Services Representative Patient
Resume:
Leshia Patrick
Oxon Hill, MD *****
*********@*****.***
Work Experience:
Patient Services Representative
Progressive Radiology - Bethesda, MD
Duties: Geeting patients and collecting all documents needed to check in for scheduled appointment. Scheduling appointments for all MRI exams for several locations via phone and in person. Retrieving scripts, authorizations and clinical notes needed. Providing reports to referring physicians and patients. Maintaining payment ledger for all charges and closing out shift. Scanning, faxing and uploading documents. Scrubbing the schedule daily. Collecting copays and fees for all services whether self pay or insurance. Entering and updating patient demographics and noting all patient electronic charts. Assisting the Technologist with preparing the patients for their exams.
Reimbursement Specialist
Smith & Nephew - Columbia, MD
2022 - 2023
Duties: Perform a detailed insurance benefit verification for all products including obtaining patient responsibility, researching payer coverage criteria, and any required prior authorization requirements. Maintain clear documentation of all tasks, review reports for accuracy and completeness, prepare and send insurance benefit verification results to healthcare providers, and protect PHI, all within the departments directed time allotment. Reports any payer delays/ reporting challenges and escalates complaints accordingly to Team Lead and/or Supervisor as necessary. Collaborates with Market Access and Field Reimbursement teams to further investigate reporting issues or change in payer coverage criteria. Performs related duties as assigned.
PAP Counselor
Regalo Rx/Heart to Heart – Lenexa KS
2021- 2022
Duties: Call center environment with inbound and outbound calls, placing refill orders and scheduling shipments, providing eligibility results, advising of and collecting missing information from patient applications, data entry, entering Rx information and verifying that the Rx is valid, Pre-screen to determine eligibility, providing program guidelines per application process, and verifying PA status with HCP, patient and insurance plans
Referral Support Specialist
Trinity Health at Home - Silver Spring, MD
2021 - 2021
Duties: Received, accepted and entered hospital referrals for patients requiring services for Homecare and Hospice by priority while working with Health Care Coordinators. Enter the patients demographics into the Homecare Homebase computer system by service address and requested skills. Verify Medicare insurance eligibility through Homecare Homebase system and outside resources. Verify PCP NPI and PECOS eligibility and add as needed. Confirm insurance is accepted if other than standard Medicare. Determine which referral source the patient will need based on necessity and skills with staffing capacity. Utilize medical records for diagnosis and other information. Verify PCP to follow the patient for services request. Confirm any other services if current with other agency. Attach all necessary discharge documents for review of service to prepare for scheduling with agency.
Case Manager
Caremetx - Bethesda, MD
2017 - 2020
Duties: Acts as single point of contact and voice for all providers, patients and pharmacies. Serves as a patient advocate and enhances the collaborative relationship between the payer, HCP and patient. Collects and reviews all patient insurance benefit information which is required to complete the enrollment application. Provided assistance to the physician’s office staff and patients to complete and submit all necessary insurance forms and program applications in a timely manner. Provided exceptional customer service to internal as well as external customers with requests in a timely and accurate manner. Escalated and handled all complaints accordingly. Maintained frequent phone contact with provider representatives, third party customer service representatives and pharmacy staff. Processed all correspondences received. Coordinated with inter-departmental associates as necessary. Communicates effectively with payors to ensure accurate and timely assistance which is requested. Works on problems of moderate scope where analysis of data requires a review of a variety of factors. Exercise judgment within defined standard operating procedures to determine appropriate action. Typically receives little instruction on day-to-day work, general instructions on new assignments. Knowledgeable of HIPAA regulations and HIPAA compliant at all times. Performed related duties as assigned.
Senior Reimbursement Counselor
AmerisourceBergen/Lash Group - Rockville, MD
2011 - 2017
Duties: Work with minimal supervision on multiple teams Obtain and provide insurance information to the patient and physician Manage patient accounts ensuring completion of Service Request Form Work with PSL's and HCP's to ensure all services available are provided Manage referrals sent to Specialty Pharmacies Confirm medication delivered and ensure patient is able to stay on therapy Coordinate, interact and process requests from patients, physicians, and other healthcare providers and clients Manage the process of referrals to patient assistance programs that provide financial assistance for patient's obligations Train Program Reps on the BI and Navigator process Complete welcome calls providing services offered and schedule assessment and preliminary testing appointments with physician offices and offsite facilities Ensure all options exhausted and patient and Healthcare Provider services are met
Education:
High school diploma – Burdick Vocational High School
Washington, DC
1981
Nursing
University of the District of Columbia – Washington, DC
1981 - 1982
Office Management
TESST Business Institute - Bladensburg, MD
1995 - 1996
Skills: Help desk • Multi-line • Switchboard • Data entry • Billing • Medical billing • IDX Medical billing • Microsoft office 360• Word • Word perfect • Problem solving • Team player • Training skills • Managerial • Case Management • Documentation • Medical Receptionist • Medical Office Experience • Insurance Benefit Verification • Medical and Surgical Scheduling • EMR Systems • Medical Terminology • ICD-10 • Medical Records • Analytical Skills • Anatomy Knowledge • Microsoft Excel • Patient service • Phone etiquette * Strong Oral and Written Communication * Excellent Customer Service * Dara Entry keystroke proficiency * Call Center * Medics Elite * Works well without supervision * Training Skills
References furnished upon request
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