JOYCE ANN MCCLAIN

**** **** ***** *****

Raleigh, N.C. 27604

919-***-**** adxoqs@r.postjobfree.com

Highly accomplished Health Care Associate in various health care departments. I am recently retired having 20 years of diverse experience in the hospital setting 20 years and 22 years in medical insurance setting with on the job training. I am looking for an opportunity for a part-time position to utilize my skills and knowledge in a renowned organization.

SKILLS

Customer Service

Accurate Typing

Multi-tasking

Communication and Telephonic

Use of Office Equipment

Teamwork

Medical Terminology

Medical Coding Training

Insurance Terminology

Healthcare and Hospital Environment

Notary

Maintain patient confidentiality

EXPERIENCE

1978 – 1980

UNIT SECRETARY MAXIMUM CARE UNIT, WAKE MEDICAL CENTER

Transcribe Physicians orders on Patients chart.

Admit Patients onto heart monitors.

Initiate orders for: X-ray, labs, consults, transfer to floor procedures

Make charts for each admission to unit.

1980 – 1998

WAKE MEDICAL CENTER/OUTPATIENT REGISTRATION, WAKE MEDICAL CENTER Receptionist for Specialty Clinics:

Manage all incoming calls, transfer calls, scheduling, rescheduled, cancellation of appointments, taking and relaying messages.

Managed all appointments books and patient logs for all Specialty Clinics.

Assist with secretarial duties for Specialty Clinics. Outpatient Clinic Patient Registration:

Register incoming patients into computer system gathering demographic, insurance information, emergency information.

Direct patients to waiting room depending on which clinic their appointment is in Outpatient Clinic Patient interviewer:

Conduct Interviews for new patients via phone or in person

Register new patients to the Outpatient Clinic.

Gather demographic, insurance, emergency information. Cashier/ Outpatient Clinic:

Handle collections of co pay partial or full payment of bill. ER Registration Clerk:

Patient intake (demographic, insurance, emergency contact) onto computer 2

Ambulance Arrival Patients:

Retrieve demographics from paramedics or go to patients’ room in ER and retrieve information.

Patient Financial Counselor:

Liaison between patients and insurance companies

Obtain authorization from insurances companies.

Assist with payment options for Patients medical bills.

Initiate and complete financial assistance applications for hospital bill assistance

Maintain daily logs and monthly report.

Conduct prenatal class weekly.

Maintain daily contact with insurance companies, dept of social services and other outside organization.

1998 – 2020 (RETIRED)

CIGNA HEALTHCARE SPECIALIST (VARIOUS ROLES), CIGNA HEALTHCARE Call Center /Provider Service Representative Specialist:

Provide support to Hospitals, Doctor offices, Rehabs other related Medical Providers.

Assist with Patient inquiries for specific surgery, EOB, claims, participating providers, verify patient enrollment.

Healthcare Service Specialist Prior Authorization Department

Assist Providers calling for prior authorization and loaded cases for Specialist Referral, Outpatient / Inpatient Surgery, Inpatient Admissions, Physical & Occupational Therapy, Hospital Transfer, Skilled Nursing

Assist Providers with coding :Medical Procedure (CPT), Diagnosis(ICD-09),HCPCS. for Outpatient, Inpatient and Surgery Cases.

Assist in precertification by assisting provider with surgery/ diagnosis codes (CPT. ICD-9) Pilot for Special Protect Team/Core Re-Design Specialist/Inpatient Admissions:

Provide support to 2 nurses who covered specific hospitals.

Load all inpatient calls for those specific hospitals.

Provide support to patients.

Manage the Inpatient Admission case after initial review from IPCM thru discharge home. Care Associate

Provide support to 4 Inpatient Case manager nurses for the state of New York.

Coordinate with medical records, hospital case managers and utilization case managers, and admissions

Manage the Inpatient Admission Census and Discharge Report from hospitals

Manage specific diagnosis and surgery case form date of admit through discharge.

Responsible for bed-days update,

EDUCATION

1976

HIGH SCHOOL DIPLOMA, BROUGHTON ADULT NIGHT SCHOOL

1976

SECRETARY COURSE, WAKE TECH

1978

MEDICAL TERMINOLOGY, WAKE TECH

1978

UNIT SECRETARY CLASS, WAKE MEDICAL CENTER

1990

FINANCIAL COUNSELOR CLASS, DUKE

2008

MEDICAL CODING I (CPT / ICD-09), WAKE TECH

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