department staff

· Designing tests to assess employee knowledge and skills; documenting outcomes and reporting information back to the appropriate manager

· Reviewing employee work for accuracy; reporting trends and recommending additional training and education

· Designing and implementing new processes/programs to improve the image, accuracy, and productivity of the registration staff

· Assisting with staffing issues for all areas that report to Patient Registration, including taking rotating on-call responsibilities

· Assist with recruiting, hiring, and disciplinary actions with director approval, according to hospital policies for all Patient Registration positions

· Providing feedback to management regarding employee performance issues

· Responsible for observing staff in assigned areas for process and training improvements

· Maintaining a database of statistics regarding training and procedural issues Financial Counselor, Patient Registration

Cook Children’s Medical Center - Fort Worth, TX

October 2005 to July 2007

· Reviewing patient accounts to determine the patient/guarantor’s ability to fulfill their financial obligations for services rendered

· Completion of pre-certification and verification of benefits on all inpatient, observation, and outpatient accounts

· Assisting walk-in patients/guarantors who have concerns with their past/present medical bills; coordinate resolution of the patient account with Patient Accounting

· Assisting walk-in patients/guarantors with the application process for government and system financial assistance programs

· Responsible for monthly re-verification of benefits and eligibility of inpatients, observations, and outpatient accounts

· Responsible for working with Revenue Management when Single Case Agreements are required

· Working closely with Department of Human Services staff assigned to Cook Children's and the Case Managers

Patient Access Specialist, Patient Registration

Cook Children’s Medical Center - Fort Worth, TX

October 2002 to October 2005

· Performing accurate and timely registrations in Meditech for patients who presented to the Emergency Department

· Maintain consumer-driven health plans, and HSAs and provide the customer with an understanding of benefits and patient portions due

· Maintain the knowledge procedure specific out-of-network or out-of-network plans, and single case agreement requirements with appropriate documentation

· Obtaining and/or updating verification/pre-certification of the patient account before the service to the patient account to financial counselors regarding inadequate, denied, or reduced benefits Medical Assistant

Fort Worth Orthopedic Clinic - Fort Worth, TX

June 1994 to October 2002

· Outpatients collecting co-payments

· Scheduling and confirming all clinic appointments

· Scheduling all outpatient services and diagnostic testing

· Assisting physician in the back office when needed

· Contacting insurance companies to obtain pre-certifications and authorizations for surgery patients Education

B.B.A. in Business Administration

University of Phoenix - Dallas, TX

June 2014 to June 2016

Certification in Medical Assistant

ATI School of Professionals - Fort Worth, TX

June 1994 to July 1995

Skills

• Office experience

• Customer service

• Typing

• Front desk

• Computer skills

• Computer literacy

• Organizational skills

• Time management

• Medical coding

• Data entry

• Administrative experience

• Word processing

• Filing

• Medical terminology

• Multi-line phone systems

• Clerical experience

• Phone etiquette

• Case management

• Care plans

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