Data Entry Customer Service
Resume:
Loveece Moore
Warrensville Heights, Oh
************@*****.***
Authorized to work in the US for any employer
Work Experience:
Referral Specialist
AxessPointe Community Health Center - Akron, OH
August 2019 to March 2020
Coordinates all referrals to specialist practices and local regional healthcare services, Process referral requests via patients or medical providers, provide appropriate Customer Service and answer patient inquires, Maintain established tracking system of referrals both external and internal, provide information and support to medical providers regarding patient referrals, ability to use sound judgement with patient scheduling effort and utilization of resources, documents and traces interaction with clients and appointments, assisting with data entry, perform other duties as may be delegated by Chief Compliance Officer or designee, obtain current identification for managed care, prepare pre-certification as required including patient diagnosis as documented by primary care physician, Make appointments and request follow up information, Review rejected requests for procedures or visits, Maintain up to date knowledge of referral guidelines, active providers, necessary coverage information, insurance requirements necessary for pre-certification, Review and explain process for referral to patient, including but not limited to what to expect, who providers are and how to get to hospital or referral specialists office, Maintain adequate records for risk management on referrals completed of patients needing to be seen outside of API, Mail, fax or communicate appropriate records, certificates and authorizations to appropriate persons for the completion of the referral process
Admissions Coordinator
Cleveland Clinic - Beachwood, OH
December 2017 to August 2019
Attends to telephone inquiries from patients, case managers, physicians and outside agencies. Explains the Pre-admission process.
Assists in overseeing the workflow relating to Pre-Admissions and supervises the department as requested.
Receives faxed referrals and ensures that the referrals are reviewed and medically approved by a physician.
Contacts insurance carriers to confirm coverage, verify benefits and obtain authorization/pre- certification to ensure reimbursement.
Verifies Medicare/Medicaid on Passport and prints out verification. Notifies referring hospital case managers of decision and schedules admissions. Enters patient data in the HMS scheduling menu and enters details of patient's benefits and billing instructions in Global notes.
Maintains a referral database in Lotus Notes.
Prepares an Advance Notification Spreadsheet with list of scheduled admissions for the day and emails list to appropriate departments.
Keeps supervisor informed of progress/problems.
Cross-trained to interview, register and admit a patient into the facility. Provides tours for families of prospective patients. Performs other duties as requested.
Eligibility Specialist
TeamHealth - Akron, OH
November 2016 to December 2017
My responsibilities consist of, Downloading, set up and log HDX reports that have been assigned to the Eligibility Analyst for the week. Recognize potential problems including issues with not receiving HDX reports, HDX web not giving the correct or accurate information, FSC or addresses not matching the DREP or MREP master list to what is in HDX, etc. Problems identified must be brought to the attention of the Director of Reimbursement. Thorough knowledge of TeamHealth billing directives and process all claims according to these directives. The goal is to insure that the HDX reports are correctly worked in a timely manner and consistently meet and maintain the QA and production standards. Determines whether or not applicants for various programs meet the necessary qualifications. I work with government aid, especially in the health care industry, like Medicare or Medicaid. My job involves fact checking, record keeping, and advocacy on behalf of my patients. Verifying that the insurance that's in the patients records is correct, if not then a phone call to the insurance company is made to get the correct ID# .Having good communication and computer skills making sure productivity is met on a daily basis.
Financial Counselor
Cleveland Clinic - Independence, OH
August 2014 to July 2016
The responsibility for in-patient and out-patient scheduling of various single and multiple tests, treatments and/or visits as ordered by a physician. Obtains accurate information from the physician/ office/patient in order to schedule appointments appropriately. Supplies prep information in regards to ordered exams. Outpatient registration for all scheduled patients through a computerized or manual system. Obtains accurate insurance and demographic information from patients and/or family members. Use of a PC to enter information into the medical center information system. Verifies insurance / Medicaid / Medicare. Works closely with insurance verifiers and notifies Financial Counselors of self pay situations. Must follow Medicare Questionnaire per government guidelines. Revises accounts as necessary. The Impact I Have On My Job Is Meeting My Goal And Expectations, Making Sure Productivity Is met on a day to day basis
Patient Account Representative
Orchard Pharmaceutical Services - North Canton, OH December 2012 to May 2014
As a Patient Account Rep. My job consist of Inbound/Outbound calls, verifies patients demographic and billing information while scheduling appointments and obtaining referral information, answers the telephone promptly and in a courteous manner, screen calls, take messages, provides information, and follow up on patient issues in a timely manner, Determines patient needs and concerns regarding medical problems, insurance issues, and medications. Checking the status situation on medical authorization with the insurance company, basic data entry
Education:
Certificate in EKG TECHNICIAN
Medtech Institute - Bedford Heights, OH
November 2020 to January 2021
Associate's degree in Paralegal Studies
University of Akron Main Campus - Akron, OH
January 1999 to June 2004
Diploma
Hower High School - Akron, OH
1999 to 2004
Skills
• Microsoft Word
• Microsoft Powerpoint
• Hospital Experience
• Medical Scheduling
• Medical office experience
• Benefits Administration
• Medical receptionist
• Clerical experience
• Typing
• Insurance Verification
• Medical Billing
• Medical terminology
• HIPAA
• Epic
• Documentation review
• Windows
• Research
• Pharmacy technician experience
• Clinical pharmacy experience
• Heavy lifting
• EMR Systems
• Medical Records
Certifications and Licenses
Certified EKG Technician
November 2020 to Present
CPR Certification
BLS Certification
TNA
April 2022 to June 2022
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