A Full-Time Financial Counselor

Tomeka L. Moore

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

Lansdowne, PA 19050

Cell: 215-***-****

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

Objective: To obtain a full-time position with a healthcare organization that will utilize my experience, skills and knowledge.

Experience

Albert Einstein Medical Center Philadelphia, PA

Financial Counselor August 2019-Current

Verify patient demographic in HIS and input all necessary correction

Verify health insurance coverage, including all supplemental coverage, for all inpatient, SPU & observation accounts using payer websites when possible according to established procedures and timeframes

Utilize knowledge of insurance carrier requirements to ensure patient eligibility and adequacy of benefits

Obtain precert or initial authorization for accounts according to established procedures

Attempt to secure all scheduled accounts one business day prior to admission or day of service.

Refer patients to outside contractors for Medicaid eligibility screening upon discovery of a non-covered patient

Communicate financial responsibility, including current and prior balances to patient in a positive and professional manner.

Hahnemann University Hospital Philadelphia, PA

Financial Counselor 11/12 –July 2019

Insurance Verification and Authorization validation for all facility Outpatient Procedures and Day Surgeries via electronic resources and telephone.

Partnered with Department Leadership and Physicians to assist in process changes and workflow efficiencies.

Advocate for patients on the behalf of the facility to ensure external offices meet insurance requirements to perform procedures timely.

Counseled patients prior to procedure on their financial responsibilities, obligations and available resources.

Partnered with Leadership to conduct quality assurance review of claims, denials and appeals.

Debt recovery and Collections

Partnered with leadership to address patients with financial complaints and billing errors.

Hahnemann University Hospital Philadelphia, PA

Patient Access Rep II 9/05 -11/12

Efficiently registered patients for Short-procedures, Radiology, Outpatient clinics and Emergency visits.

Insurance verification, Performed Compliance Checker, Validated Authorizations, Processed referrals and processed Pre-Certifications.

Partnered with Leadership on projects to implement more efficient registrations and reduce work flow errors.

Point of Service collections

Independence Blue Cross Philadelphia, PA

Billing and Collection Specialist I 11/00 -02/03

Partnered with Leadership to create efficient operation procedures and processes.

Performed Quality and Assurance of accounts by tracking and trending errors to resolve customer concerns and increase satisfaction.

Research and Analyzed outstanding balances, bad debt and adjustments for collection purposes

Independence Blue Cross Philadelphia, PA

Member Service/Benefit Rep 12/98 -05/95

Process daily claims and enrollment benefits for members.

Provided excellent customer service by researching and explaining claims, policies and adjustments.

Processed Outpatient, Facility and Professional Claims.

Education

John Bartram High School Philadelphia, PA

Diploma

Skills

CPR and First Aid Certified, Typing 65 wpm; Microsoft Office: Word, Power Point, Outlook and Excel, knowledge and understanding of Pre-Hospital Emergency Medical Services, knowledge and understanding of multiple software systems: Cerner, First net, Power Chart, All Scripts, EMR, Jeff Chart, Patient Access, P-BAR, Envision, HMS, Kronos, Taleo, Patient Access Intelligence, Medi-Soft, Med-Host, Pro-Med, AHIQA, Rev Springs, Navinet, Passport Onesource and Compass, Knowledge of Third Party Billing, Compliance Checker, medical office procedures, guidelines, ICD-10/CPT Coding, HIPPA, JCAHO,OSHA, HIM and CMS compliance guidelines and Medical Terminology.

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