Medical Assistant Service Representative

APRIL THRASH

Roseville, MI *****

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

+1-313-***-****

• Over fifteen (15) years of experience working in the healthcare industry

• Associate of Science completed in June 2021, Certificate in Medical Billing and Coding September 2022.

• Investigative nature and strong decision-making skills

• Experience with medical terminology, precertification processes, insurance claims and eligibility verification

• Expert computer skills in CareAdvance, Content Manager, Web DENIS, Finesse, Microsoft Office Suite, Proficient in Availity, and familiar with Oracle.

• Strong analytical and problem resolution skills

• Exceptional communication skills

Willing to relocate: Anywhere

Work Experience

Patient Service Representative/Medical Assistant

Entech Medical Staffing-Troy, MI

December 2022 to Present

· Greeting and assisting customers in obtaining needed services within the office.

· Scheduling patients for appointments.

· Receiving and responding to patients' requests for medications.

· Confirming accuracy of billing requests.

· Setting up patients' accurate information.

· Collecting payments

· Assists with necessary paperwork.

· Facilitate efficient patient flow through the office.

· Accurate and appropriate billing for services.

· Applying excellent organizational skills.

· Maintaining HIPAA law with patient records.

· Complete blood draws and take accurate vitals.

· Prepare examination rooms before Physician enters

· Health insurance appeals experience

· Crafting letters-strong written, proofreading and editing skills. Medical Receptionist

Metro Detroit Cardiovascular Associates-Detroit, MI October 2023 to February 2024

• Calling and confirming patients appointments.

• Setting up patient testing for procedures.

• Prep charts for the clinic week.

• Call patients for appointment reminders.

• Answer patients' requests for appointments.

• Schedule for procedures in the office/hospital.

• All Medical Record Requests.

• Do chart review for insurance companies for onsite chart review.

• Call in medications for patients

• Familiarity with Medicare Advantage.

• Collect patients copay

• Check patients in and out

• Talk to Drug Reps about prior authorization forms when needed Precertification Specialist

Bartech (Contract to BCBS)-Detroit, MI

December 2017 to October 2022

· Received, triaged, and processed incoming requests for inpatient admissions. Excelled in efficiency, accuracy, and attention to detail. Consistently exceeded expectations in productivity, quality, and error rates.

· Received and interpreted chart documentation to ensure the patient meets medical guidelines. Emphasis on correct and timely completion of case entry and following proper procedural guidelines.

· Received and responded to incoming calls regarding precertification requests, pending authorizations, and department procedures. Emphasis on efficient handling, professional communication, and accurate information delivery. Adept at diffusing irate callers and escalating issues as appropriate.

· Prioritized incoming authorization requests according to urgency.

· Research/Data Entry experience.

· Call Center Experience.

· Decision making with insurance appeals.

· Confirmed accuracy of CPT and ICD-10 diagnoses in the procedure order.

· Performed as directed, routine and special periodic quality monitoring of assigned sections.

· Acted as subject matter expert for team questions.

· Assisted in the precepting/training of employees on benefits, policies, and procedures in the assigned area.

· Assisted in the review and documentation of departmental procedures.

· Developed and improved workflows and business processes within defined areas to improve customer service, decrease operational costs and improve overall quality.

· Obtained authorization via payer website or by phone and follow up pending cases.

· Contacted facilities to discuss authorization status.

· Contributed as engaged member of regional senior leadership team

· Supported regional business unit leader(s) in business needs, fast turnaround data analysis, preparing for business reviews, etc.

· Managed and executed strategic projects and transformational business initiatives (including acquisition targets)

· Facilitated and manages development and implementation of corporate, business, or functional strategy

· Followed up on calls received on the Urgent Care Nurse Line.

· Prepared all reports as assigned.

· Documented and communicated project concepts, milestones, and results.

· Familiarity with CMS regulations

· Participated in systems testing, developed procedures/controls and provided recommendations for the ongoing improvement of the updated process.

Medical Receptionist

Ark Cardiovascular Institute-Detroit, MI

August 2016 to November 2017

· Submitted medical claims to insurance companies and payers within 48 hours of receipt.

· Monitored payments/ follow up with patients when payment lapses occur.

· Accurately applied payments to patient accounts.

· Processed monthly patient statements.

· Prepared patient documents for transplant.

· Insured accuracy of insurance claims/Verified ICD10 and CPT codes for a variety of specialties.

· Posted and reconciled insurance/patient payments.

· Resubmitted insurance claims, as necessary.

· Set up new patient accounts.

Medical Assistant

Employer Name (Contract to St. John Providence/Newland Medical)-Southfield, MI April 2014 to February 2016

· Processed authorizations and authorized surgical boarding.

· Recorded patient vital signs/Collected lab specimens.

· Removed PICC lines/Flushed med ports.

· Performed phlebotomy on patients with hemochromatosis.

· Gave vaccines/injections.

· Drew blood work/put in lab orders.

· Called in patient prescriptions/wound care.

· Prepped patients for Infectious Disease Clinic.

Medical Assistant

Heart & Vascular Institute-Detroit, MI

April 2009 to October 2012

· Prepared and administered medications for patients as directed by physicians.

· Ensured compliance with all health care regulations including HIPAA and OSHA.

· Delivered compassionate support, attention, assistance, to patients and families.

· Called Drug Representatives to supply the facility with necessary medications.

· Prepared treatment rooms for clinicals examinations and assisted practitioners with medical procedures and other medical care.

· Coordinated the daily administrative activities, including scheduling appointments, patient check-in and check-out, and patient record maintenance.

· Obtained and recorded patient medical histories, vitals, and test results, and other medical information while maintaining record confidentiality.

· Prepared medical charts and tests for the Physicians.

· Ordered testing procedures, scheduled catheterization procedures, and other medical testing needed by the physicians.

· Called patients regarding testing, medication, and clinical record information update.

· Called medications for patients to the Pharmacy. Education

Bachelor Degree in Nursing

Arizona College of Nursing - Southfield, MI

October 2023 to Present

Certificate in Medical Billing and Coding

Bryan University - Tempe, AZ

September 2022

Associate in Science degree

Wayne County Community College District - Detroit, MI November 2017 to June 2021

Diploma in Medical

Everest Institute - Detroit, MI

May 2008

Skills

• Medical Receptionist

• Documentation Review

• Content Management

• Experience Administering Injections

• Medical Scheduling

• Laboratory Experience

• Medical Records

• CPT Coding

• EMR Systems

• ICD-10

• Insurance Verification

• HIPAA

• Medical Terminology

• Venipuncture

• Epic

• Proofreading

• Medical Coding

• Medical Billing

• Web Services

• Medical Office Experience

• Triage

• Analysis Skills

• Microsoft SharePoint

• Clinic

• Communication skills

• Organizational skills

• Customer service

• Intake

• Administrative experience

• Vital signs

• Microsoft Office

• Office experience

• Leadership

• Typing

• Front desk

• Clerical experience

• Guest services

• Windows

• Hospital experience

• Computer skills

• Patient monitoring

• ICD-9

• Kronos

• SharePoint

• Cash register

• Schedule management

• Research

• Quality control

• Content management systems

• Nursing

• Workday

• Java

• Oracle

• Analytics

• Teaching

• Clinical research

• System testing

• Restaurant experience

• Bookkeeping

• Negotiation

• Order entry

• Records management

• Oracle HCM

• Driving

• Databases

• Hospitality

• Data collection

• Phlebotomy

• Medical administrative support

• Multi-line phone systems

• Microsoft Excel

Certifications and Licenses

Medical Billing Certification

CPR Certification

Medical Billing Certification

BLS Certification

Certified Medical Assistant

I am a Medical Assistant received my diploma in 2009. Driver's License

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