Medical Administration/Receptionist

267-***-**** *****.*******@*****.*** Las Cruces, NM

SUMMARY

Professional and friendly receptionist with strong customer service skills and experience in front desk operations. Proficient in handling inquiries, managing schedules, and performing clerical tasks. Skilled in using office equipment and Microsoft Office Suite. Excellent communication, multitasking, and organizational abilities, with a focus on creating a welcoming environment and maintaining confidentiality.

Key Requirements:

One year of reception experience in a healthcare setting is preferred, but not required. Any equivalent combination of education and experience will be considered. Basic computer skills, including data entry, word processing, email, and record management, are necessary. Strong organizational, time management, and communication skills are essential for success in this role.

KEY ACHIEVENMENTS

Efficient Authorization Documentation: Enhanced authorization documentation process at Centene by applying a detail-oriented and stable approach, leading to timely and accurate service documentation.

High Call Volume management: Managed high call volumes at Ciox Health by leveraging excellent telephone skills and a positive attitude, ensuring compliance with HIPPA guidelines and achieving daily call goals.

Accurate Claims Processing: Improved claims processing efficiency at Principal Medical Billing LLC by utilizing meticulous and emotionally intelligent methods, ensuring timely follow-up on unpaid Claims

EXPERIENCE

Centene Oct 2024- Feb 2024

Workforce Connections Authorization Specialist 1

Aided utilization management team to document authorization requests and obtain accurate and timely documentation for services related to the members healthcare eligibility and access

Supported authorization requests for services in accordance with the prior insurance authorization list

Preformed data entry to maintain and update authorization requests into utilization management system

Assisted utilization management team with ongoing tracking and appropriate documentation on authorizations and referrals in accordance with policies and guidelines

Contributed to the authorization review process by documenting necessary medical information such as history, diagnosis, and prognosis based on the referral to the clinical reviewer for determination

Remained up to date on healthcare, authorization processes, policies and procedures

Ciox Health a Datavant Company Oct 2023-Feb 2024

Manpower Outreach Agent

Made 90 calls per day to assign medical providers to obtain medical charts on behalf of clients while following approved HIPPA guidelines

Used call scripts to encourage medical providers to send in charts via fax, mail, and e-mail

Responded to questions or concerns from provider offices

Followed-up con initial contacts

Complied with HIPPA to ensure the right to privacy for patient’s medical records

Logged all call transactions into the designated computer software

Met minimum call volume and quality requirements for the position

Adhered to daily and weekly call goals as directed

Accurate record keeping and data management

Principal Medical Billing LLC Mar 2023-Apr 2023

Medical Billing Intern

Filed insurance claims to clearing house or individual insurance companies electronically

Followed up with insurance company on unpaid or rejected claim discrepancies

Posted insurance and patient payments using medical claim billing software

Computer literacy in accessing many websites and sufficiently self-navigate through many different portals with little guidance

Complied with all HIPPA and privacy standards

Preventadent Associates, Inc. Apr 2018- Feb 2019

Receptionist

Answered incoming calls swiftly and cheerfully, leveraging firm grasp care processes and procedures to answer questions thoroughly and accurately, address concerns, and direct patients to the appropriate resource(s)

Performed a variety of clerical tasks to support dental practice operations such as scheduling appointments, verifying insurance, and processing co-pays

Greeted patients/visitors promptly and professionally to foster a safe and welcoming healthcare environment

Lansdale Dental, P.C. Oct 2016- Jan 2018

Receptionist

Scheduled and confirmed appointments daily, weighing the urgency level of patients’ dental needs against time slot availability to determine viable openings

Demonstrated skillful multitasking and organization to execute numerous tasks within strict time frames

Exercised due diligence to follow up on unpaid claims, using direct and tactful communication to elicit the necessary patient action

Message Envy Feb 2015- Jun 2017

Receptionist

Delivered consistent, top-tier service in line with the company standards, greeting visitors with a friendly attitude, promptly answering calls, building rapport, anticipating needs, and communicating relevant sales/promotions

Trained newly hired front desk agents in company processes, selling techniques, product knowledge, and service delivery, ensuring employees are equipped with the knowledge, tools, and mindset needed to perform effectively

Collaborated with leadership, colleagues, and customers to enhance the wellness experience, increasing membership sales by 2%

SKILLS

Scheduling Oral & Written Communication Organization Teamwork Customer Service

Multitasking Administrative Support HIPPA Compliant Detail Oriented Time Management

Technology Proficiency Problem-Solving Time Management Confidentiality

EDUCATION

Dona Community College, 2023

Associate in Medical Office Admin

LICENSES & CERTIFICATES

BLS Certification 2023

Microsoft Office Specialist (MOS) Word Certification Jan 2019

Erin McNally

Receptionist

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